Most people don’t think of physical therapy (PT) as part of end-of-life-care, but they should. It can ease suffering and improve quality of life for people receiving hospice care for a terminal illness that’s no longer being treated and for those getting palliative care for a condition still being treated.
So why should PT be considered for these individuals?
People with any life-threatening or terminal illness often have difficulty with activities of daily living. They may need assistance with eating, bathing and using the bathroom due to complications such as muscle weakness, uncontrolled pain and/or bowel or bladder dysfunction. Not being able to independently perform these daily tasks often strips patients of their dignity.
PT in these situations is called “palliative rehabilitation.” It can improve patients’ quality of life by helping them cope better with their disabling complications so that they can perform their daily living activities for as long as possible.
A physical therapist can help a person receiving palliative or hospice care by…
Controlling pain. Physical therapists can use physical manipulation to help control pain. Pain-relieving PT may include massage, the application of heat or cold, or the use of transcutaneous electrical nerve stimulation (TENS).
Improving or maintaining strength, flexibility and balance. Through aerobic and stretching exercises, patients can increase their cardiopulmonary capacity and endurance. Improvements in mood, self-esteem, as well as fatigue and nausea also were reported in a study of patients with advanced cancer.
Preventing falls. A physical therapist can help patients avoid falls by helping them maintain or improve muscle strength, joint flexibility, range of motion and balance.
Palliative rehab can be provided by physical therapists at home or in a facility such as a nursing home or hospital. In addition to PT, occupational and speech-language therapies are available to help patients with the use of adaptive equipment, such as “reachers” for items not easily accessible and therapies for swallowing difficulties.
These services may be covered by Medicare, Medicaid and private health insurers. Contact your insurance company for details on what your policy covers…and search the Palliative Care Provider Directory to find a provider near you.
Understanding the terminology
Unfortunately, there’s still considerable confusion over the meaning of the terms palliative care and hospice care.
Palliative care, which combines treatment for a life-threatening illness along with therapies to ease pain, emotional distress and other quality-of-life concerns, is typically used by people with heart failure, dementia, Parkinson’s disease, cancer and other serious illnesses. This type of care is often a collaborative effort among specially trained health professionals, including doctors, nurses and counselors.
Hospice care is provided for many of the same health problems, but only when the individual’s condition no longer responds to medical treatments to cure or slow a disease’s progression. Like palliative care, hospice provides pain relief and other forms of comfort care, but efforts to cure the person’s illness are halted. People who receive hospice care have been told by a doctor that they have a short time to live, typically less than six months. Hospice care, which can be provided in a person’s home or a facility such as a nursing home, is provided by nurses, doctors, social workers and spiritual advisers.