Assessment, treatment goals and interventions for oedema/lymphoedema in palliative care

Int J Palliat Nurs. 2017 Mar 16;23(3):111-119. doi: 10.12968/ijpn.2017.23.3.111.

Abstract

Background: Little is known about the treatment of oedema in palliative care patients.

Aim: To outline the assessment, goals, and interventions for patients with oedema.

Method: A 6-month chart review of a specialist physiotherapy-led oedema service was carried out.

Results: Of the sample group (n=63), 28.6% of patients had lymphoedema, 15.9% had non-lymphatic oedema, 46% had mixed oedema and 9.8% had lymphorrhoea; 58 patients (92%) had cancer. The most common interventions were providing education (100%, n=63), using compression garments (58%, n=37), bandaging (51%, n=32), exercise (38%, n=24), lymphatic massage and kinesio-taping (35%, n=22 each). Treatment regime differed depending on the type of oedema present. Treatment goals were pragmatic: the most common were to maintain skin quality (54%, n=34), reduce limb volume (52%, n=32), and improve quality of life (48%, n=30).

Conclusion: Palliative care oedema can be treated using manual methods, including compression and massage. Goals differ from other oedema populations. Research is hampered by lack of suitable measures to record skin changes and quality of life.

Keywords: Lymphoedema; Oedema; Physiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Athletic Tape
  • Cohort Studies
  • Compression Bandages
  • Edema / etiology
  • Edema / therapy*
  • Exercise Therapy / methods*
  • Female
  • Heart Diseases / complications
  • Humans
  • Lymphedema / etiology
  • Lymphedema / therapy*
  • Male
  • Massage / methods*
  • Middle Aged
  • Motor Neuron Disease / complications
  • Neoplasms / complications
  • Palliative Care*
  • Patient Education as Topic / methods*
  • Physical Therapy Modalities*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Quality of Life
  • Retrospective Studies
  • Stockings, Compression