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PT Evaluation in Hospice and Palliative Care

Tracey Collins, PT, PhD, MBA, GCS

December 28, 2021

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Question

What do you include in a PT evaluation in hospice and palliative care?  

Answer

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?


tracey collins

Tracey Collins, PT, PhD, MBA, GCS

Dr. Collins received her BS in physical therapy from the University of Scranton in 1989, an MBA from the University of North Carolina at Wilmington in 1997, and her Ph.D. in Health Administration from Walden University in 2006. Dr. Collins has 33 years of experience as a PT, 26 years of experience in home health, and has been a Board-Certified Specialist in Geriatric PT since 1998. She has 20 years of academic teaching experience and is the Research Chair for APTA Home Health.


Related Courses

Frailty in Home Health
Presented by Tracey Collins, PT, PhD, MBA, GCS
Recorded Webinar

Presenter

Tracey Collins, PT, PhD, MBA, GCS
Course: #4442Level: Intermediate2 Hours
  'i really like the real world case studies'   Read Reviews
This course provides the attendee with the definition, evaluation methods, treatment strategies, and discharge planning for home health patients living with frailty.

Home Health Wound Care Review
Presented by Tracey Collins, PT, PhD, MBA, GCS
Recorded Webinar

Presenter

Tracey Collins, PT, PhD, MBA, GCS
Course: #3755Level: Introductory2 Hours
  'Informative and concise'   Read Reviews
Review of basic wound care including wound evaluation, pressure injuries, diabetic foot ulcers, venous stasis wounds and arterial wounds, debridement, various wound dressing categories and standards of care. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Patient-Centered Care: Bringing Quality Toward End of Life
Presented by Tracey Collins, PT, PhD, MBA, GCS
Recorded Webinar

Presenter

Tracey Collins, PT, PhD, MBA, GCS
Course: #4052Level: Introductory2 Hours
  'Clear and informative with take home material'   Read Reviews
In this course, participants are taught the role of a PT in hospice and palliative care and how to develop an appropriate patient–centered POC.

Put Down the Drugs: Evidence-Based Interventions to Reduce Unwanted Behaviors with Dementia
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
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Course: #3072Level: Intermediate1 Hour
  'Wonderful review and will be quite helpful for this PTA working in my long term facility!'   Read Reviews
PTs can apply evidence-based interventions to improve dementia care. This session reviews the etiology of common behaviors. Cognitive-emotion, multi-sensory, animal-assisted, and exercise interventions to reduce agitation are discussed as well as specific strategies for improving task-related engagement. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Interdisciplinary Approach To Stroke Rehabilitation: Outpatient, Home Health, And Community Rehabilitation Phase
Presented by Alaena McCool, MS, OTR/L, CPAM, Katherine George, PT, DPT
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Alaena McCool, MS, OTR/L, CPAMKatherine George, PT, DPT
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The unique relationship between the occupational and physical therapist when treating an acute, subacute, or chronic stroke diagnosis will be distinguished in this two-part series. Part two will focus on the subacute and chronic stroke, differentiating the home, outpatient, and community phases of rehabilitation, as well as examining the evaluation, evidence, and interventions in each setting to optimize independence for the patient.

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