title: "Running Water Won't Freeze": How people with advanced Parkinson's disease experience occupation.
abstract: OBJECTIVE
  Parkinson's disease (PD) is a progressive neurodegenerative condition often resulting in significant disability and impacting on one's ability to participate in an occupation. The present study aimed to explore how people with advanced Parkinson's disease experience the phenomenon of occupation in their daily lives in order to inform the practice of occupational therapy in palliative care.
  
  
  METHODS
  Using a phenomenological approach, in-depth interviews were undertaken with a purposive sample of 10 people in the advanced stages of Parkinson's disease. These interviews were audiotaped, transcribed verbatim, and subsequently analyzed using a thematic content analysis approach. The study received approval from the relevant university ethics committee, as well as the research network of Parkinson's UK.
  
  
  RESULTS
  The experience of occupation emerged as being physical, psychological, social, and spiritual with related subthemes. Within each of these themes, participants described their experience of occupation that they valued and that were important to their daily lives. They also identified the strategies they employed to continue participating in certain occupations and described others they were no longer able to engage in and the impact of that loss.
  
  
  CONCLUSIONS
  Participants' experiences crossed the domains of palliative care and suggest that adopting a palliative care approach would enhance an enhanced quality of life, experienced in terms of meaningful and valuable occupation. Disruption to participation in occupation caused them distress and frustration, suggesting that access to occupation-focused therapy would significantly improve quality of life for people with PD. As there is a strong link between the ethos of occupational therapy and palliative care, it is proposed that there is a valuable role for occupational therapy intervention to play within palliative care.
authors.affiliation: University of Ulster, Institute of Nursing and Health Research,Jordanstown,Northern Ireland,United Kingdom.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Murdock
authors.affiliation: University of Ulster, Institute of Nursing and Health Research,Jordanstown,Northern Ireland,United Kingdom.
authors.forename: Wendy
authors.initials: W
authors.lastname: Cousins
authors.affiliation: University of Ulster, Institute of Nursing and Health Research,Jordanstown,Northern Ireland,United Kingdom.
authors.forename: W George
authors.initials: WG
authors.lastname: Kernohan
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods / Q000523:psychology*; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D036301:Qualitative Research; D011788:Quality of Life; D029181:Spirituality
keywords: Occupation; Palliative care; Parkinson's disease; Phenomenology