Jackie Gauntlett - Portsmouth 1948 - 1962

Clinical Specialist Physio in Palliative Care

Some people wonder that physios are needed in Palliative Care when people are dying. The aim of physiotherapy in this field is to enable people to live until they die and to be able to be independent for as long as possible and to be able to fulfil their potential and do what they want to do for as long as they are able.
 
It is essential to have a good all-round knowledge and experience of physiotherapy skills as all of them will be needed in this challenging speciality. Particularly neurological and orthopaedic skills are useful, as is respiratory knowledge. Acupuncture skills can be a great asset.
 
Above all one needs to be a good listener and communicator and a fair experience of life in general will also be very helpful. Most oncology and palliative care units work in a very strong multi-disciplinary team structure, so it is essential to be a “team player” and to be able to work well with other disciplines, such as doctors, nurses, social workers, OT’s, psychologists, chaplains et cetera.
 
Physiotherapists in this field will work to help patients overcome many problem symptoms, such as lack of mobility. A simple walk to the bathroom can be an enormous achievement. Pain symptoms may be helped with advice, heat, Tenl(?) machines, acupuncture, all working alongside medication. Relaxation techniques and coping mechanisms and breathing exercises may help breathlessness. Neurological skills can help when working with brain tumour and stroke symptoms, with motor neurone disease and other neurological conditions. The other hope area is in the treatment of lymphoedema (swollen limbs). Massage and bandaging are some of the techniques used.
 
On entering this field the physio is usually a Senior I grade, as people are often working alone. This can progress to the Clinical Specialist grading or Superintendent in the larger units. Physios may work in a hospital setting or in a hospice or Day Unit.
 
There is a special interest group for physios working in Oncology and Palliative Care run under the auspices of the Chartered Society of Physiotherapy. It is in meeting with others and going on specialist courses that you gain such a lot of extra useful knowledge and expertise, as well as making friends from all over the country working in the same field, and you can share experiences and support each other. This is particularly useful if you are the only physio working for a unit.
 
I have for the past eight years worked in the hospice at Portsmouth, “The Rowans”.  It is a 19-bed hospice with a Day Unit as well as the In-patient Unit. I work with one other physio, 2 bank staff and a volunteer physio helper.
 
This is a very satisfying job, one that is hard on your emotions, but with the good support of colleagues it is a privilege to try to help people at the end of their lives when they are so vulnerable.
 
I am afraid that I am unable to offer work experience but could offer advice on the ‘phone if required. Please contact the Minerva Network Development Office if this is the case.