Dhwani Parikh gets great joy from giving people back their dignity and believes that is the gift an occupational therapist (OT) can offer people with a life-limiting illness.
“A terminal disease or aggressive cancer means clients can lose the ability to provide for their
own daily needs and care for themselves. Many feel they are losing their dignity and I have the
privilege and opportunity to give it back to them,” Dhwani said.
She fondly remembers a client with an aggressive lung disease who had been bedridden for four months before she met him. Breathlessness and anxiety had a big impact on his health and the thought of becoming breathless would provoke a panic attack. So, although Dhwani assessed that he had the strength to go to the bathroom, his mental state prevented it. Using her occupational therapy training, Dhwani was able to teach the patient some relaxation techniques and provide him with access to equipment, a referral to a physiotherapist (who worked on this breathing) and for a medical review to provide medication to address his symptoms.
“After a few weeks of intensive therapy, he was able to toilet himself and he was enormously grateful to us for that,” Dhwani said.
Fatigue can also impact a patient’s ability to participate in their own care so Dhwani might prepare a management plan that enables an individual to conserve energy for meaningful and enjoyable activities. This might mean using a wheelchair for shopping instead of walking so they can enjoy the shopping experience or plan their day differently, focusing on the things they love.
“Many people associate occupational therapy in palliative care with equipment prescription, but OT’s can provide a lot of non-pharmacology interventions to relieve pain, restlessness and anxiety,” she explained, adding that giving people back their dignity and enabling them to live well motivates her at work.
“Many think of medications for these symptoms first, but there are other options. OT’s work on symptom management and pain relief through different pieces of equipment like wedges, pillows, cushions and different styles of seating. We can also modify their routines so that medication is timed to enable more activity.
Dhwani says a lack of sleep can cause fatigue for clients and then this impacts their ability to participate in their own care. She regularly helps individuals formulate a healthy sleep environment and provides them with a relaxing pre-sleep routine.
People rarely talk about death and dying in Dhwani’s birth country of India, as followers of her Hindu religion believe talking about the end of life hastens it. Despite this, she found herself drawn to palliative care. She joined PCSE six years ago and now talks about dying every day.
“I was initially apprehensive about the role because I didn’t have any real personal experience of death amongst my family and friends and I wasn’t sure I could handle the pressures of the grief and loss process but I like to challenge myself so I thought I would give it a go,” Dhwani said.
“Palliative Care South East is not just about care for the actively dying but provides support and comforts proceeding through the trajectory of a life-limiting illness that becomes terminal.”
“I realised that I could have a significant impact on the person and family during this time and I began to feel a lot of satisfaction. I saw that something as small as being able to walk to the shower or sit up and feed themselves in bed can be a chore for our clients and that I could change this. I also realised that I had the right attributes – patience, compassion, kindness and resilience – to work in palliative care, which is such a challenging environment,” she said.
Working in a Culturally and Linguistically Diverse (CALD) region like the South East of Melbourne has a lot of opportunities to work with different cultures and religions and individuals who have different ideas about and approaches to death and dying.
“In the Hindu philosophy, which has a belief around reincarnation, if you have done bad deeds in a previous life then you will endure suffering for those deeds in your current life and it’s your Karma to endure that suffering to ‘pay’ for those deeds. Hindus believe that if you avoid it, you will get the suffering in the next life,” she explains.
Dhwani adds that when Hindus die at home, they believe the spirit of the deceased needs facilitation for spiritual freedom so it can look for another life.
“We never say Rest in Peace in my culture because we don’t consider that the soul does rest in peace.”
Since joining PCSE, Dhwani has completed a specialist palliative care postgraduate diploma at the University of Melbourne and researched end-of-life care in various Culturally and Linguistically Diverse (CALD) communities.
When not caring for clients, Dhwani can be found indulging her passion for Indian dance.
“As a palliative care clinician, it’s important to practice self-care and to maintain work life balance. My love for dancing, not only gives me an opportunity to exercise and remain fit, but also provides me with a way to release all of my stress, express negative thoughts and feelings and it is very therapeutic,” she said.
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