Rehabilitation in Palliative Care

Rehabilitation in palliative care is an important route to enable patients to preserve personhood, fulfil meaningful goals, maintain autonomy and dignity whilst at the same time supporting them to adapt constructively to uncertainty and loss that is often intrinsic in the lived experience of advancing illness. In its simplest sense, rehabilitation in palliative care is about enabling people to live fully until they die.

Rehabilitation in palliative care comprises both the specialist contribution of physiotherapists, occupational therapists, dietitians and speech and language therapists, together with ‘Rehabilitative Palliative Care’ where rehabilitation is an integral part of interdisciplinary palliative care. Rehabilitative Palliative Care calls for all members of the interdisciplinary team to adopt and actively embed rehabilitative practices and an enabling culture within their palliative care practice to support people living with advanced illness to participate to as full extent as possible in valued activities within their daily lives (Tiberini and Richardson 2015).

There is an increasingly robust body of evidence to support the effectiveness of rehabilitation for people living with advanced, incurable illness and the integration of rehabilitation and palliative care by the interprofessional team is recommended as best practice by the World Health Organisation to improve the quality, accessibility, effectiveness and cost-effectiveness of health services for people approaching end of life (WHO 2023).

From this perspective it is no longer a question of if rehabilitation should be integrated with palliative care, but rather how to best achieve this. In practice however, Rehabilitative Palliative Care is not well understood and service provision, both across Europe and internationally, remains under-resourced and highly variable.