Physical function has many dimensions and can be impacted by cancer and its treatment in a multitude of ways. For example, someone who is frail with multiple co-morbidities may struggle with simple activities of daily living such as being able to wash and dress themselves, walk around (mobility) or climb stairs. Others may have specific impairments caused by the cancer or its treatment e.g. shoulder dysfunction and ‘cording’ after mastectomy for breast cancer, muscle weakness or ‘hemiplegia’ from a brain tumour, amputation for sarcoma, or neck and shoulder problems after surgery for head and neck cancer.
Clinical nurse specialists in collaboration with physiotherapists and occupational therapists at a registered and enhanced level can:
- Complete an initial assessment of patient’s functional, social, emotional, spiritual and psychological needs including details of home environment for example, stairs, toileting
- Assess respiratory status, mobility and general physical fitness
- Carry out musculoskeletal assessment for specific impairments e.g., arm & shoulder problems after breast cancer surgery
- Assess and treat neurological impairments
- Teach exercises for maintenance and improvement of muscle tone and joint function
- Assess and treat mobility problems including transfers and gait re-education
- Undertake risk assessment for falls and manual handling and provide safety advice
- Assess and advise on hand dexterity, eye sight and cognitive ability
- Assess and assist with ability to carry out domestic activities of daily living
- Environmental adaption needs including provision of equipment
- Wheelchair assessment and provision
- Advise carers on safe handling and moving techniques for use in the home environment, if necessary
- Those staff at a supportive and assistive level such as allied health support workers will often support with treatment plans under the supervision of a registered practitioner