In the United States about 80% of individuals who die are age 65 years or older. Older persons who face end of life care issues due to chronic illness and cancer should begin the process of planning for end of life care matters. Often times end of life care decisions involve the support of family members and or friends. The road to addressing end of life care issues include: planning, developing advance directives, creating a will and deciding on a durable power of attorney for healthcare. Specific issues addressed in the advance directive include: pain management, life sustaining treatment options, etc. Healthcare decisions by patients are often based on cultural influences/factors as well as psychosocial supports. Additionally, decisions that influence end of life care include: communication between the healthcare team and patient/family regarding healthcare status and prognosis. It is important that communication coming from the healthcare team be clear and address healthcare goals and expectations of the patient and family to help facilitate a successful end of life care plan. Addressing end of life care matters in a comprehensive fashion will assist with making the patient’s end of life experience as comfortable as possible.
This series of learning modules discusses the following areas: communication, psychosocial supports, pain and symptom management, advance care directives, occupational and physical therapies at the end of life.
Leigh Ann Hewston, PT, MEd
Tracey Vause-Earland, MS, OTR/L
Tarae Waddell-Terry, MS
Christine Arenson, MD, Cecilia Borden, EdD,MSN,RN, Charles Brown, MSW, LCSW,
Emily Hajjar, Pharm.D., BCPS, CGP, Margaret Henry, OTS, Nancy A Hodgson, PhD, RN,
Christine Hsieh, MD, Allison Palaio, SPT, Susan Parks, MD,
Barbara Reville, MS, APRN-BC, ACHPN, Tarae Waddell-Terry, MS, Laraine Winter, PhD
The project described was supported by Grant Number #D31HP08834 from the Department of Health and Human Services (HHS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Health Resources and Services Administration: Department of Health and Human Services.
The quality of life refers to the perceived emotional, psychological and physical well-being. It is subjective and an individualized phenomenon. Health related quality of life outcomes includes physical, mental, social and role functioning, a sense of well being, freedom from bodily pain, satisfaction with health care and an overall sense of general health. (Field & Casse, 1996, p.25)
The concept of this module is to give healthcare professionals and students an understanding of the quality of life, physical and occupational therapy role and modules of care in therapies used to care for patients at the end of life.
Upon completion of this module, the participant will be able to:
Estimated time for completion: 30 minutes
- Recognize ways to enhance quality of life at the end of life using therapy services.
- Describe the role of occupational and physical therapy for patients experiencing end of life.
- Identify appropriate therapy outcomes for these patients.
Since this module will take approximately 30 minutes to complete, it is designed to track your progress allowing you to complete the module in more than one sitting. The progress tracking feature allows you to return to your previous session from any computer.
Saving and Printing Responses to Questions:
Use the Save Answer button under each response text box to save your responses. Saved responses can be viewed or updated in subsequent sessions. All responses can be printed from the last screen of the module. The Print Answers button on that screen generates a PDF document that may be saved or printed.
Technical Requirements and Notes:
This learning module uses Adobe Flash media and may require you to add a browser "plug-in" in order to display properly. Most computers already have this free plug-in installed. But, if yours does not, it is very easy to download and install. Try the module first because the software is "smart" enough to detect the Flash player. If the module doesn't begin, you will be automatically prompted to download the plug-in.
The module contains links to external websites which will open in a new browser window. Your browser's back button will not return to the module, so these new windows should be closed.