“It’s a unique and special privilege to be with people and their families at this stage of their life. I’m interested in how people react to the process of dying, how I can support them and their holistic needs, and I love working as part of a multi-disciplinary team to see the person as a person and not as a patient.”
What then does that mean in practice?
Phoebe explains: “Our job as OT’s is to help people think about the things they can do rather those they can’t. It’s about supporting them to be as independent as they can be within their limits and to empower them to feel some sense of control over their lives at a stage when it can feel like they are losing control. That can be apparently small things like getting out of bed, using the toilet or walking a short distance.”
Phoebe and one of her colleagues work mostly in the inpatient unit while another works exclusively in the community, supporting people in their own homes, and the fourth OT works in the wellbeing team. All of them are constantly devising strategies and problem solving to help people to do the things they really want to do.
Establishing what that is, is an essential skill, Phoebe says.
That information sharing takes many different forms. It can be a quick, informal chat, updating patients’ notes or a discussion in the daily and more detailed weekly MDT meetings.
Describing what a successful day looks like comes easy for Phoebe.
“I think leaving work at the end of the day and feeling like I’ve made a difference to someone’s quality of life, even if it’s a really small thing and just made life better for a minute for that person and their family. That’s why I do the job.”
“Communication is the most important thing – actively listening and probing to understand what it is that people really want and then working with colleagues – doctors, nurses, health care assistants and social workers – to try and make it happen by supporting them to maintain that independence or manage their breathlessness or fatigue.”
Working effectively to prepare people to be discharged back home after a stay in the hospice is a regular part of an OT’s job – ensuring everything’s set up in the home, potentially installing equipment and enabling the patient and family to feel confident there.
What’s a slightly less common occurrence is a game of football in the garden at St Christopher’s – with a patient. But it’s what happened after Phoebe had established in a couple of conversations with Isiah, a 31-year-old father of one, what really mattered to him.
“Isiah didn’t need that much physical rehab as he was independent and still walking. But from a quality of life point of view there were definitely things we could help with. Talking to him, it became apparent that the only things that were important to him were playing football (he’d been a semi-professional in Nigeria) and tennis. He had fluid on the lungs and thought he’d never play again.”
One of Phoebe’s nursing colleagues rounded up a group of people to play football and, with Phoebe holding his oxygen tank, Isiah enjoyed a ‘match’ in the garden.
“He transformed into a totally different person. You could see his quality of life and whole outlook changed. He started reflecting on his family and his football career. It was lovely to see. It was a very ‘OT’ thing for us to do – based on what was important to him.”
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This article was first published on the St Christopher’s Hospice website and is republished here with permission.
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