Palliative physiotherapy in community settings for people with terminal illness

BMJ Support Palliat Care. 2023 May 11:spcare-2023-004179. doi: 10.1136/spcare-2023-004179. Online ahead of print.

Abstract

Objectives: The need for palliative care is constantly growing worldwide. Palliative care is typically provided by a multidisciplinary team in community-based facilities. As part of this team, physiotherapists can effectively address prevalent symptoms, such as pain, breathing difficulties and reduced functional capacity. A few studies reported low physiotherapy services' utilisation by people who require palliative care. Israel was rated among countries having the highest level of palliative care integration in the array of basic medical services in a global survey. This study's purpose was to explore, for the first time, the scope of palliative physiotherapy treatments that home dwelling people receive in Israel.

Methods: A retrospective chart review of people who had been referred to home hospice care during the year 2019.

Results: A total of 1587 people were included in this study, of which only 34.7% received community-based physiotherapy treatments during the last 6 months of their lives. People treated by palliative physiotherapy usually received a short intervention of 1-3 treatments, with an average of 5.37 treatments. No differences were found regarding age, gender and geographical location in relation to metropolitan area between people who had received such treatments and people who had not. A high socioeconomic place of residence rating and the presence of chronic life-limiting illness or progressive neurological disorder significantly predicted the possibility of receiving physiotherapy treatments.

Conclusions: Future studies should explore the inhibiting and promoting factors for receiving palliative physiotherapy treatments, focusing on persons' comorbidities and their sociodemographic characteristics.

Keywords: Home care; Rehabilitation; Supportive care.