Background. Occupational therapists propose that occupation is a basic human need across the lifespan. However, there is limited understanding of how occupation contributes to the end-of-life experience.
Purpose. The purpose of this study was to examine the embodied nature of occupation at end of life from the perspectives of Canadians 60 years of age or older who are diagnosed with a terminal illness.
Methods. The study adopted a phenomenological methodological approach to conduct semi-structured interviews with eight participants.
Findings. Six themes were identified. Participants described orientations toward occupations that involved: living with death, reworking everyday life, being guided by the will of the body, giving priority to relationships, attending to the small things, and engaging existential orientations.
Implications. This study contributes to knowledge about occupation at end of life and offers a starting point to guide practice that is attentive to the lived dimensions of occupation at end of life.
BennerP. (1994). The tradition and skill of interpretive phenomenology in studying health, illness, and caring practices. In BennerP. (Ed.), Interpretive phenomenology: Embodiment, caring and ethics in health and illness (pp. 99–127). Thousand Oaks, CA: Sage Publications
2.
ByeR. A. (1998). When clients are dying: Occupational therapists' perspectives. Occupational Therapy Journal of Research, 18, 3–24
3.
Canadian Association of Occupational Therapists. (2008). CAOT Position statement: Occupational therapy and end-of-life care. Retrieved from http://www.caot.ca/default.asp?pageID=1284
CarmanT. (2008). Merleau-Ponty. New York: Routledge
6.
CarstensenL. L.IsaacowitzD. M.CharlesS. T. (1999). Taking time seriously: A theory of socioemotional selectivity. American Psychologist, 54, 165–181. doi: 10.1037/0003-066X.54.3.165
7.
DawsonS.BarkerJ. (1995). Hospice and palliative care: A Delphi survey of occupational therapists' roles and training needs. Australian Occupational Therapy Journal, 42, 119–127. doi: 10.1111/j.1440-1630.1995.tb01323.x
8.
DreyfusH. L.DreyfusS. E. (1999). The challenge of Merleau-Ponty's phenomenology of embodiment for cognitive science. In WeissG.HaberH. Fern (Eds.), Perspectives on embodiment: The intersections of nature and culture (pp. 103–120). New York: Routledge
9.
EganM. (2003, September). Occupational therapy at home and in the community for people and families in palliative care. Occupational Therapy Now, 5.
10.
FlemingM. H.MattinglyC. (1994). The underground practice. In MattinglyC.FlemingM. H. (Eds.), Clinical reasoning: Forms of inquiry in a therapeutic practice (pp. 295–315). Philadelphia: F. A. Davis
11.
FrankA. W. (1991). At the will of the body: Reflections on illness. New York: Mariner Books
12.
FrostM. (2001). The role of physical, occupational, and speech therapy in hospice: Patient empowerment. American Journal of Hospice & Palliative Care, 18, 397–402. doi: 10.1177/104990910101800609
13.
GadamerH. (1975). Truth and method. New York: Continuum
14.
HasselkusB. R. (1993). Death in very old age: A personal journey of caregiving. American Journal of Occupational Therapy, 47, 717–723
15.
HeideggerM. (2008). Being and time. New York: Harper & Row Publishers. (Original work published 1927)
16.
JacquesN. D.HasselkusB. (2004). The nature of occupation surrounding dying and death. OTJR: Occupation, Participation, and Health, 24 (2), 44–53
17.
KealeyP.McIntyreI. (2005). An evaluation of the domiciliary occupational therapy service in palliative cancer care in a community trust: A patient and carers perspective. European Journal of Cancer Care, 14, 232–243. doi: 10.1111/j.1365-2354.2005.00559.x
18.
KinsellaE. A. (2006). Hermeneutics and critical hermeneutics: Exploring possibilities within the art of interpretation. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, 7 (3), Art. 19. Retrieved from http://www.qualitative-research.net/index.php/fqs/article/view/145
19.
LederD. (1990). The absent body. Chicago: University of Chicago Press
20.
LyonsM.OrozovicN.DavisJ.NewmanJ. (2002). Doing-being-becoming: Occupational experiences of persons with life-threatening illnesses. American Journal of Occupational Therapy, 56, 285–295. doi: 10.5014/ajot.56.3.285
21.
Merleau-PontyM. (2006). Phenomenology of perception. New York: Routledge. (Original work published 1945)
LalaA. Park (2011). A phenomenological inquiry into the embodied nature of occupation at end of life (Unpublished doctoral dissertation). University of Western Ontario, London, Ontario, Canada
24.
PizziM.BriggsR. (2004). Occupational and physical therapy in hospice: The facilitation of meaning, quality of life, and well-being. Topics in Geriatric Rehabilitation, 20 (2), 120–130
25.
PollardN. (2006). JOS Comment: Is dying an occupation?Journal of Occupational Science, 13 (2), 149–152
26.
ProchnauC.LiuL.BomanJ. (2003). Personal-professional connections in palliative care occupational therapy. American Journal of Occupational Therapy, 57, 196–204. doi: 10.5014/ajot.57.2.196
27.
Quality End-of-Life Care Coalition. (2010). Quality End-of-Life Care Coalition. Retrieved from http://www.chpca.net/qelccc.htm
28.
RahmanH. (2000). Journey of providing care in hospice: Perspectives of occupational therapists. Qualitative Health Research, 10, 806–818. doi: 10.1177/104973200129118831
29.
RebeiroK. L.DayD. G.SemeniukB.O'BrienM. C.WilsonB. (2001). Northern initiative for social action: An occupation-based mental health program. American Journal of Occupational Therapy, 55, 493–500. doi: 10.5014/ajot.55.5.493
30.
SavageJ. (2000). Participative observation: Standing in the shoes of others. Qualitative Health Research, 10, 324–330. doi: 10.1177/104973200129118471
31.
ThibeaultR. (1997). A funeral for my father's mind: A therapist's attempt at grieving. Canadian Journal of Occupational Therapy, 64, 107–114
32.
ThomasS. P.PollioH. R. (2002). Listening to patients: A phenomenological approach to nursing research and practice. New York: Springer Publishing Company
33.
TrumpS. (2000). The role of occupational therapy in hospice. Home & Community Health Special Interest Section Quarterly, 7 (2), 1–4
34.
van ManenM. (1997). Researching lived experience: Human science for an action sensitive pedagogy. London, ON: Althouse Press
35.
VrkljanB.Miller-PolgarJ. (2001). Meaning of occupational engagement in life-threatening illness: A qualitative pilot project. Canadian Journal of Occupational Therapy, 68, 237–246
36.
HammellK. Whalley (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 71, 296–305
37.
WilcockA. A. (1998). Reflections on doing, being and becoming. Canadian Journal of Occupational Therapy, 65, 350–353
38.
WilcockA. A. (2006). An occupational perspective of health (2nd ed.). Thorofare, NJ: Slack
