A Review of Non-Pharmacological Pulmonary Rehabilitation for Patients Receiving Palliative Care

Kristin Dawson, Shannon Freeman* and Kevin Adam

A Review of Non-Pharmacological Pulmonary Rehabilitation for Patients Receiving Palliative Care.

Dyspnea is common in patients experiencing chronic and malignant lung conditions. It is a very distressing symptom that often results in anxiety and depression. Pulmonary rehabilitation together with palliative care can provide physical, psychological, and quality of life (QoL) improvements in patients that receive it.

Prominent themes that emerged were the beneficial effects of pulmonary rehabilitation, even in late stages of lung disease, and the positive impact palliative care can have on the patient. Simultaneously, there were considerable barriers to access mentioned throughout the literature, which prevents patients from receiving either pulmonary rehabilitation and/or palliative care at the end-of life. Educating health care providers on the benefits of pulmonary rehabilitation, and providing timely referrals to pulmonary rehabilitation and palliative care is important. Understanding factors which may prompt a patient to attend and complete, or discontinue, pulmonary rehabilitation treatment is important.

Chronic respiratory diseases (CRDs) and some malignancies often cause dyspnea and are a natural part of the disease process. However, emotional feelings of fear or loneliness can exacerbate
dyspnea. Since dyspnea itself causes fear and panic in the patient, a vicious cycle of dyspnea-fear-dyspnea can worsen shortness of breath. Therefore, shortness of breath can be a complex
symptom, resulting from an interplay between physiology and emotion, in which one treatment modality often will not offer adequate symptom relief. Pulmonary rehabilitation which encompasses tailored therapies that aim to help the physical as well as the psychological health of the patient is therefore an important consideration for patients receiving palliative care.

Pulm Res Respir Med Open J. 2017; SE(2): S26-S46. doi: 10.17140/PRRMOJSE-2-105