A growing body of studies indicate benefits of physiotherapy for patients in palliative care, for symptom relief and wellbeing. Though physiotherapists are increasingly acknowledged as important members of palliative care teams, they are still an underutilized source and not fully recognized. The aim of this study was to explore the variety of activities described by physiotherapists in addressing the needs and problems of patients and their families in specialized palliative care settings.
Using a free-listing approach, ten physiotherapists working in eight specialized palliative care settings in Sweden described as precisely and in as much detail as possible different activities in which patients and their families were included (directly or indirectly) during 10 days. The statements were entered into NVivo and analysed using qualitative content analysis. Statements containing more than one activity were categorized per activity.
In total, 264 statements, containing 504 varied activities, were coded into seven categories: Counteracting a declining physical function; Informing, guiding and educating; Observing, assessing and evaluating; Attending to signs and symptoms; Listening, talking with and understanding; Caring for basic needs; and Organizing, planning and coordinating. In practice, however, the activities were intrinsically interwoven. The activities showed how physiotherapists aimed, through care for the body, to address patients' physical, psychological, social and existential needs, counteracting the decline in a patient's physical function and wellbeing. The activities also revealed a great variation, in relation not only to what they did, but also to their holistic and inseparable nature with regard to why, how, when, where, with whom and for whom the activities were carried out, which points towards a well-adopted person-centred palliative care approach.
The study provides hands-on descriptions of how person-centred palliative care is integrated in physiotherapists' everyday activities. Physiotherapists in specialized palliative care help patients and families to bridge the gap between their real and ideal everyday life with the aim to maximize security, autonomy and wellbeing. The concrete examples included can be used in understanding the contribution of physiotherapists to the palliative care team and inform future research interventions and outcomes.
The objectives were to investigate the prevalence and predictors for falls and dizziness among people younger and older than 80 years of age. The sample was drawn from the Swedish National study on Aging and Care (SNAC) and comprised 973 and 1273 subjects with data on the occurrence of falls and dizziness respectively at baseline. Follow-ups were made after 3- and 6-years. Data included socio-demographics, physical function, health complaints, cognition, quality of life and medications. The prevalence of falls was 16.5% in those under aged 80 and 31.7% in those 80+ years while dizziness was reported by 17.8% and 31.0% respectively. Predictors for falls in those under aged 80 were neuroleptics, dependency in personal activities of daily living (PADL), a history of falling, vision impairment and higher age, and in those 80+ years a history of falling, dependency in instrumental activities of daily living (IADL), fatigue and higher age. Factors predicting dizziness in those under aged 80 were a history of dizziness, feeling nervous and reduced grip strength and in those 80+ years a history of dizziness and of falling. Predictors for falls and dizziness differed according to age. Specific factors were identified in those under aged 80. In those 80+ years more general factors were identified implying the need for a comprehensive investigation to prevent falls. This longitudinal study also showed that falling and dizziness in many older people are persistent and therefore should be treated as chronic conditions.