Occupational Therapy's Role in Hospice Care
What Is Occupational Therapy?
Occupational therapy (OT) focuses on helping people participate in meaningful daily activities, even when illness, injury, or life changes make those activities harder. These activities—called occupations—include things people need to do, want to do, or find meaningful, such as caring for themselves, connecting with others, expressing creativity, and reflecting on their life experiences.
At the end of life, occupational therapy supports quality of life, dignity, and autonomy by adapting activities and environments so individuals can continue to engage in what matters most to them.
Occupations Relevant to Hospice Care
Activities of Daily Living (ADLs)
ADLs are basic self-care tasks required for everyday functioning.
Examples include:
-
Bathing and showering
-
Toileting and toilet hygiene
-
Dressing
-
Grooming and personal hygiene
-
Feeding and eating
-
Functional mobility
In hospice care, OT may help modify these tasks to conserve energy, reduce pain, and maintain comfort while preserving independence.
Instrumental Activities of Daily Living (IADLs)
IADLs are more complex tasks that support independent living within the home and community.
Examples include:
Meal preparation and cleanup
Managing finances
Shopping
Home management
Caring for others or pets
OTs may adapt these tasks, recommend environmental modifications, or support caregivers in safely assisting with them.
Health Management
Activities that promote health and wellness, such as:
Managing medications
Symptom monitoring
Energy conservation strategies
Emotional regulation
Establishing routines that support well-being
Rest and Sleep
Sleep preparation routines
Positioning for comfort
Managing nighttime anxiety or pain
Education/Work
Participation in learning activities
Caregiver education and training
Paid employment
Volunteer work
Meaningful productivity
Leisure/ Social Participation
- Hobbies
- Creative activities
Spending time with family and friends
Maintaining roles (parent, spouse, friend, mentor)
Engaging in faith-based or community activities
Why Occupational Therapy Matters in Hospice
Hospice care primarily focuses on comfort and symptom management during the final stages of life. While this care is essential, occupational, emotional, and psychosocial needs are often overlooked.
People receiving hospice care frequently experience:
Physical changes that affect daily activities
Cognitive changes that impact participation and communication
Loss of routines, roles, and independence
Emotional, spiritual, and existential concerns
Despite these needs, occupational therapy remains underutilized in hospice. One major reason is limited awareness of what occupational therapists can offer at the end of life.
What Do Occupational Therapists Do in Hospice?
Occupational therapy in hospice is not focused on rehabilitation or “getting better.” Instead, it focuses on living meaningfully until the end of life. Occupational therapists work alongside the hospice care team to support both patients and families.
Services are individualized and may include:
Supporting meaningful daily activities
Helping individuals continue activities that reflect who they are, their values, and their life roles.
Adapting tasks and environments
Making changes to routines, tools, or surroundings to increase comfort, safety, and participation.
Preserving roles and relationships
Supporting connection with loved ones and maintaining a sense of identity during the end-of-life process.
Caregiver education and support
Teaching caregivers strategies to support daily activities, comfort, and meaningful engagement.
Life review and legacy support
Helping individuals reflect on their life experiences and create meaningful legacies for loved ones.
Occupational Therapy’s Role Within the Hospice Team
Occupational therapists collaborate with nurses, physicians, social workers, chaplains, and other hospice professionals to provide holistic, client-centered care.
This holistic approach allows occupational therapy to address needs that may otherwise be overlooked in traditional hospice care.