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Interview with a palliative care OT

‘Today, I’m going to make someone cry’

When Cathy and I were friends at university in the late 80s, she was studying Law, I was doing English. Now, 35 odd years later – we are both working, in different ways, around death and dying.

I caught up with her to ask about her work as an Advanced Practitioner Occupational Therapist with clinical expertise in palliative care, dementia and delirium.

So what was your journey from law to this?

I was always drawn to it. I hated being a solicitor. I was bored. When I was 35, there was a day when I visited the Head Injuries Team at the City Hospital where I live, as part of my work, and met a group of OTs and physios. I remember saying. ‘I would love to do your job. I hate mine!’’ I have undertaken a PhD since I started, and I’m so glad I switched.

Tell me about the palliative work you do.

I do a lot of teaching to OTs and physiotherapists.

I work with patients and their families. I will seek to identify the wishes of person dying, for example, where do they wish to die? What matters to them most in the time they have left?

I talk to families about what to expect when their loved one dies. I warn them about the sounds they will make. I tell them they should regard those breathing sounds as being like snoring.

Tell me a few things about what you’ve learnt.

When people are dying, they become more of what they were – there are no great revelations.

People are forever changed by grief.

Grief is a healthy response, but angry grief makes the rest of your life harder. Sometimes I say to colleagues: ‘What I’m going to do this afternoon is make people cry.’. What I mean is, palliative care staff will want to get the grief moving, which means helping them move on.

Hospitals don’t empathise anywhere near enough with patients. It’s massive to do that – and it makes a huge difference to people just to say: ‘You’ve had an awful time of it’.

We draw on our own experience of loss. We learn from it and become sadder and wiser.  

Women dying who have children – that is really hard. There’s very little you can do to soften that. Ditto, for people losing a child.

But if a parent dies, you don’t have to make tragedy the centre of a young child’s life. They can be quite matter of fact and move on. It’s harder for older kids who understand more about what’s happening.

Do you enjoy your work?

I worried all the time as a solicitor. Now I mostly leave it behind when I finish work. People ask about the toll job takes. Most of the time it doesn’t. As long as I’ve tried my hardest. It’s astonishingly rewarding work. But, to be fair, there is a cumulative effect, which is why I want to retire at 60.

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