Is the process of helping a person with a progressive, often terminal illness reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. The primary goal of palliative care rehabilitation (PCR) is to promote independence in self-care activities, improvement in symptom control, stabilization of functional decline, and/or provision of emotional support.
PCR rehabilitation is described based on the patient’s anticipated recovery:
: attempts to preclude or mitigate anticipated functional morbidity from the underlying illness or its treatment for patients who often have no functional impairments yet.
: refers to the effort to return patients to their premorbid functional status when little long-term impairment is anticipated.
: attempts to maximize function after permanent impairments caused by an underlying illness and/or its treatment for which morbidity is anticipated to progress over time.
: pertains to the more conventional rehabilitation – it requires at least an hour per day of physical therapy and is delivered five days a week or more in a subacute care facility.
PCR can benefit that palliative care patients with progressive illness and pain, dysphagia, skin breakdown, muscle weakness, diminished endurance, and/or orthostatic hypotension.
Physical Therapists (PT), Occupational Therapists (OT), and Speech and Language Pathologists (SLP) can focus on different aspects of palliative rehabilitation.
• PT: manage muscle weakness, deconditioning, motor deficits, and pain. Interventions include stretching, muscle strengthening, provision of adaptive equipment, environmental modification, education on energy conservation, and therapeutic exercise. They play a role in caregiver education and on the use of equipment, body mechanics, and fall prevention.
• OT: improve or maintain performance with ADLs, work tasks, recreation, use of adaptive equipment, and discharge planning. OTs focus more on fine motor deficits than PTs. Specific OT interventions include home assessments, prescription of adaptive equipment, coaching in domestic tasks, stress management, and caregiver support.
• SLP: address oral-pharyngeal-laryngeal function and the cognitive components in communication. They assist with feeding and communication via vocal training, visual comprehension, tongue coordination techniques, and food management strategies.
See reference for more information.
Adapted from Javier NM, Montagnini M. The role of palliative rehabilitation in serious illness. Palliative Care Network of Wisconsin. Fast facts and concepts #364. Internet. Accessed on January 5, 2019.