Better Than a Paid Vacation: OTs’ Contribution to Interdisciplinary Hospice Teams

PURPOSE: Although per-diem Medicare hospice benefits can be used for occupational therapy services, hospice agencies rarely employ occupational therapists. A lack of research in this area contributes to the underutilization of occupational therapists in end-of-life care and consequently, opportunities for occupational therapists to practice in hospice care remain rare and underfunded. This study explores interdisciplinary perceptions of the contributions of occupational therapists on hospice care teams to better understand occupational therapists’ role in this emerging setting.

DESIGN: A descriptive qualitative study using individual, semi-structured interviews was utilized. Participants were nurses and social workers with at least three months of experience working for hospice agencies that employ occupational therapists as part of the interdisciplinary hospice teams. Participants were recruited via email following IRB approval and facility consent.

METHOD: Interviews were conducted via Zoom video conferencing using a self-developed interview guide of seven open-ended questions eliciting information about occupational therapists’ contribution to the interdisciplinary team. A content expert provided feedback on the interview guide prior to use. A 6-phase thematic analysis method was used to analyze the transcripts along with member checking to enhance credibility and trustworthiness of the analysis.

RESULTS: A total of 14 participants were interviewed (six nurses and eight social workers). The results of the thematic analysis produced four related themes; 1) specialized knowledge and skills, 2) impact on caregiver confidence, 3) impact on team members, and 4) impact on patient quality of life; as well as eight sub-themes, and one outlying theme (associated challenges).

CONCLUSION: The themes of occupational therapists contributing specialized knowledge and skills and impact on patient quality of life support previous findings. However, the themes of impact on caregiver confidence and team members have not been previously documented. These findings are significant because they establish additional ways occupational therapists contribute to end-of-life care and interdisciplinary hospice teams. The findings from this study can be used to advocate for more occupational therapist positions on interdisciplinary hospice teams.

References

Chow, J. K., & Pickens, N. D. (2019). Measuring the Efficacy of Occupational Therapy in End-of-Life Care: A Scoping Review. American Journal of Occupational Therapy, 74(1), 7401205020p1. https://doi.org/10.5014/ajot.2020.033340

Eva, G., & Morgan, D. (2018). Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey. Palliative Medicine, 32(5), 960–968. https://doi.org/10.1177/0269216318758928

Knecht-Sabres, L. J., Weppner, A., Powers, C., & Siesel, B. (2019). Do Health-Care Professionals Really Understand the Role of Occupational Therapy in Hospice Care? American Journal of Hospice and Palliative Medicine ^®, 36(5), 379–386. https://doi.org/10.1177/1049909118812858