Gail Eva, Research Fellow, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK, and Chair of the EAPC Taskforce on Occupational Therapy
As I write this post, it’s the start of the Paralympic Games in London: the biggest and predicted to be the most watched Paralympics ever, and a celebration of sport and human achievement. During the next eleven days, 4,200 athletes from 164 countries will compete – sportsmen and women of the very highest calibre, all with a disability. Over the coming fortnight, we will no doubt hear many stories of resilience and accomplishment, and perhaps even of ways in which occupational therapy has contributed to the success of some of the athletes. The organisers of the Games hope that these stories will challenge some of the more negative public perceptions of disability. Perhaps they will also challenge assumptions that rehabilitation is of no value in late stage disease.
In some European countries, such as the UK and Ireland, occupational therapy is a relatively well-established component of palliative care services. However, conversations with colleagues suggest that this is not generally the case across Europe. Following the work of EAPC taskforces in other disciplines – such as physiotherapy, psychology and social work – we would like to get an idea of the availability of occupational therapy in palliative care in Europe, the scope of service provision and the variation in services provided.
Making the most of a person’s resources
Occupational therapists enable people to make the most of life: to maintain a sense of purpose and satisfaction in everyday living while at the same time acknowledging the practical and existential consequences of life with a deteriorating condition. The question occupational therapists ask their patients is:
“What are the things you want to be able to do, and how can we help you to achieve them?”
Occupational therapy is a careful, structured process of assessment, setting goals, and identifying and maximising a person’s existing resources.
And the sorts of questions that patients frequently ask us:
“Am I going to be able to continue to live in my second floor flat, or should my wife and I move somewhere without stairs?”
“The most important thing to me is not to be a burden on others. How do I avoid that?”
“I love to travel. It breaks my heart that I can’t go away in my caravan anymore.”
The answers to these questions might be about straightforward adaptations and modifications to patients’ environments; but equally they might be about helping people – patients and their carers – to see things differently. For example, what is it about caravanning holidays that is meaningful? Can the connection with nature and the joy of exploration be achieved in other ways?
Over the next six months, the EAPC Taskforce on Occupational Therapy would like to make contact with occupational therapists in Europe working in palliative care, or working with patients who have life-threatening illness. Towards the end of 2012, we will be carrying out a brief survey to find out a bit more about the work that occupational therapists do in palliative care, and details of the survey will be posted on the EAPC blog. In the meantime, if any occupational therapists wish to get in contact with the Taskforce committee, we would be delighted to hear from you. You are very welcome to email me.