I was asked to help manage swelling in a woman’s legs. She was living in a private assisted living home with 24/7 care and was already enrolled in hospice. The referral was for edema management. Compression. Comfort. Support.
What unfolded over time became something deeper.
Once her swelling was under control and she was wearing appropriate garments, discharge would have been reasonable. Instead, her daughter asked if I could continue coming. She shared that her mother seemed to enjoy my presence. That the visits mattered.
So I stayed.
Over the months, her cognitive status declined. Words became fewer. Awareness shifted. But one thing remained consistent. Each time I arrived, I asked her a simple question.
“Is it okay if I help you today?”
She always answered the same way. A gentle nod. Yes.
Our sessions became quieter. Slower. Less about intervention and more about comfort, routine, and dignified touch. I provided gentle manual therapy, mindful positioning, and calm presence. I spoke softly. I explained what I was doing, even when I wasn’t sure how much was understood.
Because consent still matters.
Because dignity still matters.
Because care does not stop when rehabilitation goals change.
I worked closely with her family as they transitioned further into their caregiving roles. We talked about what support looked like now. What mattered most in this season. How comfort, familiarity, and human presence can be therapeutic in ways that don’t show up on outcome measures.
I saw her every two weeks for almost a year.
About a week before she passed, I completed my final visit.
This experience reinforced something I believe deeply. Occupational therapy belongs in end-of-life care.
Not to fix.
Not to restore.
But to support comfort, routine, consent, and quality of life.
Occupational therapy at the end of life is not about productivity or progress in the traditional sense. It is about meeting people where they are. Honoring who they are. And recognizing that presence itself can be skilled, intentional care.
End-of-life care is still care.
And occupational therapy has a meaningful place in it.
