Evidence for your Practice: Measuring the Efficacy of Occupational Therapy in End-of-Life Care

Article: Chow, J. K., & Pickens, N. D. (2020). Measuring the Efficacy of Occupational Therapy in End-of-Life Care: A Scoping Review. American Journal of Occupational Therapy, 74(1), 1–14. https://doi-org.ezproxy.library.ubc.ca/10.5014/ajot.2020.033340

Study Aim: To determine how occupational therapy hospice outcomes are established in the literature and to identify gaps that could lead to improved occupational therapy services in hospice care.

Key Findings: This review identified 7 articles focusing on outcome measures and research designs relevant to occupational therapy hospice care services.

4 issues identified in current practice and subsequent recommendations were discussed:

• Inappropriate Focus on Occupational Performance
• Recommendation: Focusing on occupational participation rather than on occupational performance can help positively frame the end-of-life issues within the context of functional loss.
• Lack of an Established Outcome Measure
• Recommendation: Running studies testing the validity of the COPM and other occupation-based assessments in the context of hospice.
• Inattention to the Environment
• Recommendations: Educating family members on communication strategies around end-of-life conversations may help build relationships and support systems for the loved one.
• Limited Use of End-of-Life Occupations
• Recommendation: While ADLs are often the focus, clients may benefit from occupations specific to the end of life, such as prioritizing relationships, reworking life to accommodate illness, engaging in legacy building and life review, finding closure, putting affairs in order, and making final arrangements.   

Bottom Line for OT:  Expanding the range of occupational interventions and evidence-based outcome measures to address end-of-life occupations will increase clients’ opportunities for continued engagement and will enable occupational therapy practitioners and researchers to measure the efficacy of occupational therapy in hospice care.

Post by CAOT-BC fieldwork student Amber Sands.

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