Promoting the role of physiotherapy in palliative care

How can physiotherapy techniques help hospice patients?

Palliative care is intended to offer support, relieve pain, reduce physical symptoms, and maximize quality of life and physical functioning for someone dealing with a serious or life-threatening condition. Contrary to popular belief patients receiving palliative care do not necessarily have fatal conditions. They may also be receiving curative care concurrently. A palliative care team can encompass many different medical professionals, including physiotherapists.

Why is physiotherapy used in palliative care?

Physiotherapy is most often associated with rehabilitation, with the aim of improving someone’s physical functioning, strength, and capability. In many scenarios involving patients under palliative care, physiotherapy is actually used to maintain, rather than actively improve, a patient’s physical condition. For example, it can slow or prevent the loss of muscle tone and body function that results from being inactive or confined to bed for long periods of time. Physiotherapy can also ease pain and other symptoms like difficult breathing, weakness, and fatigue.

Read more: What does physiotherapy treat?

A physiotherapist’s role in palliative care

The role a physiotherapist plays as part of an overall palliative care team is to help patients maintain and sometimes improve their physical functioning, reduce their pain or help them manage it, and hold onto some degree of independence.

How physiotherapy helps hospice patients

Physiotherapy can help hospice patients in a variety of ways, by easing their pain and allowing them to live more fully, no matter the stage of life they are in. Depending on the patient’s condition and abilities, treatment options may include assisted exercises, massage, swimming or hydrotherapy, thermal (heat and cold) therapy, electrical stimulation (TENS), and support with assistive devices such as canes or walkers. The results that can be achieved speak for themselves.

Read more: 8 signs it may be time for physiotherapy

Improved quality of life

By helping to manage symptoms and relieve pain, physiotherapy improves hospice patients’ overall quality of life. A palliative physiotherapy approach is patient-led and tailored to the individual’s condition and capabilities, helping them feel more positive and confident about what they are able to do.

Pain relief

Physiotherapy has repeatedly been shown to ease the pain that hospice patients experience. This is one of the driving principles of palliative care. For some patients, this may be the most appealing reason to try physiotherapy.

Reduce stiffness

If a patient is confined to bed or a chair all day long, they may find that their body will feel stiff. Regular visits to a physiotherapist and properly supported positioning can prevent and treat this. Physiotherapy can keep your joints loose and your muscles accustomed to movement.

Read more: Knee osteoporosis and physiotherapy

Improved mobility and range of motion

People in hospice care may require assistance sitting up, turning over, getting into and out of bed or a chair, walking, or visiting the bathroom. With regular physiotherapy, patients may be able to maintain greater mobility even as their condition progresses or worsens, thereby increasing their range of motion and, consequently, their independence.

Anxiety management

Patients in hospice care may experience high levels of anxiety, whether brought on by pain, symptoms, or fear about how their condition might develop. Physiotherapy (and massage therapy in particular) can help manage anxiety.

Read more: Why physiotherapy offers more than just pain management

Conserve energy

Hospice patients may be ordered to spend most or all of their time in bed. Passive movements assisted by a physiotherapist help maintain their range of motion and loosen tight muscles while allowing them to conserve their energy for actions that require it, like sitting up, turning over in bed, or during visits with family.

Lowers risk of injuries

Limiting physical activity can increase the risk of injuries, including falls, sprains or strains. These may happen when a patient exerts themselves. Regular physiotherapy can help hospice patients maintain a baseline level of physical fitness that lowers their risk of getting hurt by improving muscle tone, flexibility, and balance.

What hospice patients can expect out of their treatment

We often think of physiotherapy as a strictly rehabilitative treatment. But for hospice patients, improving their condition may not be a reasonable or realistic expectation, nor may it be the goal. Physiotherapy can still help. What such patients can expect from physiotherapy may include decreased pain, better symptom management, and the ability to maintain more physical capability for a longer period of time than they would have without any treatment.

If you or a loved one is beginning to receive palliative care or treatment, do not be afraid. You won’t necessarily be forced to endure pain or hours of stillness. Having access to physiotherapy treatment while in hospice can vastly improve a patients’ mood, outlook, and quality of life. Thus, ask your palliative care professional how you can take advantage of physiotherapeutic treatment.

Michael McCreight, Registered Physiotherapist

Mike is an experienced and talented physiotherapist who holds a BSc in human kinetics and an MSc in physiotherapy. He doesn't believe in a “one-size-fits-all” approach and is committed to providing client-centred care, tailoring each treatment plan to each patient’s unique needs and personal goals.

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