Rehabilitative approach to palliative care a must for hospices

Categories: Care.

Rehabilitative palliative care empowers people with life-limiting and terminal conditions to actively manage their condition themselves, enabling them to live fully and enjoy the best quality of life possible.

A new report launched today by Hospice UK, St Joseph’s Hospice and St Christopher’s Hospice – ‘Rehabilitative Palliative Care: Enabling people to live fully until they die’ – guides and challenges hospices to place greater emphasis on this interdisciplinary approach, which involves all members of the team, including nurses, doctors, psychosocial practitioners and allied health professionals, working collaboratively with the patient, their relatives and carers to support them to achieve their personal goals and priorities.

It also suggest that this approach will allow hospices to respond to increasing demand for their services in a cost-effective way.

According to the report, rehabilitative palliative care can be brought to life in hospices in a number of different ways including:

  • identifying what is important to each person by actively exploring their personal goals for living
  • supporting and encouraging people to take responsibility for their own health and wellbeing and teaching them strategies to achieve this
  • creating an “enabling culture” of support where people are given choice and opportunities to do things for themselves wherever possible

The report also highlights simple practices that can support people living with life-limiting and terminal conditions to maintain a normal daily routine, which can help improve their overall wellbeing. These include encouraging patients to get dressed in their own clothes every day, rather than pyjamas (to reduce the ‘sick role’ experience), sitting out of bed for all meals (to support safe swallowing and normality) or maintaining the amount of walking usually done at home (to keep active).

Commenting on the report, Dr Ros Taylor MBE, national director for hospice care at Hospice UK, said:

“For too long, healthcare has focused on solving problems and symptoms, rather than on what really matters to the person who is ill.

“A rehabilitation approach to palliative care is central to the person-centred ethos of hospice care, and this new report will encourage hospices to promote a culture that helps patients to thrive, not just survive, when faced with uncertainty and serious illness

“The benefits of this approach are huge, not only for patients and their families but for hospices too, as they seek to respond to the challenges of supporting more people living longer with chronic conditions.”

Rebecca Tiberini, specialist palliative care physiotherapist at St Joseph’s Hospice in east London and co-author of the new report, added:

“Think for a moment about what is important in your life – the things you would like to be able to do for yourself right up until you die. This is what rehabilitative palliative care is about.

“It involves identifying what is important to each person, optimising their ability to do things for themselves and providing support in a way that maintains a sense of independence, choice and control. This might be as simple as walking up to the toilet on your own or maintaining your personal care. It might mean going to the park with your family or making your partner a cup of tea.

“When living with a serious illness, small things take on very big meaning. Rehabilitative palliative care puts people and families in the driving seat to enable and empower them to live life fully until they die.”

The new report includes:

  • an insight into patients’ personal priorities for care
  • a range of professional perspectives on how a rehabilitative approach can best support patients’ goals and aspirations to live life fully
  • an assessment of the economic value of rehabilitative palliative care
  • hospice examples of innovation and good practice in rehabilitative palliative care
  • a checklist to engage hospice boards, senior managers and the wider multiprofessional workforce to assess their readiness to adopt rehabilitative palliative care and guide tangible actions to implement it.

Visit the Hospice UK website for further details.

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