an inTeRlink feature
by Charles Sourby, CTRS
the patient who does not respond to treatment, or, who is
medically determined to be at the end stage of the disease
process, being admitted to a hospital or hospice is a common
for the patient at the terminal or end stage of cancer increasingly
involves an approach called palliative care.
palliative approach to treatment includes control of pain
and other symptoms while simultaneously addressing the individual
patient’s psychological, social, and spiritual concerns,
in an effort to provide the best possible quality of life
for the dying patient as well as his or her family.
care is the active total care of patients whose disease is
not responsive to curative treatment. Control of pain, of
other symptoms, and of psychological, social, and spiritual
problems is paramount. The goal of palliative care is achievement
of the best possible quality of life for patients and their
families. Many aspects of palliative care are also applicable
earlier in the course of the illness, in conjunction with
monumental, involving the search for meaning, confronting
fears, dealing with the loss of control, and issues of loss.
dying patient often experiences anger, guilt, disorganization,
isolation, and depression.
receiving palliative care need to socialize. Support is derived
from seeing others in similar situations. Research demonstrates
an elevated sense of hope and a better outlook following
social interactions with peers.
patient, often in pain, is to endure life’s final stages.
(In some cases the diagnoses is less than ninety days old.)
The patient receives palliative medical treatment and has
psychosocial needs addressed through contact support, compassion,
and comfort provided by a number of disciplines to help complete
life with dignity and grace.
The Role of the Recreation
Therapist who works in a Palliative Care Setting
1. To provide activities/programs/social
visits to residents commensurate with and appropriate to
their mental and physical status.
2. To inform, invite and
provide special escort to activities and programs of choice.
3. To modify activities/programs/social
visits offered to match resident’s mental and physical
4. To provide guidance to
staff as to appropriate recreational activities.
5. To provide guidance and
support to families as to appropriate recreational activities
to match resident’s status
6. To provide for “final
wish” opportunities to residents as tolerated and feasible.
7. To coordinate with care
plan team to provide maximum care.
Therapy is an effective intervention in Palliative Care involving
the search for meaning, confronting fears, dealing with the
loss of control, and issues of loss. Recreation Therapy addresses
the dying patient’s negative feelings; threats to self
esteem and help restore a sense of control, contributing
to an improved quality of life.
to treatment includes control of pain and other symptoms
while simultaneously addressing the patient’s psychological,
social, and spiritual concerns, in an effort to provide the
best possible quality of life. Therapeutic Recreation reduces
boredom, fosters a sense of accomplishment and enhances psycho-social
supports within the patient’s community.
W. & Holland, J.C. (1993) Psychiatric aspects of symptom
management in cancer patients, Washington DC, The American
Psychiatric Press. pp. 155-165
J.E. (1997) Commentary: Non-abandonment, physicians and
nurses as allies, New York, The American Journal of Hospice & Palliative
Care (Vol14 ) pp. 106-107
P. (1993) Balancing changing health care needs with the shortage
of quality health care professionals: Implications for therapeutic
recreation, Journal of Loss, Grief & Care, New York ,
Haworth Press. pp.15-21.
E. (1969) On death & dying, New York, Macmillan Publishing,
R. & Sokoloff, S. (1993) Clinical effectiveness in intensive
therapeutic recreation: A multiple case study of private
practice intervention. Journal of Loss, Grief & Care,
New York. 23-28.
Charles A. (1998), Barbara-Palliative Care, Journal of Therapeutic
B. A. (1988) Coping with cancer stress, The Netherlands,
Nijhoff Publishers, pp. 45, 86, 116, & 119.