Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care

Abstract

Purpose of ReviewThe goal of this review is to highlight recent literature that addresses the role of rehabilitation for managing symptoms for patients with cancer near the end of life. Recent Findings Current literature supports the integration of rehabilitation interventions as part of comprehensive symptom management in patients with advanced cancer near end of life. Research is needed to clarify the impact and timing of specific rehabilitation techniques. There is also a need for robust education for both palliative and rehabilitation clinicians about the role for rehabilitation. Summary In this article, we review evidence for the use of rehabilitation interventions to address symptoms commonly experienced by patients with advanced cancer -dyspnea, pain, depression, anxiety, and fatigue. We also touch on communication strategies important for assessing and addressing the complex needs of the patient and caregiver. Finally, we describe barriers to the use of palliative rehabilitation and explore strategies for improving implementation across care settings.

The Complexities of Prescribing Assistive Equipment at the End of Life—Patient and Caregivers’ Perspectives

“…Findings demonstrate the complexities of using AE at the end of life from patients’ and caregivers’ perspectives. AE provided by occupational therapists and physiotherapists supported participants’ adaptation to deteriorating function and symptom burden [ 11 , 17 , 28 , 29 ]. Consistent with emerging research that highlights the importance of participating in essential and valued activities at the end of life, some participants prioritised management of self-care, while others prioritised social outings, describing how AE enabled them to participate in leisure activities.…”

“…Equipment was abandoned when its use created tension or was perceived to undermine roles and relationships with family members, was a reminder of deterioration or was simply too awkward to use [ 12 , 31 , 32 , 33 , 34 , 35 , 36 ]. Although evidence demonstrates palliative rehabilitation can improve or maintain participation through proactive skilled AE prescription and training [ 9 , 10 , 28 , 37 ], its value and efficacy are not always well understood [ 38 , 39 ]. Study findings shed further light on this.…”