ADVERTISEMENT

• JOBS
• Free CE
• Geriatrics &
  Home Health
• Neurology
• Orthopedics
• Pediatrics
• Psychosocial Rehabilitation
• OT Toolbox
• HOME

Search Over 66 OT Jobs

State All States Alaska Arizona California Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas US - Multiple Locations Utah Virginia Vermont Washington Wisconsin Wyoming

Specialty All Specialties Occupational Therapist Occupational Therapist Assistant Occupational Therapist Manager Acute Health Geriatrics/Home Health Hand Therapy Outpatient/Orthopedic Pediatrics School/Community-based Therapy Other

Keywords

• Print This
• Select Text Size:
• Comments
• 

In Northwest Oregon, children and young adults find help coping with grief over the death of a loved one through a trailblazing program that lets them freely express feelings about an event that too often gets hushed up or steered clear of, even by health professionals. “Unfortunately, we’re in a society that avoids talking about death,” says Donna Schuurman, executive director of the Dougy Center for Grieving Children and Families, which operates three sites in Portland.

She says an important message conveyed during orientations is: “Don’t make grief an illness. It’s a normal response to loss.” She says an occupational therapist’s role is helping patients recover from losses, ranging from loss of a limb or physical function that requires rehabilitation, to the stressful effects of losing a job, a pet, or a home. However, a major challenge for OTs is learning to identify, understand, and help patients suffering more severe symptoms of loss because of grief from the death of a spouse, family member, or close friend.

Jana DeCristofana, MSW, coordinator of grief services at the Dougy Center, says the five stages of grief introduced by Elisabeth Kubler-Ross in her 1969 book, “On Death and Dying,” are still widely taught today and evolved from research conducted with patients at the end of life. Along the way, the model was re-worked into a way of explaining the grief process that in many ways is a myth, she says.

Although the emotions described by Kubler-Ross occur, most people don’t experience all stages of grief — shock, anger, protest, depression, and acceptance — and rarely in a linear sequence, she adds.

“Some people describe having all of these emotions, and more in the space of an hour, while others don’t experience them at all,” says DeCristofana, who has spent eight years helping kids and young people from age 3 to their late 20s navigate the grief spectrum. She says rather than dwell on a fixed model of grief, OTs should be good listeners and encourage the sharing of feelings and experiences that can speed the healing process.

One child, for example, depicted grief as a series of strong feelings coming and going like ocean waves, she says. A teen talked about how all of her emotions would suddenly back up like cars in rush hour, feeling stuck until she could hit an open stretch of highway.

“These participants make it clear that grief doesn’t unfold in a straight line, but rather ebbs and flows in different ways for everyone,” DeCristofana says.

“It’s not just the physical or emotional aspects of a loss [that] a therapist should be aware of, it’s also how to frame things,” Schuurman says, adding that an OT doesn’t have to give patients advice, but be sympathetic of their loss.

With unaddressed grief, a patient may refuse to cooperate, or react in ways that hamper a treatment goal, which an aware OT may be able to adjust.

However, Schuurman recalls a friend who died of cancer, and the friend’s 6-year-old son’s return to school. A sympathetic teacher e-mailed the boy’s father to say she was letting him do what he wanted for a while. It turned out to be disruptive for the class and it didn’t help the boy.

“You don’t let a kindergartner whose mother just died do what he wants,” she says. “It’s confusing; because what he really wanted was structure and direction. He didn’t want to be treated differently.”

Francis Waithaka, OT, says he joined a palliative care team at City of Hope medical center in Duarte, Calif., equipped to assist patients dying of cancer in performing tasks, as well as help them through personal grief experiences. “I found that grieving is a process that is different for everyone, and whatever stage a patient is in is the one I’ll work within,” he says.

For his master’s thesis, Waithaka did a paper on activities for end-of-life care that is helping him work with grief issues expressed by patients and their families. Such activities can be putting together a family history, painting a picture, finishing a pet project, or connecting with an old friend.

“I don’t set any goals, but let patients take the lead,” he says, adding that he may prompt them in certain directions, such as recounting positive achievements and good deeds that won’t simply vanish when they’re gone.

“Some of the stronger patients may set objectives, while others just want to be left alone to grieve in their own way,” Waithaka says. “Patients get angry, depressed, and ask, why me? Some hope for a cure, while others simply accept their fate. It’s a grieving process that takes a lot of endurance.” •

John Leighty is a medical writer for the Gannett Healthcare Group.

---

To comment, e-mail oteditor@gannetthg.com.

© Copyright 2009 Gannett Healthcare Group