The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada

2016 ◽  
Vol 34 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Christopher M. Wilson ◽  
Christine H. Stiller ◽  
Deborah J. Doherty ◽  
Kristine A. Thompson
Keyword(s):  
United States ◽  
Palliative Care ◽  
Data Analysis ◽  
Physical Therapy ◽  
Physical Therapists ◽  
The United States ◽  
Direct Patient Care ◽  
Life Threatening ◽  
Hospice And Palliative Care

Purpose: Little is known regarding the extent to which physical therapy is integrated into Hospice and Palliative Care (HPC). The purpose of this study was to describe perceptions of physical therapists (PTs) regarding their role within HPC or working with patients having life-threatening illnesses and to develop a conceptual framework depicting a PTs role within HPC and factors affecting it. Participants: Ten PTs, 5 from the United States and 5 from Canada, with at least 5 years of physical therapy experience and 5 years working experience with patients having life-threatening illnesses or in HPC. Methods: Demographic data were collected by electronic questionnaire. A semistructured interview was conducted with each participant to investigate their perceptions about the role of PTs in HPC. Data Analysis: Interview results were analyzed for trends between participants, practice settings, regions, and other sociocultural aspects. The constant comparative method of qualitative data analysis was used to identify similarities and differences and to develop themes and concepts relative to the role of PT in HPC. Results: Participants identified their 3 primary roles in HPC: providing patient/family care, serving as an interdisciplinary team member, and fulfilling professional responsibilities outside of direct patient care. They described factors within and outside direct patient care which influenced their roles. Concepts included shifting priorities, care across the continuum, and changing perceptions of PTs within HPC. Clinical Relevance: This study described perceptions of the role of PTs within HPC that may be utilized when coordinating future strategies to appropriately promote and expand the role.

Volunteering in the United States of America

2018 ◽  
Author(s):  
Greg Schneider
Keyword(s):  
United States ◽  
Palliative Care ◽  
Patient Care ◽  
United States Of America ◽  
The United States ◽  
Care Quality ◽  
Direct Patient Care ◽  
Hospice Movement ◽  
The Usa ◽  
Hospice And Palliative Care

Hospice and palliative care volunteering in the United States of America (USA) has changed dramatically since its inception in the late 1960s. Inspired by physician Dame Cicely Saunders, the modern hospice movement officially began in the USA in 1971 with Florence Wald founding the first hospice, Hospice, Inc., a non-profit in New Haven, Connecticut. Then in 1983, the US Congress established the Medicare Hospice Benefit, whose Conditions of Participation (CoPs) mandated that volunteers must provide administrative or direct patient care in an amount that, at a minimum, equals 5 per cent of the total patient care hours expended by all paid hospice employees and contract staff. Hence, every hospice programme must have a volunteer programme in order to receive reimbursement for services rendered. The primary forces currently shaping hospice and palliative care volunteering have been regulations, care quality, skill requirements, liability concerns, and changing business objectives in a highly competitive environment.

Complementary and Integrative Therapies in Palliative Care

2019 ◽  
pp. 361-370
Author(s):  
Mary-Anne Meyer ◽  
Melinda Ring
Keyword(s):  
United States ◽  
Palliative Care ◽  
Integrative Medicine ◽  
Critical Factor ◽  
The United States ◽  
Integrative Care ◽  
Complementary And Integrative Medicine ◽  
Integrative Therapies ◽  
Hospice And Palliative Care

A large portion of adults in the United States use some form of complementary and integrative medicine, but while these therapies are offered in many hospice and palliative care programs, few patients end up accessing the therapies. Studies show that patients who receive these services are more satisfied with their care. Additionally, surveys show that nurses are often the critical factor is assessing a patient’s appropriateness for integrative care and making the referrals. This chapter reviews therapies and supplements that can be used for specific conditions, and it ends with a list of resources to help put ideas into practice.

The Use of Yoga by Physical Therapists in the United States

2017 ◽  
Vol 27 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Mary E. Wims ◽  
Shayla M. McIntyre ◽  
Ann York ◽  
Laura G. Covill
Keyword(s):  
United States ◽  
Physical Therapy ◽  
Physical Therapists ◽  
The United States ◽  
Primary Concern ◽  
Health And Wellness ◽  
Clinical Practices ◽  
Post Discharge ◽  
Electronic Communications ◽  
American Physical

Abstract How physical therapists (PTs) in the United States currently use yoga in their clinical practices is unknown. The purpose of this study was to determine how PTs in the United States view yoga as a physical therapy (PT) tool and how PTs use yoga therapeutically. The authors conducted a 24-item survey via electronic communications of the Geriatric, Orthopedic, Pediatric, and Women's Health Sections of the American Physical Therapy Association. Participants (n = 333) from 47 states and the District of Columbia replied. Reported use of therapeutic yoga among participants was high (70.6%). Of those participants, nearly a third use asana and pranayama only. Most participants using therapeutic yoga also include additional mindfulness-related elements such as sensory awareness, concentration/focus, and/or meditation. Most participants learned about yoga through personal experiences, with many participants citing lack of familiarity in using yoga in PT practice. Safety is the primary concern of participants when recommending yoga to patients as an independent health and wellness activity. Interdisciplinary communication between PTs, yoga therapists, and yoga teachers is warranted to address the post-discharge needs of clients. Healthcare changes have required PTs to adapt to a biopsychosocial-spiritual model (BPSS) for improved patient outcomes. Therapeutic yoga may provide an opportunity for PTs to expand their role in health and wellness and chronic disease management. There is opportunity for continuing education in therapeutic yoga for PTs.

Hospice Approach to Palliative Care

2018 ◽  
Author(s):  
Sriram Yennurajalingam
Keyword(s):  
United States ◽  
Palliative Care ◽  
Social Work ◽  
Physical Therapy ◽  
Life Expectancy ◽  
End Of Life ◽  
Nursing Care ◽  
Hospice Care ◽  
The United States ◽  
Medicare Part

For the provision of palliative care in the hospice setting in the United States, Medicare covers any care that is reasonable and necessary to manage palliative and hospice care at end of life. To be eligible for this Medicare hospice benefit, a beneficiary must be entitled to Medicare Part A and be certified by a physician to have a life expectancy of 6 months or less if the illness runs its expected course. Medicare covers medications, nursing care, and medical services including care by a physician, physical therapy, social work. This chapter briefly reviews the various aspects of the Medicare hospice benefit.

Development of Hospice and Palliative Care in the United States

2008 ◽  
Vol 56 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Stephen R. Connor
Keyword(s):  
United States ◽  
Palliative Care ◽  
Health Care Industry ◽  
The United States ◽  
Regulatory Change ◽  
Care Providers ◽  
Care Industry ◽  
History Of ◽  
Hospice And Palliative Care

More than 30 years have passed since palliative care was introduced in the United States, and what began as a small rebellion has evolved into a fairly large health care industry. Although the palliative care movement has considerably improved the care given to those at the end of life, many challenges remain for palliative care providers in the United States. This article discusses the history of hospice and palliative care in the United States, the Medicare Hospice Benefit, the growth of hospice and palliative care, and challenges such as the need for regulatory change, workforce issues, improving access to care, and improving the quality of palliative care.

Microethical & Relational Insights from Pediatric Palliative Care

2020 ◽  
Vol 7 (4) ◽  
pp. 94-96
Author(s):  
Dr. Abhijit Shinde ◽  
Dr. Sunil Natha Mhaske ◽  
Dr. Ramesh Kothari ◽  
Dr. Sonal Shinde
Keyword(s):  
United States ◽  
Palliative Care ◽  
End Of Life ◽  
The United States ◽  
Pediatric Palliative Care ◽  
Live Births ◽  
Care Services ◽  
Palliative Care Services ◽  
Life Threatening ◽  
Developed World

In the India, more than 30 per 1000 live births of infants die each year before, during, or after birth as do many children with life- limiting conditions. In most countries in the developed world including the United States, the vast majority of infants, children and teenagers at end of life do not have access to multidisciplinary pediatric palliative care services in their community or at a children’shospital. Pediatric palliative care is for children and teenagers suffering from life- threatening or life-limiting conditions in which survival into adulthood is or may be jeopardized if curative treatments  fail. As a result, pediatric palliative care may last over many years.

Spirituality and the Care of Patients at the End-of-Life: An Essential Component of Care

2008 ◽  
Vol 56 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Christina M. Puchalski
Keyword(s):  
United States ◽  
Palliative Care ◽  
Healthcare System ◽  
Spiritual Care ◽  
Healthcare Professionals ◽  
The United States ◽  
Evidence Base ◽  
Essential Component ◽  
Spiritual Issues ◽  
Hospice And Palliative Care

Spirituality is an essential component of the care of patients with serious illness and those that are dying. Dame Cicely Saunders developed the hospice movement based on the biopsychosocialspiritual model of care, in which all four dimensions are important in the care of patients. Of all the models of care, hospice and palliative care recognize the importance of spiritual issues in the care of patients and their families. The National Consensus Project Guidelines for Quality Palliative Care, in the United States, provides specific recommendations about all domains of care including the spiritual domain, which is recognized as a critical component of care (The National Consensus Project for Quality Palliative Care www.nationalconsensusproject.org ). Studies indicate that the majority of patients would like their spiritual issues addressed, yet find that their spiritual needs are not being met by the current system of care. Interestingly, spirituality is the one dimension that seems to get slightly less emphasis than the biopsychosocial dimensions of care. Some reasons may include the difficulty with definitions of spirituality for clinical and research purposes, the time constraints and financial burdens in the current healthcare system in the United States, and the lack of uniform training for all healthcare professionals. Yet, there are theoretical and ethical frameworks that support spiritual care as well as some educational models in spirituality and health that have been successful in medical education in the United States. Spirituality can be seen as the essential part of the humanity of all people. It is at its root, relational and thus forms the basis of the altruistic care healthcare professionals are committed to. Spirituality has to do with respecting the inherent value and dignity of all persons, regardless of their health status. It is the part of humans that seeks healing, particularly in the midst of suffering. Spiritual care models are based on an intrinsic aspect that calls for compassionate presence to patients as well as an extrinsic component where healthcare professionals address spiritual issues with patients and their loved ones. Currently in the healthcare system, evidence-base models are the criteria for practice recommendations. Yet, spirituality may not be amenable entirely to strict evidence-base criteria. As hospice and palliative care continues to develop as a field, healthcare professionals are challenged to think of ways to advocate for and include the spiritual dimension of care.

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