Download Slide 1

Physiotherapy in
Palliative Care
WHAT PALLIATIVE CARE
DOES.
• Affirms life and regards dying
as a normal process.
• Neither hastens or
postpones death.
• Provides relief from pain and
other symptoms.
• Integrates the psychological
and spiritual aspects of
patient care.
• Offers a support system to
help patients live as actively
as possible until death.
• Offers a support system to
help the family cope during
the patient’s illness and in
their bereavement
ROLE OF A.H.P.’S
• Therapists adopt a patient centred approach
while working as part of the multidisciplinary
team.
• Patients with palliative care needs represent
complex and challenging health care
problems. AHP interventions aim to improve
mobility, nutritional status, communication
and restore confidence in every day living.
• AHP’s assess each individual to establish where they
are within the disease process, ascertain the patient’s
understanding of this and how this relates to their
personal situation.
• AHP’s subsequently tailor interventions according to
each individuals situation, stage of illness and wishes
by setting achievable treatment goals that foster
hope, independence, control and quality of life.
• Physiotherapy is concerned with the care
management and rehabilitation of patients from
diagnosis to the end of life.
• Palliative care physiotherapy differs from
conventional rehabilitation by virtue of the
certain knowledge that all patients will decline
during the period of care.
• The time and course of the decline can vary
considerably; some patients grow
progressively weaker, some remain on a
plateau for weeks or months and then decline
suddenly, some remain active until death.
CONDITIONS SEEN IN
PALLIATIVE CARE
• Cancer
• End stage cardiac
disease
• End stage
pulmonary disease
• End stage renal
disease
• MND
• Progressive
cerebellar atrophy
• MS
AIMS OF PHYSIOTHERAPY
• Maintain optimum
respiratory function
• Maintain optimum
circulatory function
• Prevent muscle atrophy
• Prevent muscle
shortening
• Prevent joint
contractures
• Influence pain control
• Optimise independence
& function
• Increase confidence
• Educate carers
Fostering a Different Image.
• A common image of physiotherapists is that of
someone who pushes people in to doing things they
don’t want to. Patients may have this perception and
the therapist needs to work to create an image that,
through encouragement and enabling, will achieve
highly beneficial results.
• Patients may have unrealistic expectations about
what physiotherapy can do for them.
• Therapists can spend a considerable amount
of time relating closely to patients & may be
drawn into situations involving difficult
questions. Therapists need good
communication skills and may train in
counselling skills.
Clinical reasoning should be modified by the
patient’s goals, be realistic & identified by the
patient, coupled with a calculated
professional input from the therapist.
• Rehabilitation has been described as the
restoration of a patient to a person.
• Palliative care rehabilitation at its best is the
transformation of the dying into the living.
Oxford Text of Palliative Medicine.