On this page you'll find rationale and guidance on how to adopt a holistic, interdisciplinary approach to rehabilitative palliative care.
Background
All hospices should consider how they might embed a rehabilitative approach within palliative care services.
This enables people with life-limiting and terminal conditions to live as independently and fully as possible. It also allows hospices to respond to increasing demand for their services in a cost-effective way.
The Rehabilitative Palliative Care approach
Our publication ‘Rehabilitative Palliative Care’ offers a rationale and guidance for adopting this interdisciplinary approach. This integrates rehabilitation, enablement, self-management and self-care into the holistic model of palliative care.
The guide was developed with colleagues from St Joseph’s Hospice and St Christopher’s Hospice.
What is Rehabilitative Palliative Care?
Rehabilitative palliative care empowers people with life-limiting and terminal conditions to actively manage their condition themselves, live as fully as they can and enjoy the best quality of life possible until they die. It integrates rehabilitation, enablement, self-management and self-care into the holistic model of palliative care.
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- Person-centred: focusing support to best meet people’s goals and personal priorities
- Interdisciplinary and multiprofessional: all members of the palliative care team actively contribute to rehabilitative palliative care
- Supportive: it helps people anticipate and cope constructively with losses resulting from deteriorating health
- Enabling: it provides patients and their relatives or carers with enough support to empower them to manage on their own
- Empowering: it gives people greater independence, autonomy, choice and dignity
- Collaborative: between patients, relatives and carers and the multidisciplinary team
- About optimising people’s ability to function in the widest sense. This includes moving around, eating and enjoying food, communicating with others, managing activities of daily living and participating in meaningful activities.
- About living with dying
- Everybody’s business
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- About moving away from the ethos and values of palliative care. Instead it enhances these through the shared characteristics of rehabilitation.
- About ignoring dying or promoting false hope.
- Just about mobility and walking.
- The sole domain of allied health professionals: it involves everybody in the multidisciplinary team.
- Driven by the allied health professionals’ agenda: it should be led by patients’ priorities.
The importance of rehabilitative palliative care
Rehabilitative palliative care presents fresh thinking on how hospices can prepare to be fit for the future.
The demand for hospice support is forecast to dramatically increase over the next 20 years and the needs of the population that hospices support are changing. People are living longer, with (frequently multiple) chronic illnesses. These are often further complicated by increased disability, frailty and dependency preceding death.
Rehabilitative palliative care has the potential to reduce disability, and dependence on families, hospices and health and social care services. It helps to reduce costs by:
- Reducing the need for hospital admission.
- Supporting earlier discharge from hospital or hospice services.
- Decreasing or delaying the need for authority-funded care including admission to nursing or residential homes.
Implementing rehabilitative palliative care
‘Rehabilitative palliative care: enabling people to live fully until they die’ provides evidence of the benefits and effectiveness of rehabilitative palliative care. It also includes a range of resources to support its implementation.
The publication offers:
- 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.
- Examples of innovation and good practice in rehabilitative palliative care from across the UK.
- A checklist to engage hospice boards, senior managers and the wider multi-professional workforce. It will help them assess their readiness to adopt rehabilitative palliative care and guide tangible actions to implement it, both now and for the future.
Download the publication from the resources section below. Here you’ll also find the checklist as a separate document, infographics, and videos showing rehabilitative palliative care.
Acknowledgement
Thank you to the Burdett Trust for Nursing for supporting the development of the publication.
Patients' Perspectives and Priorities
St Joseph's Hospice patients talk about their perspectives and priorities for rehabilitative care.