Occupational therapy can be defined as the science of healing
by occupation. Humans have a need to engage in occupations and
roles, and occupation is a natural means of restoring
function. Occupational therapy is traditionally prescribed for
patients whose functional abilities are going to improve.
However, occupational therapy is also an essential component
of hospice and palliative care. Loss of independence and role
can result in social death prior to biological death.
Occupational therapy can help a person to adopt new and
appropriate functions and roles and to maintain self-esteem.
person’s self-esteem, mastery and adaptation rest in the
ability to be purposefully engaged in regular and familiar
life experiences.” (Kent Tigges)
Occupational therapy aims to improve the quality of remaining
life and focuses on rehabilitation of the whole person.
Promoting physical independence may involve an assessment of
daily living skills, home visits, adapting the home to promote
independence and safety and selecting suitable aids and
adaptations for disability.
Lateral Sclerosis, Home Care)
symptoms are controlled, boredom remains a genuine
problem for the many patients who remain restricted by
disability or lack of energy. Such patients often find it
difficult to be imaginative and to initiate activities.
Skillful and enthusiastic occupational therapists can
transform the remaining life of these patients.
can become dominated by basic medical and functional needs.
The occupational therapist recognizes that social and
recreational activities are also essential for a
of us, a balanced life includes:
care (activities of daily living)
(the productive use of time)
Recreation (relaxation, amusement, self-expression)
these has physical, social and emotional elements and a
balance between dependence, independence and inter-dependence.
Assessment will include review of previous occupation and
interests, previous activity levels, the limitations imposed
by the disease, mental concentration, emotional preoccupation
and the important priorities for that person.
Most patients usually want to go on being as independent and
useful as possible.
Rehabilitation to full previous normal living is always
the goal, but may not always be possible. The occupational
therapist will encourage independence in some areas, and
appropriate dependence or inter- dependence in others. As the
patient’s condition deteriorates this balance shifts and
activities may need to be re-graded. Continuous reassessment
is more important than a single appraisal.
Occupational therapy may involve:
Assessment (living skills, work, leisure)
visits, environmental changes
Provision of aids and adaptations
Training in the use of equipment
conservation, time management
therapy (touch, role play, psychodrama)
skills or assertiveness training
Education in coping with change (patient and family)
Relaxation and stress management
Therapeutic activities (arts, crafts, poetry, music)
Maintaining normal social activity and conversation is
often the best form of occupational therapy. Reminiscence
therapy has proved a very useful tool.
(see Spiritual Pain)
normal lifestyle is no longer possible, learning new skills
can be a way of reducing the frustration of losing previous
abilities. Craft work (such as embroidery, leatherwork,
knitting, weaving, sewing, pottery, basketry, or making soft
toys) can be therapeutic for many patients. Projects should
be short-term, easy to pick up and set down, and have a
pleasing result. They can then be given as presents, or left
behind, or even sold as a donation. They allow the patient to
give rather than to keep receiving.
hospice brings opportunities for group activities and
games. Group entertainments are often enjoyed, such as
demonstrations of crafts or cooking, or musical or theatrical
performances, or short trips.
(see Day Hospice)
Attention to personal appearance (barber, beautician,
manicurist) and personal well-being (relaxation
techniques, meditation, massage, aromatherapy) can raise
morale and restore a person’s spirits.
Occupational therapy encourages patients to lift themselves
out of the passive sick role (often associated with
feelings of helplessness and loss of control) and to be more
independent, creative and productive. It emphasizes
“doing” rather than “being done to”. This can restore a sense
of purpose and accomplishment.
The author and publisher have taken
precautions to ensure that the information in this book is
error-free. However, readers must be guided by their own
personal and professional standards of good practice in
evaluating and applying recommendations made herein. The
contents of this book represent the views and experience of
the author, and not necessarily those of the publisher.