Palliative Care vs Hospice: “Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness” (Vorvick, 2020).

 

The unique skillset of occupational therapists allows for the emphasis of valuing the individual who has specific feelings, abilities, and hopes. It is the role of the occupational therapist to improve quality of life through client-centered, purposeful occupation even in this setting (Pizzi, 1984).

 

Occupational therapy evaluation in hospice/palliative care begins with time spent listening to the patient’s story, observing their current abilities, and learning about what is most important to them physically, socially, emotionally, and spiritually (Pathways, 2020).

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Occupational Therapy Interventions in Hospice (AOTA, 2015):

• Use of adaptive equipment

• Activity modification

• Energy conservation

• Body mechanics

• Fall prevention strategies

• Optimal positioning

• Mobility devices

• Assessment of environment

• Relaxation techniques

• Coping strategies  

• Facilitating cognitive function

• Practical preparations for end of life

 

Throughout the implementation of interventions, goals need to be reassessed and modified based on the changing needs of the client due to disease progression. As this occurs, interventions may begin to focus on practical preparations, reflection, closure, and saying goodbye to loved ones (Pathways, 2020).

 

Behavioral health is important to address in all stages of life, but in hospice/palliative care, it is especially important to engage both the client and their family in discussions about their feelings and fears (AOTA, 2015).

 

Caregivers play an important role and can be supported through open, honest communication and education on transfers, body mechanics, and resources to decrease burnout (AOTA, 2015).