I have almost no experience in hospice, but have two OT friends that
do...from what I know they do, in addition to how I practice OT, I would
say that the role of the OT in this setting should be to enable occupation.

  I know that sounds ridiculously simple, but if the clients are truly
recieving OT, they should be getting the benefit of a therapist who can
help them determine which occupations are pertinent to the quality of their
daily life in this last stage  (i.e., using the COPM), with a  care plan
that reflects how those occupations can be achieved.

This isn't to say that positioning, splinting, etc are not a part of the
plan; if  they enable the client to engage in occupations, then they are a
necessary intervention.  I think in the area of hospice we also have to
remember that a persons occupational sphere is shrinking, and that a
meaningful occupation may be as simple as being able  to sit up each day
for 30 minutes when the children come home from school, etc.

Also, and this is the beauty of the COPM, the family's needs can be
considered too.   And of course environmental assessment and
recommendations, in addition to family/caregiver education are a given.

I would love to hear what others are thinking...

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