ABSTRACT
Purpose: The goal of rehabilitation for advanced cancer patients is to improve their quality of life (QOL). The meaning of QOL can only be determined by an individual patient. Rehabilitation begins with exploring the patient's hope. Here, we report a case suffering to express hope with difficulties by terminal stage lung cancer with brain metastases. Case: An 83-year-old male who was diagnosed with lung cancer (adenocarcinoma) and brain metastases admitted to palliative care unit because of progressive disease against chemo-radiotherapy. On admission, he could eat independently and walk to bathroom with slight assistance. A few weeks later, he had an epileptic seizure, right-hemiplegia and disturbance of consciousness. This episode made it drastically difficult for us to communicate orally with him. And, we tried hard to know the patient's hope by assessment using activities of daily living (ADL) observation and non-verbal communications. He revealed to be eager to eat even in a PS grade 4. He sometimes could talk a few words and, by rehabilitation techniques, he started to enjoy eating independently. For about three weeks, he could eat until the day before he died. Discussion: Eating behavior could be influenced by proper way of rehabilitation. Conclusion: ADL observation and non-verbal communication could be an effective rehabilitation approach to stimulate feeding behavior resulting in the improvement of patient's QOL.
ABSTRACT
<b>Background:</b> Rehabilitation and palliative care for advanced/terminal cancer patients share a same goal of enhancing patients' quality of life (QOL). <b>Aim:</b> The aim of this study was to identify the patients' narratives during the rehabilitation session, by analyzing words reflecting their ideas and hopes. <b>Method:</b> Out of forty-seven advanced/terminal patients' narratives during the rehabilitation session from April through September in 2011, the rehabilitation therapists recollected the impressive words. Then, the words were grouped into four categories of "total pain" concept by their meanings. <b>Result:</b> Out of a total of 215 words identified, 60% was grouped into physical aspect, 14% into psychological, 10% into social, 7% into spiritual and 9% into mixed aspects. <b>Discussion:</b> If rehabilitation therapists only deal with physical aspects of enhancing their QOL, 40% of patients' wishes will be ignored. <b>Conclusion:</b> Rehabilitation for advanced/terminal cancer patients might need multidimensional interventions with a concept of "total pain".