Physical Therapy Utilization in Hospice and Palliative Care Settings in Michigan: A Descriptive Study

Purpose: Physical therapists (PT) are described as integral members of hospice and palliative care teams; however, the degree that hospice administrators use PT in these settings is not known. This study describes PT utilization in hospice and palliative care settings as reported by hospice administrators in Michigan. Methods/Subjects: A prospective, descriptive study using e-mailed surveys (Zoomerang r) was performed to gather data from hospice administrators in Michigan. Electronic mailings contained cover letters, informed consent, and online surveys. Follow-up surveys were e-mailed 2 weeks later to nonresponders. Results/Discussion: Thirty-one of 133 (23.7%) surveys were returned. Thirty of 31 (97%) respondents reported using PT services in 2005; however, an average of only 2.4 to 3.0% (range of 0% to 5.0%) of patients were reported to have received PT in these settings. Survey responses indicated that the most common medical diagnoses referred to PT were stroke (70.0%), cancer (53.3%), multiple sclerosis (43.3%), and heart disease (40.0%). Most frequent reported PT diagnoses treated were decreased mobility (83.3%), decreased balance (76.6%), fall risk (76.6%), and gait training (73.3%). Most frequent reported PT interventions were caregiver education (76.7%), fall prevention (73.3%), and range of motion (66.7%). Most frequently reported PT outcomes were improvements in caregiver confidence (66.6%), quality of life (63.3%), safety (60.0%), and mobility (50.0%). Conclusion/Recommendations: Survey results suggest that PT is not commonly used in hospice and palliative care settings in Michigan. Further study is required to determine the efficacy of PT in these settings.