Acute Medicine | Palliative care | Management of physical deterioration

Management of physical deterioration
Session overview
Description
As illness progresses in the last year of life, physical function inevitably diminishes. This session provides a framework for the management of physical deterioration of patients at the end of life.

This session was reviewed by Sarah Hanrott and last updated in November 2022.

Learning objectives
By the end of this session you will be able to:

• list the key groups of professionals involved in managing deteriorating physical function
• outline the different interventions, pharmacological and non-pharmacological, available for optimising physical function in this patient population with increasing levels of need
• explain the aims and challenges of each intervention
• discuss the communication and information needs of the patient and their family/carer
• describe a practical integrated approach to managing deteriorating physical function

Prerequisites
Before commencing this session you should complete the session:

• Assessment of physical and cognitive deterioration in function (215-0439)

As disease progresses and the end of life approaches, physical decline is experienced by patients who have malignant and non-malignant terminal illnesses. This has an impact on many aspects of a patient's life, and that of their family and carers. Coping with physical decline can be particularly challenging when change happens rapidly, for example after a new stroke or chest infection.

Managing progressive physical deterioration requires a multi-professional approach. This is usually led by allied health professionals, such as physiotherapists and occupational therapists, who work collaboratively with each other and other disciplines.

This session explains the roles of these key professionals and the different interventions available to maximally compensate for deteriorating physical function at progressive levels of need.

The individual's physical function is also influenced by other factors including physical symptoms, mood, fear and anxiety. Providing emotional support, information and education can help the patient and both their family and carer cope with decline in physical function and maximise what level of function remains. This session concludes by discussing how these elements are combined to provide a practical integrated approach to managing deteriorating physical function.