The role of rehabilitation in patients receiving hospice and palliative care

Patients receiving palliative and hospice care experience high levels of functional loss, dependency on activities of daily living, and impairment in mobility. Physical disability affects important aspects of life, oftentimes leading to depression, poor quality of life, increased caregiver needs, increased health resource utilization, and institutionalization. Physical strength, the number of hours spent in bed, and the ability to do what one wants are important indicators of quality of life for patients with cancer and their families. Progressive debility with a sense of being a burden has been cited in the literature as a reason for desiring death among these patients. This perception of increased dependence on others serves as a strong predictor for a patient's interest in the physician aid in dying (PAD). This highlights the desire and willingness of most palliative and hospice care patients to remain physically independent during the course of their disease. Several studies have shown that maintaining the most optimal level of functional ability, especially mobility, for as long as possible is one of the main benefits of rehabilitation in the palliative and hospice care settings. Studies demonstrate that rehabilitation in patients receiving hospice and palliative care can reduce the burden of care for families and caregivers and improve patient's quality of life, sense of well-being, as well as control of pain and non-pain symptoms.