The end of the year has come around again, and what would Christmas be without some holiday reading? So for our last blog in 2016, we thought we’d share some seasonal treats.

A few years ago, the December 2013 Nurses Hub News (106kb pdf) created a set of Christmas offerings that is worth revisiting:

• Case Study: Ornithophobia and the 12 days of Christmas (122kb pdf)
• Pharmacy Update: Santa’s health considerations (182kb pdf)
• OHS update: Christmas edition (103kb pdf)

Health professionals need to know the law that governs withholding and withdrawing life-sustaining treatment. Law is not at the centre of the clinical encounter, but it is part of the regulatory framework that governs these decisions. Failure to know and follow the law puts health professionals and their patients at risk. But we know there are gaps in health professionals’ legal knowledge in this area and this is not surprising either, given how complex and difficult this field of law is.

As a young doctor I spent some time working in a palliative care hospital in the early 90’s.  It was such a privilege to be working with people at end of life - with the opportunity to make a difference to quality of life and well-being of patients, and their family members. That experience made me decide to devote my career to Palliative Medicine.
 
I had some experiences at that time that stayed with me.
 
I had a patient, Marion, who had been a school principal. Marion had suffered a severe stroke. She had survived but was very incapacitated, confined to bed and unable to communicate. She was being kept alive, surviving on a feeding tube, and facing a life of care and dependence. Her specialist was very committed to her survival.
 

When someone has an incurable disease like advanced cancer or motor neurone disease, they experience many changes, one of which is functional decline. Although functional decline is inevitable at the end-of-life, the drive for people to remain as independent as possible is actually heightened at this time. The occupational therapist (OT) has two key roles to play here. Firstly, they play an active role in optimising a person’s independence and participation as function declines. Secondly, by supporting active participation in everyday activities to the best of a person’s ability, the OT can support people to come to terms with bodily deterioration and pending death. I’ll look at these two concepts in more detail.  
 

Move it or lose it, as the saying goes, is relevant to the field of palliative care. In fact, evidence suggests that up to 30% of muscle weakness in advanced illness can be due to inactivity itself.

Physiotherapists are in a prime position to make a difference to how patients experience end of life by helping them maximise their independence at each stage.  Expertise in functional assessment combined with an understanding of the impact of symptoms on the lived experience enables therapists to work closely with patients to improve their quality of life (QOL).