Rehabilitation Services for People Living with Cancer
Felicia Rawls, Restorative Rehab Supervisor, Careage
According to the National Cancer Institute, approximately 8.4 million Americans today are living with cancer. While some of these individuals can be considered cured, others still have evidence of cancer and may be undergoing treatment. People are now living longer with this disease. For many, cancer is essentially a chronic disease that is treatable, even with metastases.
The Four Stages
Physical Therapy, Occupational Therapy, and Speech Therapy offer the cancer survivor a dynamic team of rehabilitation services. It is easiest to think of rehabilitation goals for cancer survivors in four stages.
1. PREVENTION
This stage is for people undergoing chemotherapy, recovering from surgery, or requiring bed rest. The goals for this type of rehabilitation are to reduce the severity of the disability, to prevent complications, to improve endurance and provide strength training, to prevent loss of or maximize range of motion, to decrease muscle tension, and to decrease anxiety and stress.
2. RESTORATIVE
This stage is for people who have completed chemotherapy, radiation therapy, or are recuperating from surgery. The goal is to obtain full mobility, muscle power, and a return to previous life-style with minimal disability. This level aims to decrease pain, muscle tension, anxiety, stress, lymphedema, and to obtain optimal function in gait and activities for daily living.
3. SUPPORTIVE
This level provides help for those who have a permanent deformity or dysfunction but who still want to live independently. The goals include all of those in stage two, as well as minimizing the disability, teaching energy conservation, and patient and family education.
4. PALLIATIVE
This stage is for individuals who are in the end stages of cancer. The goal for the therapist is to provide emotional support, help with positioning and comfort, control edema, teach relaxation techniques, instruct the patient and caregivers on the proper ways of doing transfers, positioning and exercises, and suggest ways to prevent or treat the complications that arise from long-term bed rest and immobility.
Each individual with cancer has different needs due to metabolic changes, the nature of treatment and the psychological impact of the disease. When rehabilitation services for a person with cancer are authorized, the goals are functional, realistic and attainable. Rehabilitation services encourage family involvement. Therefore sharing the plan with the family is vital. Written exercise programs are available so that the family or caregivers can instruct the person with cancer. A self-program can be done anytime, whenever the person with cancer feels well enough to do the exercises.
Hospice is also available to help with the emotional and physical stress of the terminally ill and their families. The goal is to manage pain and other symptoms so that the final days may be spent with dignity at home or in a pleasant inpatient surrounding.
The Benefits of Rehab Services
It has been shown that rehabilitation services can contribute to earlier discharge from the hospital, as well as increase a person’s motivation to get well faster. Since the therapist often spends more time with the patient and family members, good communication between all those involved in the care of the individual is vital.