Physiotherapy in Palliative Care
Written by Mehakpreet Kaur - UPG Physiotherapist
As a physiotherapist, I often walk alongside my clients through their health journeys. Recently, I faced a particularly challenging situation with one of my clients, a woman diagnosed with lung cancer after battling COPD and asthma for years. Despite her previous progress with chest physical therapy, her condition took a significant turn, leading to an acute asthma attack and subsequent hospitalisation.
When she broke the news of her cancer diagnosis to me, tears filled her eyes as she questioned whether physiotherapy could still help her or if she should even attempt any exercises. At that moment, it was clear that she needed more than just physical support; she needed someone to listen to her and guide her through the emotional turbulence she was experiencing. This experience sparked a deep desire to understand palliative care better, and I now feel compelled to advocate for it and share valuable information with my colleagues, family members, and patients seeking guidance.
A simple way to understand palliative care is not synonymous with end-of-life care; it's a comprehensive approach that can enhance the quality of life at any stage of a life-limiting illness. It focuses on symptom relief and emotional support, ensuring that patients can live as fully as possible during their journey.
Approximately 100,000 of the 160,000 deaths in Australia each year are predictable, yet only 40,000 patients receive specialised palliative care. Those who do often experience fewer hospital visits and a better quality of life. As I learned more about the nuances of palliative care, I recognised the importance of understanding the disease trajectory. There are three common trajectories for progressive chronic illnesses: cancer (short decline), organ failure (intermediate with acute episodes), and dementia or frailty (gradual decline). Each trajectory requires a tailored approach to care, ensuring that patients receive the support they need as their conditions evolve.
As a physiotherapist, I understand our vital role in palliative care. My goal is to address not only my patients' physical needs but also their emotional, psychological, and spiritual needs.
When I returned to my patient, I implemented a rehabilitative approach focused on person-centred goal setting. Together, we identified her priorities, emphasising her desire to maintain independence and mobility for as long as possible. Using the Supportive and Palliative Care Indicators Tool (SPICT), I was able to pinpoint unmet needs and develop a plan tailored to her situation.
Regular physical function assessments helped me monitor her progress and recognise any signs of deterioration. Honest communication became crucial; I made it a point to discuss the realities of her condition while instilling hope. "It's okay to plan for the worst while hoping for the best," I reassured her.
Collaboration with an interdisciplinary team was another key component of her care. Recognising her need for emotional support, I informed her case officer about the importance of involving a psychologist for her mental well-being, a carer for daily tasks, and an occupational therapist for mobility aids like an electric scooter.
Early referrals to physiotherapy in palliative care can significantly improve patients' quality of life. We empower our patients to navigate their journeys with dignity and support by addressing their physical, emotional, and social needs. Through my experiences, I've learned that physiotherapy isn't just about movement; it's about providing holistic care that enhances the quality of life for those facing life-limiting illnesses.
For more detailed information on palliative care, including key guidelines, visit the RACGP's Silver Book: Palliative Care Guidelines. Additionally, for insights into the role of physiotherapy in palliative care, explore the Australian Physiotherapy Association's page on palliative care and ageing well.