This study reviewed the role of occupational therapist’s in palliative and hospice care over the past 20 years.
Methods
A scoping review following Arksey and O'Malley’s five stages was undertaken using PubMed, OTseeker, Scopus, Elsevier, Cochrane Library-Medline, CINAHL, PsychInfo, Web of Science and Google Scholar.
Results
A total of 41 articles were reviewed. The most publications occurred in 2010, 2011, 2015, and 2023. The majority of the studies (48.7%) were of qualitative design. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.
Conclusion
Occupational therapy within the context of palliative care aims to assist individuals in attaining their highest level of independence in important occupations. Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays.
MarrelliTM. Hospice and Palliative Care Handbook: Quality, Compliance, and Reimbursement. Indianapolis, IN: Sigma Theta Tau; 2023.
2.
BhatnagarMKempferLALagneseKR. Hospice Care. 2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
3.
SharafiSZiaeeADahmardehH. What are the outcomes of hospice care for cancer patients? A systematic review. Support Care Cancer. 2023;31(1):64.
4.
DroniaM-CDillenKElsnerF, et al.Palliative care education and knowledge transfer into practice–a multicenter survey among medical students and resident physicians in Germany using a mixed-methods design. GMS J Med Educ. 2024;41(3):Doc27.
5.
ViladotMGallardo-MartínezJ-LHernandez-RodríguezF, et al.Validation study of the PALCOM scale of complexity of palliative care needs: a cohort study in advanced cancer patients. Cancers. 2023;15(16):4182.
6.
PickensNChowJKMcKayH. Role of occupational therapy in end-of-life care. AJOT: Am J Occup Ther. 2016;70(S2):1–16.
7.
CooperJ. Occupational Therapy in Oncology and Palliative Care. USA: Wiley: Hoboken; 2006.
8.
DawsonSS. The role of occupational therapy in palliative care. Aust Occup Ther J. 1982;29(3):119-124.
9.
ChowJKPickensND. Measuring the efficacy of occupational therapy in end-of-life care: a scoping review. Am J Occup Ther. 2020;74(1):7401205020p1-7401205020p14.
10.
HammillKByeRCookC. Occupational therapy for people living with a life-limiting illness: a thematic review. Br J Occup Ther. 2014;77(11):582-589.
11.
ArkseyHO'MalleyL. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32.
12.
CooperJLittlechildB. A study of occupational therapy interventions in oncology and palliative care. Int J Ther Rehabil. 2004;11(7):329-333.
13.
LeeWTKChanHFWongE. Improvement of feeding independence in end-stage cancer patients under palliative care—a prospective, uncontrolled study. Support Care Cancer. 2005;13:1051-1056.
14.
La CourKJohannessenHJosephssonS. Activity and meaning making in the everyday lives of people with advanced cancer. Palliat Support Care. 2009;7(4):469-479.
15.
EvaGMorganD. Mapping the scope of occupational therapy practice in palliative care: a European Association for Palliative Care cross-sectional survey. Palliat Med. 2018;32(5):960-968.
16.
KeesingSRosenwaxLMcNamaraB. ‘Doubly deprived’: a post‐death qualitative study of primary carers of people who died in Western Australia. Health Soc Care Community. 2011;19(6):636-644.
17.
WhiteKM. Occupational therapy interventions for people living with advanced lung cancer. Lung Cancer Manag. 2013;2(2):121-127.
18.
KeesingSRosenwaxL. Establishing a role for occupational therapists in end-of-life care in Western Australia. Aust Occup Ther J. 2013;60(5):370-373.
19.
KeesingSRosenwaxL. Is occupation missing from occupational therapy in palliative care?Aust Occup Ther J. 2011;58(5):329-336.
20.
LittlechildB. Managing fatigue: a trial of group and individual educational support for hospice outpatients. Eur J Palliat Care. 2016;23(4):166.
21.
ErikssonLÖsterILindbergM. The meaning of occupation for patients in palliative care when in hospital. Palliat Support Care. 2016;14(5):541-552.
22.
Ann BurkhardtOMack Ivy MotOKannenbergKRYoungstromMJ. The role of occupational therapy in end-of-life care. Am J Occup Ther. 2011;65(6):S66.
23.
VolbergCFleckPVradelisPMorinAGschnellMPapeAE. How to enable participation until the end of life? A survey of German occupational therapists working in palliative care. J Clin Med. 2023;12(16):5257.
24.
KealeyPMcIntyreI. An evaluation of the domiciliary occupational therapy service in palliative cancer care in a community trust: a patient and carers perspective. Eur J Cancer Care. 2005;14(3):232-243.
25.
LeysenBVan DaeleAVerreptTSaeysW. Applied physiotherapeutic and occupational therapeutic interventions within palliative care: an exploratory survey. Prog Palliat Care. 2019;27(3):109-116.
26.
LalaAPKinsellaEA. A phenomenological inquiry into the embodied nature of occupation at end of life. Can J Occup Ther. 2011;78(4):246-254.
27.
MorganDDCurrowDCDenehyLArandaSA. Living actively in the face of impending death: constantly adjusting to bodily decline at the end-of-life. BMJ Support Palliat Care. 2017;7(2):179-188.
28.
MurdockCCousinsWKernohanWG. “Running Water Won’t Freeze”: how people with advanced Parkinson’s disease experience occupation. Palliat Support Care. 2015;13(5):1363-1372.
29.
PeoplesHNissenNBrandtÅla CourK. Perceptions of quality of life by people with advanced cancer who live at home. Br J Occup Ther. 2021;84(11):723-730.
30.
la CourKJosephssonSLuborskyM. Creating connections to life during life-threatening illness: creative activity experienced by elderly people and occupational therapists. Scand J Occup Ther. 2005;12(3):98-109.
31.
La CourKJosephssonSTishelmanCNygårdL. Experiences of engagement in creative activity at a palliative care facility. Palliat Support Care. 2007;5(3):241-250.
32.
JeyasingamLAgarMSoaresMPlummerJCurrowD. A prospective study of unmet activity of daily living needs in palliative care inpatients. Aust Occup Ther J. 2008;55(4):266-272.
33.
Kasven-GonzalezNSouverainRMialeS. Improving quality of life through rehabilitation in palliative care: case report. Palliat Support Care. 2010;8(3):359-369.
34.
Talbot-CoulombeCBravoGCarrierA. Occupational therapy practice in palliative and end-of-life care in Québec. Can J Occup Ther. 2022;89(2):201-211.
35.
MillerJHopkinsonC. A retrospective audit exploring the use of relaxation as an intervention in oncology and palliative care. Eur J Cancer Care. 2008;17(5):488-491.
36.
SaarikJHartleyJ. Living with cancer-related fatigue: developing an effective management programme. Int J Palliat Nurs. 2010;16(1):6-12.
37.
FunchAKruseNBla CourKPeoplesHWæhrensEEBrandtÅ. The association between having assistive devices and activities of daily living ability and health-related quality of life: an exploratory cross-sectional study among people with advanced cancer. Eur J Cancer Care. 2019;28(3):e13002.
38.
WæhrensEEMorganDDla CourK, et al.International consensus on occupational therapy interventions for people with palliative care needs: a European association for palliative care group concept mapping study. Palliat Med. 2023;37(9):1389-1401.
39.
ImanishiMTomohisaHHigakiK. In-home occupational therapy for a patient with stage IV lung cancer: changes in quality of life and analysis of causes. SpringerPlus. 2015;4:1-5.
40.
SakaguchiSOkamuraH. Effectiveness of collage activity based on a life review in elderly cancer patients: a preliminary study. Palliat Support Care. 2015;13(2):285-293.
41.
WallisAMeredithPStanleyM. Occupational therapy in oncology palliative care for adolescents and young adults: perspectives of Australian occupational therapists. Aust Occup Ther J. 2022;69(2):165-176.
42.
JacquesNDHasselkusBR. The nature of occupation surrounding dying and death. OTJR Occup Participation Health. 2004;24(2):44-53.
43.
Van HuijzenSvan StaaA. Chronic ventilation and social participation: experiences of men with neuromuscular disorders. Scand J Occup Ther. 2013;20(3):209-216.
44.
BadgerSMacleodRHoneyA. “It’s not about treatment, it’s how to improve your life”: the lived experience of occupational therapy in palliative care. Palliat Support Care. 2016;14(3):225-231.
45.
MarstonCAgarMBrownT. Patients’ and caregivers’ perceptions of occupational therapy and adapting to discharge home from an inpatient palliative care setting. Br J Occup Ther. 2015;78(11):688-696.
46.
HoyJTwiggVPearsonE. Occupational therapy home assessments: more than just a visit? An audit of occupational therapy practice in oncology and palliative care. Br J Occup Ther. 2008;71(2):59-63.
47.
PickensNDO’ReillyKRSharpKC. Holding on to normalcy and overshadowed needs: family caregiving at end of life. Can J Occup Ther. 2010;77(4):234-240.
48.
LimGHYongCBreenLJKeesingSBuchananA. Occupational therapy practice with terminally ill Chinese older adults in Singapore: A qualitative exploratory study. Aust Occup Ther J. 2023;70(1):18-31.
49.
AngeloJWilsonL. Exploring occupation roles of hospice family caregivers from Māori, Chinese and Tongan ethnic backgrounds living in New Zealand. Occup Ther Int. 2014;21(2):81-90.
50.
HalkettGKCiccarelliMKeesingSAounS. Occupational therapy in palliative care: is it under-utilised in Western Australia?Aust Occup Ther J. 2010;57(5):301-309.
51.
Knecht-SabresLJWeppnerAPowersCSieselB. Do health-care professionals really understand the role of occupational therapy in hospice care?Am J Hosp Palliat Care. 2019;36(5):379-386.
52.
IkechiYInoueKIshimaruM. The role of occupational therapists in palliative care teams: differences of rehabilitation occupations expected by other occupations. Jpn J Compr Rehabil Sci. 2020;11:98-101.
53.
ChowJKPickensNDFletcherTThompsonMBowyerP. “You’ve got to do something”: developing occupational therapists’ role in end-of-life care. OTJR: Occup Ther J Res. 2023;43(1):109-118.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
