Antea Worldwide Palliative Care Conference

Rome, 12-14 November 2008

ABSTRACT FORM

Presenting author Role of Rehabilitation in Palliative Care

Andrea Pace
Email:
pace@ifo.it
Phone
Mobile phone
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abstract
• Pain and other symptoms
• Palliative care for cancer patients
• Palliative care for non cancer
patients
• Paediatric palliative care
• Palliative care for the elderly
• The actors of palliative care
• Latest on drugs
• Pain
• Illness and suffering through
media
• Marginalisation and social stigma
at the end of life
• Palliative care advocacy projects
Authors (max 6, presenting author included): Andrea Pace
Introduction: In patients affected by diseases with poor prognosis, the evaluation of efficacy of
rehabilitation should consider not only the functional gain but even the palliative effect on
patients’ symptoms, particularly in the advanced phase of disease. The management of cancer
patients in the terminal stage should always provide supportive care including rehabilitation
strategies for prevention of complications and educational programs for caregivers to meet the
patient’s care needs.
The role of rehabilitation for cancer patients should be better investigated focusing different goals
in different stage of disease: in the acute phase of disease it is aimed at obtaining a functional
improvement, while in the phase of progression at the last stage of disease it is focused on the
patient’s quality of life, symptoms’ palliation, prevention of complications and improvement in
mobility and daily living activities.
We report our experience of rehabilitation in home care setting for brain tumor patients.
Objective: to determine whether a program of post-discharge rehabilitation at home in patients
operated for brain tumor was associated with functional gain and improvement in Quality of Life
(QoL). Patients and Methods: One hundred twenty-one patients affected by malignant brain
tumor were enrolled in a program of post-discharge home care including neurorehabilitation.
Functional outcome was evaluated with Barthel Index (BI) and Karnofsky Performance Status
(KPS) measured before and after rehabilitation. The impact of rehabilitation on quality of life was
evaluated with a quality of life questionnaire (EORTC QLQ-C30-BM 20). Results: Barthel Index
improved in 47 (39%) patients, was stable in 20 (16%) and worsened in 54 (44%).
Only 54 patients completed the QoL questionnaire before and after treatment. After three months
of rehabilitation, 72% of patients were found to have an improvement in at least one domain
scores compared with their baseline QoL scores.
Conclusions: rehabilitation at home in brain tumor patients was associated with significant
functional gain measured both with BI and KPS. The benefit of rehabilitation may influence
patient’s perception of quality of life.

• Prognosis and diagnosis

communication in
different cultures
• Communication between doctor-
patient and patient-
equipe
• Religions and cultures versus
suffering, death and
bereavement
• Public institution in the world:
palliative care policies
and law
• Palliative care: from villages to metropolies

• Space, light and gardens for the terminally ill patient

• End-of-life ethics
• Complementary therapies Session: Rehabilitation in palliative care
• Education, training and research
• Fund-raising and no-profit Chair of the session: Claudio Pellegrini
• Bereavement support
• Volunteering in palliative care
• Rehabilitation in palliative care