If Rehabilitative Palliative Care is the answer… what is the question?
Palliative care has helped us understand that there is life beyond treatment and before death. It has opened up a little formulated but increasingly common phase of our life which is the living with dying phase. Patients that I see in a hospice setting are often surprised that they don’t have to take to their beds and wait for death. Rather, there are many occupations of value, purpose and meaning that with encouragement, adjustment, acceptance and opportunity, can make this period of time the most critical and rewarding part of a life’s journey.
In short, Rehabilitative Palliative Care is the answer to the question: How can I live and die with dignity?
- It may mean finding strategies to manage common barriers to achieving goals such as fatigue, breathlessness, anxiety and depression.
- It may mean redefining a wheelchair as a means to take control back, thereby being able to get onto the moors to smell the Yorkshire air, rather than the commonly heard first response: “I am not ready for that, yet”.
- Over the years, I have never met anyone who has said to me the time is now right for a bath aid, but I have met many people who have said, “I really miss being able to have a bath”.
Palliative rehabilitation looks different to every person I have ever worked with, but it is based on a patient’s need to find purpose and meaning in the life they have left to live. The occupational therapist is ideally placed to work with patients to ensure their strengths and skills are working in a suitable environment to allow them to do the things they want to do (hopefully in negotiation and sometimes in conflict with the significant people in their lives). Occupational therapists are also well placed to lead and support the wider multidisciplinary team to adopt a rehabilitative approach to palliative care practice that supports these aims.