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The views and opinions expressed in our blog series are those of the authors and are not necessarily supported by CareSearch, Flinders University and/or the Australian Government Department of Health.
It is uncertain how each of us will die and how we will experience the declining capacity to manage everyday activities as we approach death. Dr Deidre Morgan from Flinders University discusses her recent study evaluating the trajectories of functional decline of Australian patients receiving specialist palliative care and how the findings can provide guidance about resource allocation.
Occupational therapy is a health profession which enables people to participate in everyday life activities to the best of their ability despite their condition, illness progression, activity limitations or participation restrictions. In palliative care this premise does not change, as occupational therapists are skilled in enabling people to adapt to their changing ability levels, and helping people to continue living until they die, just as Dame Cicely Sanders famously quoted. However, the role that occupational therapists play is often misunderstood and under-utilised, resulting in the role being limited to discharge planning, home assessments, and equipment prescription. While these are important parts of the occupational therapy role, palliative care occupational therapists can offer so much more to their clients to enable them to keep living and remained engaged in everyday activities for as long as possible. To do this, occupational therapists follow a process which helps them to assess, intervene and evaluate their treatment plans.
When someone has an incurable disease like advanced cancer or motor neurone disease, they experience many changes, one of which is functional decline. Although functional decline is inevitable at the end-of-life, the drive for people to remain as independent as possible is actually heightened at this time. The occupational therapist (OT) has two key roles to play here. Firstly, they play an active role in optimising a person’s independence and participation as function declines. Secondly, by supporting active participation in everyday activities to the best of a person’s ability, the OT can support people to come to terms with bodily deterioration and pending death. I’ll look at these two concepts in more detail.