RESUMEN
Objective: To clarify changes in the quality of life (QOL) of ambulatory patients with locally advanced/metastatic cancer who underwent rehabilitation in a palliative care unit. Methods: Patients aged 18 years or older who were admitted to the Palliative Care Unit, had a Functional Ambulation Category of 1 (assisted ambulation) or higher, and were assessed at admission and two weeks after admission using the Comprehensive Quality of Life Outcome (CoQoLo) short version, were included in the study. Results: Twenty-one patients completed the 2-week assessment. Ten subjects were male, with a median age of 78 years. The Functional Independence Measure cognitive items significantly declined 2 weeks after admission, but the CoQoLo total score was not significantly different. In addition, the rate of change in the CoQoLo item “Being respected as an individual” was significantly higher in the ≥4 days/week rehabilitation intervention group than in the <4 days/week group. Conclusion: This study has shown that it is possible to maintain the QOL of ambulatory patients with cancer who received rehabilitation in a palliative care unit.
RESUMEN
Objective: To examine the trajectory of activities of daily living (ADL) in cancer patients from 6 weeks before death using the Functional Independence Measure (FIM). Method: This study was a retrospective observational study. The participants were cancer patients aged 18 years or older who died and were discharged from the palliative care unit in Tsurumaki-onsen Hospital. Six weeks of FIM data were collected from the patients’ medical records from 6 weeks before death to the time immediately before death (week 0). Results: Fifty-five participants were included in the study. FIM scores declined from 55 points at 6 weeks before death to 25 points immediately before death. Functional independence was higher for cognitive items on the FIM than for motor items, and both cognitive and motor functioning significantly declined just before death. Within the motor subscale, the patients were more independent with regard to eating, grooming, and bladder management compared to other activities until just before death. Within the cognitive subscale, the patients showed greater independence with regard to expression and social interaction. Discussion: A support for ADL needs to be considered to assist out-of bed activities in a safe and comfort manner until two weeks before death. Patients’ activities on the bed can also be continued for independence until just before death.