Palliative Physical Therapy

Physical therapy plays a special role in hospice care, as it maximizes functional ability and comfort to enhance quality of life, assures patient and caregiver safety, and provides support around physical, emotional and spiritual issues people face as they near the end of life, according to the Indian Journal of Palliative Care.

What is a Physical Therapist?

Physical therapists are movement experts whose job it is to enhance the quality of life of a person through prescribed exercise, hands-on care, and patient education, says the American Physical Therapy Association. They teach patients how to prevent or manage their condition in order to achieve long-term health benefits. In the case of hospice patients, PTs design their programs customized to each individual in order to optimize the remaining quality of life.

PTs develop a plan, utilizing treatment techniques to allow the patient to more freely move while reducing pain, restoring function, and preventing further disability.

Value of PT in Hospice

Physical therapy for patients receiving hospice care has these common goals:

Symptom control
Comfort control
Maximize remaining functional abilities
Provide caregiver education
Contribute to interdisciplinary team communication

In hospice care, physical therapists help patients maintain self-identity, achieve a comfort level, and best utilize their remaining abilities as the gradual decline in functional abilities, roles, and expectations happens.

In the hospice setting, a physical therapist can evaluate a patient’s ability to move around safely, determining what problems they have in doing so, and assisting with walking and getting in and out of bed.They can also help them safely transfer from chair to bed, from wheelchair to bedroom, or from wheelchair to car. Such therapists assess the patient’s level of pain, then provide therapies that help to reduce pain. Some therapies may include strengthening exercises, which can be determined on a case by case basis.

Role of the Therapist

The role of the physical therapist in hospice care differs from that of the therapist as a member of a rehab team. There are fundamental role changes physical therapists must implement to gear their services toward the hospice care sector. Physical therapists contribute to the care of the hospice patient, as they change from a controlling role to a role of problem solver and listener, points out a study by the NIH.

Thus, therapists can:

Assist the patient in maintaining functional abilities for as long as they possibly can.
Reduce the burden of care for all caregivers involved, including close friends and family members.
Assist in pain control.
Provide hospice nurses with valuable assistance in caring for their patients.

When it comes to delivering direct patient care, physical therapists play a major role in the hospice care team, providing such key services as:

Pain management and relief
Positioning to prevent pressure sores, lessen pain, prevent contractures, and help with breathing and digestion
Endurance training and energy-conservation techniques
Gait training, transfers, safety instruction, stair climbing
Therapeutic exercises
Management of edema, a condition characterized by an excess of water in the body
Equipment recommendations, training and modification
Home modifications (if necessary)

Perhaps one of the bigger parts of being a PT in a hospice care setting is taking on the role of educator. Education may involve teaching the patient to move efficiently and safely, of course, but to also educate the patient’s care givers so they can get to know the routine. Physical therapists, as with many members of the hospice care team, may also take on the role of counselor, bringing strong communication skills to each interaction. In fact, many PTs have perfected the art of active listening.

Yes, PTs help with injury avoidance, resolve safety hazards, and bring pain relief to their patients. But they also have another job to do and that often involves restoring the sense of self of their patient. To face end of life in dignity and self-respect can make a hug difference in quality of life, while decreasing the frequency of nursing and social worker visits and avoiding the potential for injury. As such, physical therapists often enhance the dignity and quality of life of patients with the goal of promoting a healthy life until death comes.