Background Health promoting palliative care (HPPC) considers dying and death as a social phenomenon where communities play an integral role. The dominant interpretation of HPPC in the UK has been through community engagement activities but there is a disconnect between this and the support provided in the hospice in-patient setting.
Aim To assess whether rehabilitative palliative care (RPC) enables HPPC to be integrated in the in-patient setting.
Method Using participatory action research, a co-operative inquiry group planned how to integrate RPC in a UK Hospice in-patient unit paying attention to the facilitators and barriers.
The findings from this study and the literature were examined to identify the alignment and dissonance between HPPC and RPC.
Results A post intervention review indicated that RPC had been implemented, but there was conflict, also identified in the literature, between a model perceived to be focused on caring (palliative), and one based on enabling (rehabilitation).
Factors demonstrating the similarities between HPPC and RPC were presented:
democracy, empowerment and participation were underpinning principles
focused on enablement, control, choice and independence where self–esteem, self–determination and self–reliance co–existed with high levels of physical dependence
participatory models with an emphasis on social interaction
encouraged health care professionals to relinquish an expert–led approach to enable patients to become active participants in their care
interdisciplinary – involving all health and social care professionals, patients, families, communities and volunteers.
Claims challenging whether RPC could be considered as HPPC, e.g. lack of community involvement, a failure to address death education, RPC was death denying and perpetuated a clinical model of death and dying were discussed and alternative perspectives presented.
Conclusion Despite its close associations with community initiatives, the principles of HPPC can be integrated in a hospice in-patient setting using RPC.
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