At St John’s Hospice, it’s extremely important to us that we help ensure patients in palliative care are able to carry out the tasks and activities that matter most to them – and occupational therapy plays a key role in this process.
Gina Pavlo is a Specialist Occupational Therapist who has been working at St John’s Hospice for nearly nine years. Prior to that, she spent five years in the mental health sector on drug and alcohol units, working with people diagnosed with schizophrenia and anxiety.
Now, she finds solutions for patients whose lives have been turned upside-down by illness, helping provide an all-important continuity in their day-to-day activities. Here, in her own words, she paints a picture of what her work entails.
Occupational therapy means helping people do what’s meaningful to them
Being an occupational therapist is something very few people understand; because of the term ‘occupational’, they often think it’s about employment – but that’s not it at all. The way we see it is that we’re helping people do the things that bring them meaning in life – the things that are synonymous with someone’s roles and values; the things that make us who we are.
So, for example, if I was suddenly diagnosed with a terrible illness I could be cut off from all my roles – I have two young children, I have my husband, I have my work – and if I was suddenly in hospital having treatment, what would happen to my life? How would I manage all those things? That’s what we help with as occupational therapists.”
Our key role is problem-solving
How are we going to make this happen? That’s what we often ask ourselves. At the back of your head is the catchphrase: ‘the one chance to get it right’. That’s the headline. If a patient wants to go home, for example, there is one chance to make that happen and we have to pull out all the stops.
You solve problems on a daily basis. One of the community nurses just came rushing in earlier saying, ‘Can you get so-and-so a wheelchair? Her sister wants to take her out.’ We always do the best we can to help people accomplish their goals – it’s not always possible, but we always try.
We work with mental and physical health in a very holistic way
We make a comprehensive assessment of how people are managing, the things they aren’t managing and can no longer do, and who is doing those things for them.
Then it’s about what they’d like to do again. A lot of people, for example, hated cooking and doing laundry, so they’re quite happy to never do that again! But for people who work from home – I’ve worked with a lot of freelance writers, for example – we can empower them to continue doing that. So that means helping them understand fatigue management on a day-to-day basis. It’s always a very individual approach tailored to what each person is struggling with, but within the context of their environment and the support they already have.
We’re extremely focussed on patients’ needs
People surprise you all the time with what’s important to them and it’s our job to find a way for them to continue having that in their lives. So, in one instance, there were two men in a civil partnership who had been together for 61 years, and they were worried about the stigma and being judged if they went into a nursing home.
We had a great conversation with their carer about ways of supporting them when they’re home, and we were able to arrange for the patient’s partner to get on a train and go up to Birmingham to see his sister who is also at the end of life. The Hospice gave him that bit of respite from his carer duties to go and see another loved one. So a big part of the job is to look at how the patient’s illness is impacting others around them as well as themselves.
“We can be creative in how we meet those needs, as well. So if someone says, ‘I love animals’, then before you know it you have organised a day at the zoo and Chris Packham is coming along to make it that bit more special!
To me, the job is about building a rapport with patients
We really get to know the patients, and the Hospice always tries to go the extra mile. We had a young patient who had been volunteering for us when his mother died 10 years before, and then he was diagnosed with cancer and was spending his final few months here.
When we went through all the things that mattered in his life, he mentioned live music was something he loved. He spoke about all the bands he’d seen, and the only one he’d always wanted to see but hadn’t was The Who – because he’d been having chemo when they played in Hyde Park.
Then, by pure coincidence, there was a Teenage Cancer Trust concert in the Royal Albert Hall featuring The Who. The fundraising team pulled out all the stops to get him there. He had tickets in a box, but the icing on the cake was that the wife of another patient was the hairdresser for Roger Daltrey – the lead singer for The Who! So she called Roger and arranged for the patient to meet the band backstage. I was there, and seeing that happen was one of the greatest days of my life.
As an occupational therapist, you always feel like you were part of each person’s journey. You develop relationships with their family members. They’re more than just patients to us.