[UPDATE COMING: Capstone has since been completed. Content will be uploaded as available.]
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As I enter my third year, my doctoral capstone experience and project are beginning to come into focus. My foremost interest continues to be occupational therapy’s role and potential in palliative care. At the heart of palliative care is quality of life, reduced suffering and impact on daily function, and client- and family-centered care (National Consensus Project for Quality Palliative Care, 2018). And in these respects, and more, occupational therapy is primed to help.
To better explore occupational therapy’s role in palliative care, I conducted a literature review that sought to address the following scholarly question: how can occupational therapy be incorporated into palliative care to support the quality of life of palliative care clients and their families? The literature indicates that occupational therapy continues to have an ambiguous and poorly utilized role in palliative care in the U.S. Occupational therapy is often understood to be rehabilitation-minded, which is to say that the health and well-being of our clients is expected to improve. In palliative care, rehabilitation may not be possible; health deterioration is expected for those living with serious illness. Life may even be at risk for death as a client’s disease progresses. This shift in practice focus can lead therapists to experience a crisis in professional identity and sense in futility (Bye, 1998; Hammill et al., 2014). Indeed, when the crux of a therapist’s profession feels misaligned with their area of practice, it can be difficult to envision how the therapist’s specialized skill set can be utilized and where they may be most efficacious. Why, then, is it so important for occupational therapists to be present in this practice setting?
Occupational therapists are specialists in helping people participate in the everyday activities that “occupy time and bring meaning and purpose to life [and] include things people need to, want to and are expected to do” (World Federation of Occupational Therapists, 2022). People in all life stages have a desire to participate in these meaningful occupations, including life’s final stages. Functional loss secondary to life-threatening illness can present a threat to one’s sense of self-worth, disrupt routines, and result in a loss of roles (Costa & Othero, 2012; Keesing & Rosenwax, 2011; Lyons et al., 2002; Park Lala & Kinsella, 2011). Engagement in occupation can help counteract this sense of loss and support clients in dying a “good death.” That is, living well while dying. Life-threatening illnesses may deprive a client of their right to occupation, but occupational therapy can give it back.
I endeavor to use my doctoral capstone experience and project to advocate for occupational therapy’s presence in palliative care. This could include writing a manuscript for publication, or partnering with national palliative care organizations to increase occupational therapy’s visibility. I also envision partnering with hospice or home health agencies to promote a continuum of care and support clients living with serious illness through a palliative lens. This could take such forms as a grant-funded palliative position or providing palliative-specific client/caregiver education.
See ‘References’ (PDF) for resource details.