End of Life Care: Everyone's Business

Article excerpt

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. …