Palliative Care from an Occupational Therapists perspective

We typically think of OTs in rehab. Where do they fit in in palliative care?

Occupational therapists want to optimize a person’s quality of life through meaningful occupations. This means that we will adapt and modify activities and ensure that you can live and function regardless of your diagnosis and current health status; we want to ensure that you can live as independently as possible – which flows so well with the principles of palliative care – to live as actively as possible until death

When we refer to occupation, we are not only talking about work but also all activities of daily living that are important to you and that bring you meaning and purpose. We will find unique ways to ensure you can still do the things you love. 

What motivates you to support patients and families in this way?

Everyone has an idea of what is important to them, but being able to help people and make it possible for that patient is essential to me. 

Hearing clients’ stories about their lives and what is important to them makes the job enjoyable for me. I enjoy listening to their life experiences and their legacy. We all have a story to tell, and I want to help someone share their story so that they feel like they have achieved something. 

I like to ask my clients simple questions like, “How long have you been married?” these questions help them relive those moments again, bringing them so much joy. I often see clients for months, and for up to an hour, we build strong relationships. They trust me, and I get to know them and their families.

Having an OT in your team allows for an additional layer of support. We do much more than just rehabilitation. We also support your emotional health. 

What else are you able to offer patients apart from the physical rehab?

I not only assist with the physical adaptation of the client, but I also work a lot on legacy activities and building memories with and for families. I sit with them and discuss their fears, worries, and the future. 

I focus on building trusting relationships with the people I work with. If you ever have questions or feel too scared to ask the doctor, I’m here to help bridge that communication gap. It is important that my clients are able to voice their concerns and communicate their needs and wants. I can then relay that information to the rest of the team.

Can you tell us about one of your patients and how you were able to add value to their journey?

I’m reminded of a 44-year-old woman with stage 4 colon cancer I worked with last year. She had been hospitalized for about four or five months, and she had refectory (persistent) nausea and vomiting. 

She had young children, and building a legacy was very important to her. We worked very hard to keep her as independent as possible, to do self-care and mobility at home. We did exercises and adaptations in her house so she could move around comfortably. She made particular and unique gifts for her children and husband. She also dictated a life story that her friend wrote a book/novel for her girls as they were still relatively young. They also wanted to do a lot of outings and activities as a family to maintain normalcy. I managed many practicalities for outings, such as the Christmas market. 

We focused on energy conservation, getting a wheelchair so she wouldn’t need to walk at the market, sitting and enjoying the afternoon, and ensuring she had all her medications and breakthrough doses in her handbag. 

She also managed to go away with her family for a weekend, which was a significant achievement. I ensured she knew how to use the car seat for maximum comfort during the ride. Despite facing mobility challenges, she continued to find joy in her life, fulfilling her wish to be at home and enjoy Christmas with her family. 



By: Madelein Kritzinger

Palliative Care Occupational Therapist