Living actively in the face of impending death: constantly adjusting to bodily decline at the end-of-life

Abstract

Word count:Abstract: 248 2 Manuscript: 3500 ABSTRACTContext: People with advanced cancer experience bodily change resulting in debilitating functional decline. Although inability to participate in everyday activities (occupation) contributes to profound suffering, limited research has examined the relationship between altered bodily experience (embodiment) and functional ability. Objectives:The purpose of this study was to better understand the lived experience of functional decline for people with advanced cancer living at home. Methods:In-depth interviews were conducted with ten community dwelling people with advanced cancer about their bodily experiences of functional decline. This study employed a pragmatic qualitative approach, informed by hermeneutic phenomenology.

Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey

“…This is a common frustration for OTs in palliative care 8 , 10 , 22 and is perceived to be influenced by other health professionals’ limited understanding of the full range of occupational therapy interventions. 8 , 11 , 22 Paradoxically, however, respondents also reported reluctance to publicise the scope of their role for fear of being not being able to meet the anticipated need.…”

“… 7 – 10 The ability to participate in everyday life and contribute to social relationships maintains a sense of competence, reciprocity and well-being for people with life-limiting illnesses and is highly valued. 11 – 13 It follows from this that suboptimal access to occupational therapy services limits patients’ and carers’ ability to manage daily activities in their preferred environments. While there are no formal data on the availability of occupational therapy services in palliative care in Europe, 14 anecdotal information shared at EAPC conferences and in online discussion forums (such as the Palliative Rehabilitation Facebook Group 15 ) indicates that provision of occupational therapy in palliative care varies widely, with services in the United Kingdom and Ireland being more established than in other European countries.…”

The role of the occupational therapist in the care of people living with lung cancer

“…Transl Lung Cancer Res 2016;5(3):244-246 tlcr.amegroups.com therapists build on this evidence and continue to research the efficacy of interventions used to optimize function for people living with lung cancer. The focus of occupational therapy interventions for people living with lung cancer is on enabling continued participation in valued and chosen activities in the face of functional decline and increasing symptom burden (2).…”

“…Occupational therapists are integral members of the lung cancer multidisciplinary team, working with lung cancer patients in the inpatient hospital setting, hospital outpatient clinics and in the community. The occupational therapists' focus is on enabling an individual's participation in chosen everyday activities (1,2). For people living with metastatic lung cancer, this entails enabling continued participation in the face of functional decline and increasing symptom burden.…”

“…Occupational therapists are experts in analyzing how people complete tasks that are meaningful to the individual. Through goal setting with the individual, the occupational therapist is able to ensure the focus is on tasks and roles that provide meaning in the face of deteriorating function, rather than tasks the health professional feels the person with lung cancer should focus on (2,4).…”