Rehabilitative palliative care: enabling people to live fully until they die
Published on: 03 July 2015
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This publication provides evidence of the benefits and effectiveness of rehabilitative palliative care, and includes guidance and tools to support its implementation.
Download Rehabilitative palliative care: enabling people to live fully until they die – a challenge for the 21st century.
About this publication
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In 2013 the Hospice UK Commission into the Future of Hospice Care challenged hospices to look to the future: to critically appraise their fitness to respond to the significant shifts in demography and illness upon the horizon and to be dynamic and innovative in our response to meet the needs of people with a life-limiting or terminal condition.
Hospices face a number of key challenges:
to respond to a dramatically escalating demand for palliative and end of life care
to adapt to meet the needs of an ageing population, living with and dying from chronic illnesses and multiple co-morbidities; where longevity is frequently compromised by frailty, disability and dependence
to deliver equitable, quality care to those who need it in an environment of financial constraint.
These challenges are contextualised in today’s society where personal autonomy is paramount; where people are increasingly expressing the importance of choice and independence as major components of dignity in advancing illness and old age, where most of us expect to make decisions, not only on how we live the last years, months, weeks and days of life but also on how and where we die.
Hospices are recognised as beacons of holistic, person-centred care for people living with a life-limiting or terminal illness and their families. This is important and provides a firm foundation from which hospices can respond to the challenges of the future. However, in the face of change hospices must also be open to change, both of culture and practice.
To meet the needs of the future hospices must be prepared to do things differently – starting with placing patients’ goals for living at the heart of our holistic support. Hospice care needs to be tailored so that we are providing just the right amount of support to empower and enable individuals to achieve their goals – to live their lives until they die – not more, not less. Hospices must shift their paradigm to interweave a culture of enablement alongside their rich culture of care, to enable people greater choice, independence and dignity in advancing illness or old age even if this may feel ‘risky’ compared to what you are used to.
This publication describes such an approach to care, makes the case for change, helps hospices think about what this looks like in practice and provides guidance about how best to achieve it. Hospice UK endorses it and encourages trustees, senior managers and clinical leads from all disciplines as well as allied health professional teams to explore its messages and the potential implications for their own hospice. Rehabilitative Palliative Care is, in our view, an important next step in preparing hospices for the challenges and opportunities of the 21st century.
Foreword by Dr Ros Taylor MBE, National Director for Hospice Care, Hospice UK
Acknowledgements
This publication was written by Rebecca Tiberini, Specialist Palliative Care Physiotherapist and Therapies Services Manager at St Joseph’s Hospice, and Heather Richardson, Joint Chief Executive at St Christopher’s Hospice, RMN / RGN. Both have asserted their right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act 1988.
