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Review
. 2019 Feb 15;14(3):243-257.
doi: 10.1177/1559827619830049. eCollection 2020 May-Jun.

Lifestyle Medicine Interventions in Patients With Advanced Disease Receiving Palliative or Hospice Care

Gowri Anandarajah  1   2   3 , Haran Asher Mennillo  1   2   3 , Gregory Rachu  1   2   3 , Tyler Harder  1   2   3 , Jyotsna Ghosh  1   2   3
Affiliations
Review

Lifestyle Medicine Interventions in Patients With Advanced Disease Receiving Palliative or Hospice Care

Gowri Anandarajah et al. Am J Lifestyle Med. .

Abstract

Background: Lifestyle medicine interventions have the potential to improve symptom management, daily function, and quality of life (QOL) in patients with advanced or terminal disease receiving palliative or hospice care. The goal of this review is to summarize the current state of the literature on this subject. Methods: The authors used a broad search strategy to identify relevant studies, reviews, and expert opinions, followed by narrative summary of available information. Results: Four main categories of lifestyle interventions feature prominently in the palliative care literature: exercise, nutrition, stress management, and substance use. High-quality studies in this vulnerable population are relatively sparse. Some interventions show promise. However, most show mixed results or inadequate evidence. For some interventions, risks in this generally frail population outweigh the benefits. Clinical decision making involves balancing research findings, including the risks and benefits of interventions, with a clear understanding of patients' prognosis, goals of care, and current physical, emotional, and spiritual state. Achieving optimum QOL, safety, and ethical care are emphasized. Conclusions: The use of lifestyle interventions in patients receiving palliative or hospice care is a complex undertaking, requiring tailoring recommendations to individual patients. There is potential for considerable benefits; however, more research is needed.

Keywords: exercise; hospice; lifestyle medicine; nutrition; palliative care; stress management; substance abuse.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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