An issue that has been raised a few times throughout my rural placement has been physio’s role in palliative care. I have been asked on a few occasions to provide a falls risk assessment / mobility assessment on palliative and terminal care patients. I have at times struggled with this as in my mind, this is probably not a top priority for patients, especially if they are trying to sleep.
In the end I decided to reach a compromise. I introduced myself to one of the patients, told them what I was there to do, and gave them the option of wether or not they wanted treatment. On most occasions when the patient was sleeping I decided to come back later, however when it was evident the patient was awake I tried to do an assessment, but often didn’t really achieve even basic falls risk / mobility… in fact didn’t get past sitting. Obviously, like any patient care is warranted, and patients have the right to refuse this. The only thing I’m questioning are priorities.
Has anyone else come across a similar situation?
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I decided to follow this one up, as it was causing quite some distress. Having now spoken to a few more senior nursing staff, as well as my supervisor, I have come up with this solution: Physiotherapy is generally there to help if a palliative care patient is wanting to go home, for example if they just need to get strong enough to be able to walk from room to room and be in the comfort of their own home, surrounded by family and friends. We may be of help to give a strengthening program / provide walking aid. It is also useful for respiratory physiotherapy, however is not generally indicated for mobility or falls assessment or strengthening programs when the patient has come to hospital in the terminal stage.
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