Rapid response team helps support end of life patients at home
Patients coming to the end of their lives are being helped to do the little things that mean so much by a designated team of physiotherapists offering a rapid response service.
Sitting with their family for a meal, or spending time in their garden are examples of small but hugely meaningful pleasures that people in their final days often need support to achieve.
The physiotherapy project runs in the Bay Health Local Cluster Collaborative (LCC), which covers areas including Sketty, Uplands, Killay, Mumbles and Gower.
It sees physiotherapists visit end of life patients in the community to help them with issues around pain, mobility, positioning and to alleviate symptoms, such as breathlessness.
They also support patients to achieve goals they may have, which could include helping them to sit in a chair to have a meal with their family, time outside in their garden or enabling them to sleep in their own bed.
Pictured (l-r): Clinical lead physiotherapist for oncology and specialist palliative care Kathryn Elias, physiotherapist technician Donna Fleming-Powell, team lead physiotherapist for specialist palliative care Nicola Perkins, physiotherapist technician Rachel Schiavone and Bay Health LCC lead Dr Nicola Jones.
Bay Health LCC provided temporary funding for the pilot project, which has enabled a more rapid and enhanced offer by specialist palliative care physiotherapists based out of Ty Olwen.
The physiotherapists travel to patients’ homes across the cluster, to help support them to remain at home in their final days, accessing support quickly and reducing the need for hospital admissions.
Rebecca Kennedy, Swansea Bay’s Head of Physiotherapy, said: “Lots of patients’ wishes are to be able to spend their last few days at home, rather than in hospital.
“Bay Health LCC were finding that within their area there was a significant demand to support symptom management in patients nearing the end of life. These symptoms can be distressing for patients, carers and their families.
“Lots of requests from patients to GP practices related to pain management, positioning, breathlessness and end of life symptoms, which physiotherapists are well placed to help with.
“They identified a need for additional support so we introduced the pilot project, which has now been extended into its second year.
“The team has responded to the majority of patient requests within 72 hours.
“It means patients are having a better experience, they are getting the right support from the right person, having an improved experience and greater comfort.
“This project is also reducing demand on GP time within the cluster.”
The team support patients with a range of meaningful end of life goals.
Kathryn Elias is the health board’s clinical lead physiotherapist for oncology and specialist palliative care.
She said: “The goals can range from very simplistic things to sometimes bigger challenges.
“They can be around maybe a meal with their family for the last time, so we would support them to be able to sit in a chair.
“Some people may want to sleep in their bed upstairs with their partner for one last time, as a lot of patients end up being downstairs as they can’t use the stairs.
“Or even being able to go out for the day, so we would support them to practice being able to get in and out of the car.
“Physiotherapists can also help to position people so they are more comfortable to be able to eat, drink and talk.
“It is very individualised care to help people achieve their last memories.”
Referrals are mainly received from within the specialist palliative care team, but as part of the project GP practices based in the Bay Health LCC can directly refer patients.
“Supporting people with end of life care is one of the health board’s priorities,” Kathryn added.
“It is so important to communicate openly with patients around end of life care because it can be scary. We can discuss with patients and their families and carers what they want to achieve at the end and often support them to remain in their own home.
“If a patient has got one last wish that we can help them to achieve before the end of their life, it just makes a huge difference to them and their families.”
Dr Nicola Jones, Bay Health LCC lead and a GP at Gower Medical Practice, said: “This responsive palliative service has already made a difference to so many of our patients at the end of their lives.
“Rebecca and the physiotherapy team have created a bespoke and innovative service which allows these patients to achieve simple or more complex goals before the end of their lives and helps them deal with some of the more distressing symptoms of dying, like breathlessness.
“I am very keen to see this service develop more fully to allow more patient access to such a supportive team in their time of need.”
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