Background Palliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients’ quality of life by restoring physical function and maximizing autonomy despite advancing illnesses.¹ It emphasizes the importance of personalized goal setting and its transformative impact through open dialogue and negotiation throughout the duration of physiotherapy.

Case Description A 85-year-old male with angioimmunoblastic T-cell lymphoma on best supportive care was referred to physiotherapy after admission to home hospice. He was wheelchair bound with restricted mobility compounded by a fear of recurrent falls. His primary goal was to regain modified independence in his mobility with a suitable walking aid. Through collaborative discussions including the use of a conversation guide, his preferences and motivation were sought and validated. This patient-centred approach allowed therapeutic interventions align with his needs and provided holistic palliative care; appropriate strengthening exercises that maximised the benefits from his exercise programme were prescribed. Within a month of enrolment, he had significant improvements in both his level of dependency and self-performance satisfaction scores. Achieving his goal validated his perseverance through therapy and provided motivation to continue working on his mobility and strength.

Discussion Even with life-limiting conditions, individuals receiving guided therapy interventions can make significant improvements in their physical and mental well-being. The palliative rehabilitation approach allows physiotherapists to actualize goals while respecting individual preferences. By fostering confidence and allowing for flexibility in decision-making, they empower individuals to make choices that align with their values. Exercise remains valuable throughout the palliative care continuum, but clear and achievable goals are essential to optimize these benefits while conserving limited physiological reserves. This approach empowers patients to take an active role in their rehabilitation journey, enhances their sense of control and ultimately complements exercise interventions to improve their overall quality of life.²

References

1. Harding Z, Hall C, Lloyd A. Rehabilitation in palliative care: a qualitative study of team professionals. Bmj Supportive & Palliative Care.2022;12:e28-e38.

2. Melin J, Nordin Å, Feldthusen C, Danielsson L. Goal-setting in physiotherapy: exploring a person-centered perspective. Physiotherapy Theory and Practice. 2021 Aug 3;37(8):863–80.