Hospice with Physical Therapy together??

[Shell5]

I work at an assisted living center. Most of our patients are self pay. We have a patient on hopspice services and has an order for PT to eval and treat. Can a patient be on PT/OT and hospice at the same time?

[westieluv]

We don't have any patients on PT/OT, but I think it would depend on the nature of the therapy. If the goal is to make the patient more comfortable (e.g. working to ease a contracture that is causing the patient great pain or helping a patient's posture so that they can stand more erect and facilitate their breathing), then I think it would be okay. For the hospice diagnoses that I can think of off the top of my head, PT/OT would not be curative, but palliative. We want to focus on not just making our patients comfortable in their last days but also giving them the best quality of life possible. Being free of pain and being able to breathe more freely would fall under that category.

[curiousauntie]

We will order Physical Therapy if we think it will help with the patient's quality of life. We use it for caregiver training, especially for transfer training with patients who have gotten too weak to get about by themselves, or for positioning for patients who are newly bed bound. We will also use it for very short term theyapy for some strengthing if they have become debilitated due to a prolonged hospital stay and we think there is some chance the therapy will help them get to that optimal level for a short while. Also therapy is good for training for people who are using assistive devices, walkers and the like, for the first time.

There is a place in hospice for physical therapy as there are people who can have a better quality of life with the therapy. I worked in sub-acute rehab for many years before finally following my dream into hospice and worked closely with the hospices in my facilities to find that fine line between rehab to cure and rehab to get someone ready to be home with hospice. The last facility I worked at had a great rehab department with physical and occupational therapist who understood the difference between the two, and would refuse to "rehab them to death". Sometimes the therapists are the first ones to see the decline that is marking the "final decline".

[ErinS, BSN, RN]

We often will order a PT eval, and our aides are cross trained to restorative therapy and will continue whatever the PT suggests.