Hospice and End of Life

Mueller, Karen Thudium; Wilson, Christopher M.; Briggs, Richard W.

doi:10.1016/b978-0-323-60912-8.00027-0

Cited by 3 publications

(3 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Briggs has constructed further models of physical therapy services in the palliative spectrum which include rehabilitation light , rehabilitation in reverse , case management , sk illed maintenance , and supportive care [ 15 ]. Skilled maintenance therapy is utilized when a patient is unable to complete an activity independently or with the assistance of a trained family member, thus requiring the skills of a licensed physical therapist [ 15 ]. With the inevitable functional decline and dependence present with a terminal diagnosis, the implementation of rehabilitation in reverse is of the utmost importance.…”

Section: Introductionmentioning

confidence: 99%

Acute Palliative Physical Therapy Services for a Patient With Metastatic Rectal Cancer and Subsequent Spinal Cord Compression

Huber

Wilson

2021

Cureus

View full text Add to dashboard Cite

Colorectal cancer is the third most common cause of cancer-related deaths with approximately 40%-50% of people diagnosed experiencing subsequent metastases. Surgery is the only curative treatment for colorectal cancer, although chemotherapy and radiation are often used neoadjuvantly or adjuvantly to decrease recurrence rates and improve survival. Many individuals experience adverse effects and physical impairments secondary to extensive medical treatment. Therefore, the purpose of this case is to signify the important role of physical therapy in the continuum of care of a patient diagnosed with metastatic rectal cancer and subsequent spinal cord compression. The patient was a 70-year-old male admitted to the hospital for lower extremity (LE) numbness and weakness secondary to metastatic rectal cancer. Seventeen months prior to hospitalization, he was diagnosed with rectal cancer and underwent neoadjuvant chemotherapy and radiation followed by laparoscopic abdominoperineal resection with posterior prostatectomy en bloc with a colostomy. Adjuvant chemotherapy included FOLFIRI. While hospitalized, the patient experienced spinal cord compression secondary to metastasis and elected decompressive laminectomy with discectomy for palliation. Due to the poor prognosis of metastatic rectal cancer, the patient's functional mobility and independence declined throughout hospitalization. The patient was able to achieve one of two personal goals; he was able to tolerate sitting in an upright position for his daughter's wedding but unfortunately did not return home prior to expiration. Although the patient suffered eventual mortality, consistent physical therapy allowed him to achieve a major life goal, serving as an important motivator and improved quality of life (QoL) even in end-of-life conditions. Unfortunately, physical therapy services are often overlooked and under-utilized in patients with terminal conditions receiving palliative care, despite the growing body of literature supporting the benefits. By utilizing rehabilitation in reverse as well as skilled maintenance, physical therapy assists in maintaining mobility and achieving personal goals of individuals with terminal cancer, thus improving QoL even with a poor prognosis.

show abstract

Section: Introductionmentioning

confidence: 99%

Acute Palliative Physical Therapy Services for a Patient With Metastatic Rectal Cancer and Subsequent Spinal Cord Compression

Huber

Wilson

2021

Cureus

View full text Add to dashboard Cite

show abstract

“…For example, in the concept of "Rehabilitation in Reverse," skilled physical therapy intervention focuses on energy conservation techniques and maintaining safe functional mobility for patients who are experiencing systemic decline. 4 Unlike many health care practitioners today, PTs are often afforded the luxury of spending an increased amount of time with patients both in frequency and duration of their care. Therefore, in addition to performing traditional physical therapy interventions and treatment techniques, PTs are able to engage in exploratory discussions on topics such as how these persons are managing at home, any difficulties or challenges encountered with daily activities, and anticipating barriers that may arise as a result of a forthcoming decline from the terminal diagnosis.…”

mentioning

confidence: 99%

“…One of the primary roles of PTs when treating persons with cancer who are receiving palliative or hospice care is to consider the differences between palliative approaches and traditional rehabilitative care. For example, in the concept of “Rehabilitation in Reverse,” skilled physical therapy intervention focuses on energy conservation techniques and maintaining safe functional mobility for patients who are experiencing systemic decline 4. Unlike many health care practitioners today, PTs are often afforded the luxury of spending an increased amount of time with patients both in frequency and duration of their care.…”

mentioning

confidence: 99%

Palliative Care Physical Therapy: The Challenges and the Opportunities

Patton

Wilson

2021

Rehabilitation Oncology

View full text Add to dashboard Cite

Physical therapists (PTs) and physical therapist assistants (PTAs) have a unique and crucial role in the lives of persons living with end-stage cancer, as well as in the lives of their family members directly or indirectly involved in their care. Physical therapy for this patient population focuses on maintaining or improving functional mobility, as well as aids in decreasing cancer-related fatigue, decreasing pain levels, and educating patients and their family members on the disease process including ways to prepare for and minimize declines they will likely face throughout the disease trajectory. In 2020, the National Hospice and Palliative Care Organization (NHPCO) Palliative Care Needs Survey Results Summary respondents reported that approximately 89 609 patients received palliative care services, an increase from 85 153 reported in 2017. 1 The NHPCO also reported that in 2018, there were 1.55 million Medicare beneficiaries enrolled in hospice care and 29.6% of these people had cancer as their principal hospice diagnosis. 2 Unfortunately, for much of this patient population, physical therapy services are underutilized, of which a contributing factor may be a limited understanding of the roles and contributions of PTs in this setting. According to the article "Oncologists' and Physiatrists' Attitudes Regarding Rehabilitation for Patients With Advanced Cancer" by Spill et al, 3 of the 395 medical oncologists returning surveys, only 8% said they would refer a patient with advanced can-Rehabilitation Oncology

show abstract

Policy Issues and Clinical Documentation

Wilson¹,

Litterini²

2021

Physical Activity and Rehabilitation in Life-Threatening Illness

View full text Add to dashboard Cite

Hospice and End of Life

Cited by 3 publications

References 59 publications

Acute Palliative Physical Therapy Services for a Patient With Metastatic Rectal Cancer and Subsequent Spinal Cord Compression

Acute Palliative Physical Therapy Services for a Patient With Metastatic Rectal Cancer and Subsequent Spinal Cord Compression

Palliative Care Physical Therapy: The Challenges and the Opportunities

Policy Issues and Clinical Documentation

Contact Info

Product

Resources

About