End of life care: everyone's business.
Article Type: Editorial
Subject: Terminal care (Management)
Occupational therapy (Management)
Author: Pearson, Debbie
Pub Date: 07/01/2010
Publication: Name: British Journal of Occupational Therapy Publisher: College of Occupational Therapists Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 College of Occupational Therapists Ltd. ISSN: 0308-0226
Issue: Date: July, 2010 Source Volume: 73 Source Issue: 7
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 232382973
Full Text: In 1789, the American writer, statesman and scientist Benjamin Franklin wrote: 'In this world nothing can be said to be certain, except death and taxes.' As universal and certain as death is, the majority of us prefer to ignore it, and health and social care practitioners can feel ill prepared to support people at the end stages of life.

My colleagues were bemused at my choice to work exclusively in palliative care: 'How can you do it, all the time?' In my experience as an occupational therapy lecturer, death, as a discrete subject, is still mysteriously absent from the curriculum (as it was during my education and training 25 years ago), and practice educators have refused to offer students placements on the basis that their work is 'too specialised'. Students can be fearful of practice placement in palliative care settings and may struggle to cope with the unexpected death of clients in other contexts. In a society that largely ignores death, this is understandable. However, are we missing out on an important opportunity to develop skills that enable occupational therapists to work effectively with people to support their occupational needs at the end stage of their lives?

As advances in the medical management of serious illness extend life expectancy, 'terminal diagnoses' are now referred to as 'long-term conditions' and occupational therapists will encounter people who live with a life-limiting illness. This provides an ideal opportunity for occupational therapists to support people to fulfil their priorities for living, while dying, and to enable participation in occupations that are important to them.

The recent publication End of Life Care--a Framework of National Occupational Standards (Skills for Health 2010) aims to develop the workforce to work more effectively with people who are dying. This framework, which builds upon the End of Life Care Strategy (Department of Health 2008), sets out core principles and competences. These include person-centred practice, respecting client choice, demonstrating sensitive and supportive communication, and consideration of carers' and family members' needs.

Such principles resonate closely with the practice of occupational therapy and, as such, occupational therapists are well placed to be exponents of quality care and services for people at the end of life. Crucially, the framework advocates that all workers, irrespective of level and organisation, are responsible for developing their knowledge, skills and attitudes in relation to end of life care. With care of the dying everyone's business (remember Benjamin Franklin; it will be you, one day), we must be mindful of the need to develop competence and ability for practice in this context. End of Life Care--a Framework of National Occupational Standards is a good place to start and provides a template for students, therapists and those in education to use as a basis for consideration and for action.

Department of Health (2008) End of Life Care Strategy--promoting high quality care for all adults at the end of life. London: HMSO.

Franklin B (1789) In: E Knowles, ed (1999) Oxford dictionary of quotations. New York: Oxford University Press.

Skills for Health (2010) End of Life Care--a Framework of National Occupational Standards. Available at: http://www.skillsforhealth.org.uk/ about-us/news/2010/End-of-life-care.aspx Accessed on 21.01.10.

Correspondence to: Debbie Pearson, Senior Lecturer Occupational Therapy, Faculty of Health and Life Sciences, York St John University, Lord Mayor's Walk, York YO31 7EX. Email: d.pearson@yorksj.ac.uk

Key words: End of life care, practice skills.

DOI: 10.4276/030802210X12759925544227
Gale Copyright: Copyright 2010 Gale, Cengage Learning. All rights reserved.