Physiotherapy in palliative care– - Stockholms sjukhem

problems increase and the possibility to aid the patient with better symptom relief and a betterquality of life improve.Palliative care can be divided into an early and a late phase. In the early phase the cancer hasspread but is responding to the tumor specific treatment. The goal is then quality of life and toprolong life. Patients may sometimes live several years with the disease, for example withbreast- or prostate cancer. In the late phase the tumor specific treatment has stopped and thisphase is often just a few weeks or sometimes months. The goal for this phase is quality of lifeand not life prolongation.(3) Also during this phase radiation therapy can be given to relievepain.Palliative care has its roots in the modern hospice movement initiated by Dame CicelySaunders. She was an English nurse, social worker and later physician who in her work foundthat the patients did not just have physical pain but also psychological, social and existentialproblems. She founded St Christopher’s hospice in London 1967. Apart from being the firsthospice it was also the first educational and research unit in this subject. The goal was toimprove the condition of life of the dying person and the family. Cicely Saunders work inspiredothers to follow and today there are followers throughout the world including Sweden.The quality of life of the patientWhen cure is unlikely the patient can get help to maintain and if possible improve the quality oflife. The physiotherapist has an important role to complement palliative care treatment with avariation of symptom relief activities and thus keeping/improving the patients bodily functions.When a person is seriously ill the awareness of how important the physical body is for allexperiences and emotions becomes obvious. The state of the body decides what the patient cantake part in and do in everyday life.The state of the patient can vary considerably from day to day. Patients tell how stressful it is tosee the body change and how the illness has made them more vulnerable as to how their body istreated and cared for by others.(4) To be touched on the body in an emphatic way can givesatisfaction and confirmation.When the illness progresses the physiotherapeutic contribution can still be important and thecontact with the patient is of course easier if there has been an earlier relation with the patient.Examples can be passive movements, massage and showing positions of rest. Advice andsupport to families and personnel can be given.Physiotherapy in palliative care – a clinical handbook Ulla Frymark, Lilian Hallgren, Ann‐Charlotte Reisberg 8