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End of Life Care and Occupational Therapy

End of Life Care and Occupational Therapy
Heather Javaherian-Dysinger, OTD, OTR/L
February 29, 2016

Dr. Heather Javaherian-Dysinger:  Before we get started, I want to take a moment and acknowledge that this is a very sensitive topic and I thank all of you for being here today to listen to this and to participate. I encourage you to be reflective, because likely you have been exposed or experienced this with someone either personally or professionally. Some of you may work in this area and I hope that you can add with your questions and comments to the discussion about our role as occupational therapy practitioners in end of life care.

Chronic Illness

It is important to understand our society and what we are up against. There are 100 million people in the United States who have at least 1 chronic illness. Fifty million have more than 1. Eighty-eight% of people over 65 have at least 1 chronic illness. As we age, we are more likely to have more diseases, and then 22% of people age 65 have 4 chronic illnesses. These are important statistics to know. We have an aging population. Many people are going to be 65 or older by 2030. We are living longer with advances in technology. We can even prolong life, but I think we have to question, are we prolonging a life with good quality?

This is what I really want us to think about today as we look at our role. How can we promote quality of life as a person ages and often has multiple chronic illnesses?

Palliative and Hospice

Palliative and hospice care targets people with chronic conditions. Often there is eligibility for Medicare and Medicaid. They target people who use multiple hospital services, and people who are in the last year of their life. Palliative care specifically focuses on improving life and providing comfort to people of all ages with serious chronic and life threatening illnesses.

Palliative Care

Often when we think of palliative care, we say cancer, but it is really much broader than that. It focuses on preventing or treating symptoms and side effects of diseases. It can include cancer, CHF, kidney failure, chronic obstructive pulmonary disease, AIDS, and Alzheimer's among others. It is an inter-professional approach.  The team includes doctors, nurses, a variety of therapists, social workers and chaplains. Palliative care is 

"an approach that improves quality of life for patients and their families who are facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of problems including the physical, psychosocial, and spiritual" (WHO, 2011).

When I read that description, I think about our philosophy as an occupational therapy practitioner that helps treat the whole person. As we talk about this more today, reflect upon "what is our role? How can we more be involved here?"

heather javaherian dysinger

Heather Javaherian-Dysinger, OTD, OTR/L

Heather Javaherian is an Associate Professor and Program Director at Loma Linda University. She graduated with her doctorate from Creighton University in 2004. Her research and practice areas include domestic violence, end of life care, primary care, and education. Dr. Javaherian provides pro bono services and supervises Level I and II students in domestic violence settings. She is co-founder of Roots Down, Inc, a non-profit for survivors of domestic violence. Dr. Javaherian has presented at regional, state, and national levels on domestic violence and has authored several publications in this area. She has served the profession at the national level in the Education SIS and at the state levels as a regional director in Ohio and now is on the Executive Board for the Occupational Therapy Association of California. In April 2019, Dr. Javaherian was named to the Roster of Fellows of the American Occupational Therapy Association. 

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