Occupational therapy and end-of-life care: Development of high-density foam orthosis as comfort measure

Abstract

An orthosis is a rehabilitation device applied to a body segment (with one or more joints), whose function is to stabilize, immobilize, prevent, or correct deformities, and maximize patient functionality.However, in end-of-life care and palliative rehabilitation, changes are needed for orthosis prescription, once the main objective is comfort and symptom management. The aim of this article is to present a specific model of high-density foam orthosis developed in a Brazilian hospice for terminally ill patients, and discuss about the roles and strategies in palliative rehabilitation. This orthosis model is proposed for patients with advanced disease and no prognosis of functional recovery. It is manually made with high-density foam, cotton fabric, board velcro, EVA (ethylene vinyl acetate), hot glue, folding or electric knife. The foam is cut with the folding knife according to the required orthosis model, then covered with fabric and EVA. Board velcro is added to place the device on the patient. Positive results can be described: adherence to the use of the orthosis, minimal discomfort reported, muscular relaxation/tonus regulation, pain management and reduction of edema. Rehabilitation is an integral part of Palliative Care, and in case of terminally ill patients, comfort is the main objective of the care plan. The intervention of Occupational Therapy and the use of foam orthosis is an important strategy to achieve this goal.