Hospice care aims to improve the quality of life for terminally ill patients who have exhausted all medical treatments. Typically, these patients have a life expectancy of six months or fewer, and the hospice program can help them accept their impending death with compassion. It is intended to be a reassuring, compassionate setting for the patient who has had significant medical therapy and whose treatment team has ruled out a cure for their ailment and, maybe, their ability to live comfortably.
Physical Therapy in a Hospice Setting
Physical therapy for hospice patients is a growing trend, as it can increase their functional ability and make it simpler for them to navigate their environment safely. Physical therapy for hospice patients, unlike physical therapy for individuals in their prime, focuses more on giving comfort for their physical challenges near the end of life. Physical therapy can aid hospice patients in several ways, including applying therapeutic measures such as heat, cold, and massage. Physical therapy is also effective for pain management and overall comfort enhancement.
Physical therapists collaborate with physicians, nurses, social workers, psychotherapists, and trained volunteers in a multidisciplinary hospice setting. To encourage team interaction, the physical therapist must be a team member with well-developed clinical skills and excellent communication. They must be sensitive, caring, and aware of their function on the patient's treatment team throughout their final months of life.
In a hospice setting, physical therapists are responsible for the following:
- Pain management
- Arrangements to prevent bedsores
- Facilitate respiration and digesting
- Energy conservation techniques
- Therapeutic activity
- Management of any edemas Recommendations for medical equipment
- Home modifications
As hospice patients' health declines, their needs will change. For instance, they may need to teach an unsteady patient how to walk with a cane and instruct family members to aid with their balance. Eventually, the patient may require a walker, followed by a wheelchair or bed. As the patient's health deteriorates, the physical therapist must treat them with the decency and respect they deserve to comfort and relieve their discomfort.
According to the American Physical Therapy Association, physical therapists are movement experts whose mission is to improve a person's quality of life through prescribed exercise, hands-on care, and patient education. They teach patients how to prevent or manage illnesses to achieve long-term health advantages. Physical therapists design individualized programs for hospice patients to maximize their remaining quality of life.
Physical therapists devise a treatment plan, including techniques to help patients to move more freely while minimizing pain, restoring function, and preventing additional disability.
Benefits of PT in Hospice
The goals of physical therapy for patients receiving hospice care are:
- Symptom management
- Comfort management
- Optimize remaining functional capacity
Provide education for caregivers. Contribute to interprofessional team communication.
As functional abilities, duties, and expectations wane gradually, physical therapists in hospice care assist patients in maintaining their sense of self, achieving comfort, and maximizing their remaining capacities.
In a hospice setting, a physical therapist can assess a patient's capacity to move around safely, identify obstacles, and assist with walking and getting out of bed.
They can also assist with transfers from chair to bed, wheelchair to the bedroom, and wheelchair to the automobile. These therapists analyze the patient's pain level and then administer pain-relieving therapy. Depending on the circumstances, specific treatments may incorporate strengthening exercises.
The function of the Therapist
The physical therapist's involvement in hospice care differs from their work as a rehabilitation team member. To tailor their services to the hospice care industry, physical therapists must make critical job adjustments. NIH research indicates that physical therapists assist in caring for hospice patients by shifting from a controlling to a problem-solving and listening role.
Therefore, therapists may:
- Assist the patient for as long as possible in retaining functioning capacities.
- Reduce the caregiving strain for all involved caregivers, including close family and friends.
- Assist with pain management.
- Offer hospice nurses vital support in caring for their patients.
Physical therapists play a vital part in the hospice care team when it comes to providing direct patient care, providing essential services such as:
- Pain management and relief
- Positioning to prevent pressure ulcers, alleviate pain, prevent contractures, and facilitate respiration and digestion.
- Endurance training and energy-saving strategies
- Instruction in gait, transfers, safety, and stair climbing
- Physical therapy exercises
- Management of edema, a condition characterized by an excess of water in the body
- Equipment recommendations, training, and modification
Home modifications (if necessary)
One of the more extensive parts of being a PT in a hospice care setting is taking on the educator role. Education may involve teaching the patient to move efficiently and safely, of course, but also educating the patient’s caregivers they can get to know the routine. Physical therapists, as with many hospice care team members, may also take on the role of counselor, bringing strong communication skills to each interaction. Many PTs have perfected the art of active listening.
Yes, PTs help with injury avoidance, resolve safety hazards, and relieve their patients pain relief. But they also have another job to do that often involves restoring the sense of self of their patient. To face death with dignity and self-respect can significantly impact quality of life, while reducing the frequency of nursing and social worker visits and preventing the possibility of damage. As a result, physical therapists frequently increase the dignity and quality of life of their patients in an effort to promote a healthy existence till death.