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'Nobody is dying alone here': How one hospice is dealing with end of life care during the Covid-19 crisis

Due to Covid-19, the hospice is now restricting visitors to two at a time for patients.

Image: Shutterstock/Photographee.eu

MANY RESIDENTIAL CARE settings and hospitals have placed restrictions on visitors in response to the Covid-19 pandemic, including hospices caring for those nearing the end of their lives.

Last week, the Irish Hospice Foundation recommended that one family member should be allowed with every person who is dying in hospitals and care settings.

The Foundation called for ways to be examined to ensure a family member is there with every person who is dying. This can include phone calls and video calls, it said. 

One hospice that is offering such supports to patients and families during the pandemic is Our Lady’s Hospice (OLH) in Dublin. Speaking to TheJournal.ie about how the hospice has been dealing with the new challenges, OLH principal medical social worker Louise Casey said that “nobody is dying alone” in the palliative care unit in the hospice. 

“There are restrictions, of course, and we are following the guidance from the HSE,” Casey said. Due to Covid-19, the hospice is now restricting visitors to two at a time for patients coming towards the end of their life. 

“The only reason somebody would die on their own – obviously there’s always staff around them – would be if it was unexpected and unforeseen and in a way that could happen regardless of any restrictions,” Casey said. 

Prior to the pandemic, there were no restrictions on visitors to the hospice. 

Our Lady’s Hospice has now put additional supports in place for patients and their families as a result of Covid-19. 

As many patients may not be able to see family members as often now, the hospice has offered virtual communication options, such as video calls. 

Families are also now being provided with two phone calls a day from staff to update them on their relatives’ condition, one call from a nurse and one call from a social worker. 

“I think families find that extremely supportive,” Casey said. 

Due to the unprecedented nature of the pandemic, it may be that in some cases family members who are cocooning, for example, won’t be able to see their relatives in a hospice in person before the end of their lives. 

When asked about what psychological impact this could have on a family member, Casey said that it “depends on the person, it depends on the meaning they give to it”.

“I can’t generalise but, for example, an elderly person might say ‘I’m so thankful my relative was cared for well in the hospice, given that I couldn’t go visit them’,” she said. 

“It might be a kind of relief to them or it could be that they have some sort of unfinished business that they didn’t get to say what they wanted to say to them.”

Social workers

It isn’t just patients and families who have to deal with the changes that come along with restrictions within the hospice, staff members have also had to adjust how they work. 

Casey noted it has been a “different way of working” in recent weeks, but added that social workers are “used to working with uncertainty and unpredictability”. 

We’re here because we want to support people and we know the difference it can make to people when they get social work support and so it can be hard when we can’t do the work we usually would.

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For example, she said that a big part of the social workers’ role is supporting families in dealing with anticipatory grief. This is usually done face-to-face but the workers have now moved to provide support over the phone. 

“In saying that, we are adapting,” she said. 

Guidance

The Head of Social Care at the Department of Health, Dr Kathleen MacLellan confirmed at last night’s Department of Health briefing that there is no visiting patients allowed except for certain circumstances, including compassionate circumstances.

She said that where somebody is dying, on a case-by-case basis the family members or member can visit them.

It is down to the family member as to how they feel about the risk involved, and PPE will be provided, it was also confirmed.

The Irish Hospice Foundation last week issued the following advice to patients and healthcare sector workers on dealing with the death of patients during the pandemic:

With reporting by Gráinne Ní Aodha

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