Care for patients with a serious illness or nearing end-of-life is evolving, and with that evolution comes an increased appreciation for the roles PTs and PTAs can play in these crucial times.

Palliative care is for anyone with a serious illness, providing additional support to the patient and family. In the early stages of a serious disease, a person may work with a palliative care team to promote access to disease-related specialists, develop a life care plan, and receive emotional and psychological support. A patient can obtain palliative care at any age and at any stage of a serious illness. Palliative care is not dependent on prognosis and can be provided along with curative treatment. Such patients would not qualify for hospice services. In the later stages of disease, when death is likely within 6 months and the patient is no longer seeking curative measures, the palliative care team can facilitate a smooth transition to a hospice program.

Hospice care is provided by an interdisciplinary team. The core team, as defined by the Medicare Hospice Benefit, includes physicians, nurses, social workers, and bereavement counselors. These team members are required to provide care for every patient. The broader team includes providers of therapy services (eg, physical therapy, occupational therapy, and speech therapy), home health aides, chaplains, volunteers, dieticians, and pharmacists, as well as others involved in customizing appropriate care for each individual. Each hospice agency has its own approach, providing unique blends of care.

Members of both hospice and palliative care teams may be similar, but the focus of each team is different.