Interventions for Improving Leisure for Older Adults on the Palliative Pathway living with Advanced Cancer: A Qualitative Systematic Review

Introduction:
While occupational therapists (OTs) promote quality of life through meaningful occupation, little attention has been paid to the role that leisure plays in palliative care. This review aims to explore the perceptions of service users and OTs regarding engagement in leisure activities at the end-of-life.
Objective:
1. Determine the value of leisure activities for older adults living with cancer on the palliative pathway, 2. To identify interventions to promote occupational engagement.
Method:
A qualitative systematic review was conducted in accordance with the PRISMA Statement. The electronic databases namely ASSIA, AMED, CINAHL, Medline, PsycArticles, and PubMed were searched. Qualitative studies meeting the eligibility criteria were included. Two reviewers independently screened the identified articles. The findings were qualitatively synthesised using thematic analysis.
Results:
We included seven articles with 405 participants. This review demonstrated that leisure could help people in palliative care maintain a sense of identity and normalcy. Leisure also increased happiness and provided relief from pain. Occupational therapy interventions targeting leisure allowed people to maintain a consistent level of engagement.
Conclusion:
Further empirical research is required to explore palliative patients’ perspectives on leisure and to develop specific occupational therapy interventions that enable OTs to facilitate leisure engagement for people in palliative care.
Plain Language Summary
Why we conducted this review:
• There is little focus on engaging people in leisure when they experience palliative care and there is a big emphasis on managing symptoms of cancer.
• More and more people need palliative care due to the increasing ageing population who live longer with debilitating chronic illness.
What did We do:
• We systematically identified relevant articles and reviewed the literature from the past 14 years to understand the perspectives of older adults receiving palliative care on participating in leisure.
What did we find out:
• Older adults living with cancer value leisure activities because leisure gives them a greater sense of control over their lives, helps them to maintain a sense of normalcy, provides relief from pain, and increases feelings of happiness.
• Occupational therapists have the skills to enable people to participate in leisure by changing the way an activity is done or changing the environment.