Physiotherapy in the Palliative Phase of Life in Geriatric Patients

Physiotherapy in the Palliative Phase of Life in Geriatric Patients is organized by Netherlands Paramedical Institute (NPi) / Nederlands Paramedisch Instituut (NPi) and will be held from Mar 23 - Apr 20, 2024 at Fletcher Hotel-Restaurant Epe-Zwolle, Epe, Gelderland, Netherlands.

Description
In the palliative phase of life, the end of life comes explicitly and inevitably into view. In this phase, medical treatment focuses on combating diseases and symptoms as best as possible, with the aim of achieving the best possible quality of life. With this so-called disease-oriented palliation and symptom-oriented palliation, the aim is to make patients as comfortable as possible. In the dying phase, attention shifts from quality of life to quality of dying.

The palliative phase in geriatric patients often has a relatively long phase in which a gradual decline in functioning occurs, after which deterioration occurs until death. The progression of this process depends on the primary condition and the comorbidities present. The individual differences are large and the palliative phase can last from several months to many years. A process that by its nature can be slow, but sometimes very abrupt.

In the palliative phase, support from a physiotherapist can be useful for various requests for help in the areas of daily functioning, maintaining fitness and vitality, and dealing with symptoms such as pain, anxiety or dyspnoea. For this reason, the physiotherapist is expected to have competencies in the field of psychosocial problems and meaning. The physiotherapist can also support informal caregivers, including by teaching ergonomic techniques to support transfers and to balance load and load capacity. Moral dilemmas may arise, where, for example, the principle of preventing further damage conflicts with the objective of promoting autonomy as much as possible.

Treating and coaching patients in the palliative and/or terminal phase often places great demands on the mental capacity of the physiotherapist; the ability to balance professional commitment and personal distance is sometimes particularly tested at this stage. These and related themes are discussed in the course.

The course is offered as a 3 day course. The first 2 days of the course are consecutive, the third day follows over time, so that the student can work with the material provided and collect case studies from his practice. On the first day, the student is introduced to the concept of “palliative care”, starts working on communication with patients in the final phase of life and their loved ones and with guidance on psychosocial problems and questions about meaning. Attention is also paid to the organization of palliative care, including palliative networks and knowledge centers for palliative care. During the second day, physiotherapeutic care is discussed, as well as complementary care and knowledge of diseases and medications. During the last day of the course, ample attention is paid to mutual interactive discussion based on the collected case studies. Ethical issues are also discussed on this day, in particular euthanasia, palliative sedation and the patient's wishes regarding dying.

Goal:
After this course, the participant is able to recognize and name the different domains of palliative care. The participant knows the (medical) treatment options in the various palliative phases, can identify the value and limitations of physiotherapy to support autonomy, functioning and quality of life in these phases and can act accordingly. The participant can discuss psychosocial questions and questions about meaning and advise the patient on this or refer them for guidance. The participant can also express explicit moral considerations and provide informal caregivers and palliative care volunteers with training regarding transfers and advice regarding burden and resilience. The student can identify ethical issues and can apply the important procedures and laws and regulations.