Abstract: This blog entry reflects on my experience as an occupational therapist treating a terminally ill patient and my lack of understanding of a doctor's and a palliative care team’s perspective.

What happened:
I once treated a deteriorating patient diagnosed with gall bladder cancer. She did not know her diagnosis or prognosis and asked for rehabilitation to go home. Her relentless efforts to mobilise were not rewarded as she became progressively weaker and she asked me several times what was wrong with her. I asked the doctor responsible for her care to see her to answer her questions but he told me that things must have been explained to her, because the palliative care team had seen her, and he therefore deduced that she must have memory problems. A mini-mental state assessment revealed no memory impairments so I read through her medical records and was unable to find any notes to say that anybody had explained her diagnosis and prognosis to her. When I presented this information to the doctor he told me that just because something had not been documented, that did not mean it had not been done. I then contacted the palliative care team. They told me that the patient’s daughter had asked them to withhold information about diagnosis and prognosis to avoid upsetting her mother.