When the small things become extraordinarily important

This post was originally from CareSearch.

Although functional decline is inevitable at the end-of-life, or when someone has an incurable disease or motor-neuron disease, the drive for these people to stay independent increases instead. The occupational theraphist (OT) then has to key roles to play – optimise a person’s independence and participation as function declines and support active participation in everyday activities.

OTs work to optimise and support people with advanced diseases to stay in their preferred place of care and assessing their capacities to manage at home. Effective management of symptoms, such as breathlessness, pain and fatigue, also allows people to remain at home for as long as possible and participate in values activities. Although the OT’s intentions to optimise function may be supportive, interventions are often a stark reminder to a person that they are dying.

However, as the diseases progress, partial independence with simple self-care activities can be tough and sometimes, clinicians and carers want to take over to help and minimise distress. Therefore, the OT needs to continually check in to clarify when a person wants assistance with a task, as trying and not managing is an important part of adjusting to functional decline.

Testing out these functional limits is incredibly challenging and requires constant readjustment and is hard work, physically and emotionally. However, to deny a person this opportunity is to remove space and time to process what is happening, which is work of simultaneously living and dying. The role of the occupational therapist in palliative care is to work with each person to envision what is possible in the future that remains, then practically enable participation in this time limited but invaluable future, and together hold what this brings forwards.

Read the full article here.

 

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