I was appointed as the Clinical Nurse of Daw House in September 2002. I remember my first impressions of the place. As an outsider coming from a brand new hospital I found the aesthetic to be something that required a complete overhaul, but I was greeted by an enthusiastic nurse who said to me, “I know what you are thinking, this place is amazing!”
No, that is not what I was thinking. But I can tell you that within half an hour of commencing my first shift in Daw House I witnessed something that I thought health care had lost. I witnessed holistic patient care like I had never seen before.

In spring each year, postgraduate students from all around Australia leave family and work responsibilities to spend 2 intensive days at Flinders University in Adelaide. These professionals come to interact with peers and facilitators to learn more about communication at the end of life, the topic covered as core in all of our courses. 

Communication, the cornerstone of excellent end-of-life care, is that delicate skill that can flourish in the fertile environment of mindful practice and supportive critique. 

The aim of modern palliative care, whether provided by generalist, or specialist service providers, is to support palliative patients to live and die within the context of their lives, in the setting of their choice, with symptom control and a pattern of care that is supportive of patients’ caregivers.

Most Australian palliative care patients prefer to be cared for at home and the majority want to die at home, though only about 16% of Australians achieve that wish [1]. While there is no nationally consistent data on the volume of community services providing palliative care, it is known to be limited [2].
 

In May 2014, Carers Australia published a discussion paper, Dying at home: Preferences and roles for unpaid carers. It seems fitting that during National Carers Week we recognise the contribution that carers make to people who are dying. Most people wish to be cared for and die at home with the people they love and in familiar surroundings. Remaining at home is made much more likely where there is someone, or a group of people, who is willing to provide care and support for the dying person. Family, friends, work colleagues and neighbours all have taken on a caring role.

Occupational therapy is a health profession which enables people to participate in everyday life activities to the best of their ability despite their condition, illness progression, activity limitations or participation restrictions. In palliative care this premise does not change, as occupational therapists are skilled in enabling people to adapt to their changing ability levels, and helping people to continue living until they die, just as Dame Cicely Sanders famously quoted. However, the role that occupational therapists play is often misunderstood and under-utilised, resulting in the role being limited to discharge planning, home assessments, and equipment prescription. While these are important parts of the occupational therapy role, palliative care occupational therapists can offer so much more to their clients to enable them to keep living and remained engaged in everyday activities for as long as possible. To do this, occupational therapists follow a process which helps them to assess, intervene and evaluate their treatment plans.