4.6 (4.6) Occupational therapy in palliative care

Question 1

Occupational therapists are an essential part of the palliative care team. What does occupation refer to in the name of this profession?

Answer 1

• self/personal care
• productivity - work related and domestic
• leisure - hobbies, sports etc

Question 2

A patient on the PCU has a glioblastoma and seems to be becoming increasingly confused over several weeks. A medical student wonders about asking the OT to do serial cognitive assessments to track this change. List two reasons this is ill advised

Answer 2

time consuming tiring for patient
reassessment will only confirm for the patient they are deteriorating

Question 3

An occupational therapist provides an assessment for a patient to determine in what ways that patient requires assistance in optimizing independent function. What are five major skills that the OT will assess in determining the patient’s ability to perform ADLs and iADLS

Answer 3

Motor skills
Sensory skills
cognitive skills
intrapersonal skills
interpersonal skills

Question 4

The palliative OT meets with a patient to discuss their goals for the future. What are 5 features of goals that are required for them to be helpful

Answer 4

SMART
specific 
Measurable
attainable
realistic 
time bound

Question 5

An OT is working with a patient to enhance their ability to perform a particular task. What are two ways of grading the activity to enhance patient function?

Answer 5

Adapt the environment (ie. move furniture)
Adpat the task (forward chaining, backward chaining - OT does all steps except last step)

Question 6

A patient is identified as having a symptom cluster or anxiety, breathlessness, and fatigue. The OT becomes involved and after assessing the patient creates a plan for relaxation. What are three types of relaxation that the OT might recommend?

Answer 6

progressive muscular relaxation
passive neuromuscular and release only relaxation
autogenic relaxation
guided visualization
unguided visulation
challenging negative thought patterns

Question 7

A patient is identified as having a symptom cluster or anxiety, breathlessness, and fatigue. The OT becomes involved and after assessing the patient creates a plan for energy conservation to reduce breathlessness. What are the five P’s that make energy conservation possible?

Answer 7

prioritize  (importance activities)
plan (organize)
Pace
position 
permission (not to do activities)

Question 8

List 5 aspects of fatigue management

Answer 8

1. fatigue diaries
2. educating patient on the nature of the fatigue symptoms and how to manage
3. Energy conservation techniques
4. Encourage patient to break down tasks into smaller components
5. Equipment that can help alleviate fatigue