Pioneering Prehab in Palliative Care With Dr. Lori Boright

Palliative care is not the same as hospice.  Period.

While common, this misconception is problematic & is keeping your patients from getting truly comprehensive care throughout their cancer care journey.

In today’s conversation with Dr. Lori Boright, we dive into what palliative care really means within oncology, how prehab & palliative care are more closely related than you think, & how to actually implement rehab into palliative care as a first step.  All this to truly improve the quality of care (& life!) your patient experiences, no matter the phase of their cancer experience.

Listen now!

What Palliative Care Actually Is

Palliative care is the delivery of multidisciplinary services for individuals with chronic illnesses, particularly those affecting their quality of life and functioning. It is differentiated from hospice care, which is reserved for patients with a life expectancy of less than six months.

Simply put, palliative care supports patients with potentially life-limiting, quality of life-affecting diagnoses.

How Cancer Rehab Fits Within Palliative Care

Cancer rehabilitation improves the quality of life & function of oncology patients.  So of course it makes sense that cancer rehab is absolutely part of palliative care for these patients.

However, Dr. Boright notes that rehab services are often underutilized in palliative care and that there’s a need for earlier involvement.

Defining Palliative Care Prehabilitation

Dr. Boright introduces the concept of “palliative care prehabilitation,” which involves preparing and fortifying patients physically and emotionally before they begin treatment. As she states, it’s about raising the baseline level of function to slow down functional decline.

But this doesn’t come without some challenges.  For example, appointment fatigue is real for your patients.  Between surgery, radiation, medical oncology, & beyond, a rehab appointment may feel like a totally unnecessary additional visit.

So here’s how we can combat this, while still providing super necessary prehab services:

At bare minimum, you should provide your patients with education in the prehab phase, so your patients understand how rehab can benefit them in the future & how to access these services when they need them.

Another great approach is to incorporate discussions about health & wellness into prehab.  This can be tremendously helpful in increasing patient awareness & understanding of cancer rehab.

While patients may not always understand rehab, they definitely understand the importance of staying healthy & well during cancer treatment, especially to avoid hospitalization.

YOUR Role within Interdisciplinary Palliative Care

Dr. Boright stresses the importance of an interdisciplinary approach, where various healthcare professionals, including physical therapists, collaborate to provide comprehensive care to patients. This approach places the patient at the center of care.

It’s absolutely YOUR job to champion rehab within palliative care & proactively advocate for your involvement in palliative care teams. Dr. Boright suggests finding opportunities to join interdisciplinary meetings, educate key stakeholders, and demonstrate the value physical therapy brings to patient care.

Having a supportive leadership team is tantamount to facilitate the integration of physical therapy into palliative care. In short: don’t try to muscle through this all on your own.  Having a physician champion who recognizes the value of physical therapy is also crucial.

Additional Resources Dr. Boright recommends:

About Dr. Lori Boright:

Lori Boright PT, DPT, DScPT, CLT is an Assistant Professor at Oakland University in Rochester Michigan where she also serves as Coordinator of the Graduate Certificate in Oncology Rehabilitation. She is a Clinical Cancer Exercise Specialist, credentialed by the University of Northern Colorado Cancer Rehabilitation Institute. She received her DScPT and Graduate Certificate in Oncology Rehabilitation from Oakland University, DPT from AT Still University, MPT from University of Michigan Flint, and BS in physiology from Michigan State University. Her research agenda focuses on primary and secondary disease prevention inclusive of prehabilitation for a variety of cancer diagnoses and upstreaming initiatives for community and population health promotion.

Dr. Boright is a practicing physical therapist at Ascension South East Michigan, where she is responsible for leading clinical research initiatives and the statewide development of Oncology Rehabilitation across care settings. Dr. Boright currently serves the American Physical Therapy Association Michigan as Chair of the Oncology Rehabilitation Special Interest Group, the first state-level rehabilitation special interest group dedicated to advocacy and clinical best practice development for persons with oncology diagnoses. She is serving as the APTA-Michigan representative to the Michigan Cancer Consortium, a state-wide multidisciplinary organization to further cancer research, clinical practice, and survivorship initiatives. She has many peer-reviewed publications and is a frequent speaker at the state and national level in the prevention domain. She co-edited and authored the textbook entitled: Oncology Rehabilitation: A Comprehensive Guidebook for Clinicians published by Elsevier in October of 2022.

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