Occupational Therapy In Hospice Care ( hospice , locus of control , occupation , quality of life )

As hospice care becomes more integrated in the overall health care delivery system, the profession of occupational therapy needs to analyze further its potential within this unique system. This article briefly discusses the goals and philosophy of the hospice concept from the perspective of the National Hospice Organization. Occupational therapy intervention in terminal care is examined, with emphasis on locus of control and occupation as determinants in enhancing quality of life for the terminally ill in a nontraditional rehabilitative environment. A brief case study illustrates some of the general principles discussed throughout the article. T he hospice concept is comparatively new in our health care system and is a nontraditional setting in which occupational therapists have begun to practice. It is new in that little has been researched, documented, or published with respect to occupational therapy intervention. It is nontraditional in that a different perspective has been added to occupational therapy practice in physical and psychosocial rehabilitation. Picard and Magno (I) presented a brief overview of hospice care and shared their perspective of occupational therapy intervention. "Although it is generally understood that hospice patients already have or are in the process of confronting and accepting the reality of imminent death, the presence of an occupational therapist in the hospice array of services points to a continued meaning in life, even if that life is measured in days." (I, p. 598) They also emphasized the need for therapists to make their work with hospices known. Tigges and Sherman (2) shared their work in hospice care and illustrated occupational therapy intional performance in skill areas important to the patient. "In the hospice setting, the occupational therapist must concentrate on making the most of patients' capacity and independence in selfcare, work and play within the constraints of their physical limitations." (2, p. 236)