What do you include in a PT evaluation in hospice and palliative care?
A PT evaluation in hospice and palliative care should be patient-centered. You're looking at the caregiver's abilities and what caregivers there are. Some patients have lots of caregivers, but you need to know who they are, who's doing what, what equipment they already have, and what equipment they might need. What setting are you doing this in? Are you doing this on an inpatient hospice unit and they're actively dying, or if they're not and they want to go home, are they safe to go home? What is their prior level of function? What were they able to do immediately prior to your evaluation?
What is the history of their functional status? Is it rapidly declining? What are the patient's goals? What do they want to be able to do? I've had patients tell me they just want to be able to walk to the bathroom. Some just want to be able to walk enough to go get in the car or to get in the wheelchair then transfer to the car so they can go to their favorite steak restaurant. What are the caregiver's goals? Where would they like them to be and what setting does the patient want to be cared for in? Can you make that happen with your support and equipment recommendations?
Here are questions I always ask in evaluation:
- What is it I can help you with?
- What do you want to be able to continue to do?
- What does your caregiver need help with?
- What does your caregiver need to be taught how to do?
- What equipment can I help you obtain?
- What setting do you/caregivers want to be in?
- Are you having any pain? How can I assist with pain?
Remember, these are very patient/caregiver-centered. What do they want to be able to do and what can you help them do?