The restorative power of physiotherapy in palliative care in Bangladesh

Categories: Care.

“I am very happy with your service. You are doing a great job! I never thought I could move my limbs. With your physiotherapy care, now I can move my hands and feet and also can stand from sitting position.” These were the words of Md. Ripon, a 40 year old man accessing palliatyive care through the Compassionate Narayanganj project in Narayanganj, Bangladesh.

The project aims to build a compassionate community for palliative care in Narayanganj.

Physiotherapy is a new component which has been included in this project recently. After noting concerns with patients with chronic stroke, and children with cerebral palsy, the project staff recommended that patients with neurological disorders including hemiplegia, paraplegia or facial palsy, would benefit from physiotherapy treatment. Now, around 68 registered patients are receiving physiotherapy care through the project.

To make sure each person accesses the care they need, the palliative care team works together. After finishing patient’s assessment, we confirm the diagnosis then draft a treatment plan according to their condition.

First, we communicate to the patient to inform and educate them about the condition. Following this, we educate them on positioning and exercise. We provide knowledge about proper positioning which is very much important for our patients. Range of motion and active assisted exercise are provided by us to betterment of our patients.

The involvement of the Palliative Care Assistants  and the patient’s carer is essential to achieve the best results.

In the community, we don’t have proper equipment but this doesn’t stop us. We improvise, using what we have around us, usually sand bags, packets of salt, or water bottles as weights to strengthen the muscle power of our patients.

We can’t change their environment, so we try to modify this. We teach our patients about work simplification because in palliative care setting, physiotherapy is not only symptom management technique, it also try to fulfil physical, mental, social and spiritual requirements.

When we visit our patient, we try to encourage them to do their exercise regularly, and to manage without the support of their carer, which can be very difficult. So we try to help our patients and their family to deal with their condition so that they can live with the illness the best that they can.

Palliative care is a multidisciplinary approach and the concept of rehabilitation is becoming more widespread. Physical therapists, as part of the interdisciplinary team, tries to improve the quality of life in palliative care patients.

Compassionate Narayanganj is a unique collaboration between Bangabandhu Sheikh Mujib Medical University (BSMMU), The Worldwide Hospice and Palliative Care Alliance (WHPCA) and Narayanganj City Corporation (NCC) to build a compassionate community for palliative care. This project is funded by UK Aid Direct.

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