End-of-Life Care Changes Due to Virus Crisis

There seems to be many ‘new normal’ items today because of the virus crisis. Even end-of-life and hospice are affected by COVID-19. Advance directives and professional help make life’s end easier on family.
Updated: March 10th, 2021
James Kelly

Contributor

James Kelly

We will all face the end of our life at some point in the future, but for many people, the process can take weeks to months as we suffer through a terminal illness or the process of aging itself. The COVID-19 virus crisis has also impacted the end-of-life due to pressures placed on health care facilities.

Unfortunately, many people die in facilities such as hospitals or nursing homes. Those suffering from COVID-19 are also isolated in these facilities. For many people, this end-of-life is not consistent with their wishes.  

People are encouraged to express their end-of-life preferences to their families and caregivers in advance. Today there are many options available. If an older person desires to die at home, it can often be arranged as long as their wishes are known and plans can be made. This way, it is less likely he or she will die in a hospital receiving unwanted treatments.

The Final Months and Days

Hospice care is used when a cure is not likely or when people are in the final months of life. It can also make a person more comfortable to relieve severe symptoms from diseases like cancer. The idea of hospice care is to make the final months or weeks of a person's life as pain-free as possible and help both the patient and the family cope with the death process. The anxiety level is also high, and the appropriate care reduces this anxiety as best as possible.

When a person is told they have less than six months left to live, it can be overwhelming. The family also faces tremendous emotion. Families face fear, worry, and sadness.

If the terminal patient is suffering from COVID-19, it adds additional pressure on the caregivers and families. The patient may have been isolated due to the virus, and that isolation might not change much as they go into hospice care.

Caregivers and Families Need to Be Concerned with COVID-19 Infection

Ken Haglind, President and Co-Founder of Minnesota Hospice, that caregivers need to be careful about their interactions with a patient. When a caregiver is responsible for multiple patients in hospice care, it can lead to other patients' accidental exposure. All it takes is for one patient to have COVID-19 for all of the other patients under the caregiver's care to be at a higher risk.

He says that in some instances, elderly individuals who are suspected of having COVID-19 are being refused care by hospitals due to insufficient support. However, hospice facilities are working to provide comfort packs so that families can care for the sick without risking added exposure being admitted into a hospital.

Families need to be aware of COVID-19 symptoms, including fevers, shortness of breath, and a dry cough. Everyone, the patient, the family, and the caregivers need to be vigilant. The mission of hospice, Haglind explains, is to make sure that the quality of life at the end of one's life is the primary goal. Comfort, dignity, and choice are afforded to those who are served by hospice.

What is Palliative Care?

The doctor's role is to treat patients in the hopes of a cure for as long as possible. When there is little or no hope for the person to get better, palliative care is an option. This type of care is focused on providing relief from the illness's symptoms and stress to improve the quality of life for both the patient and the family.

According to Medline Plus, both palliative care and hospice care provide comfort. But palliative care can start with the diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped, and when it is clear that the person is not going to survive the illness.

Both hospice and palliative care are impacted because of COVID-19. Yet, the importance of both is even more critical during this crisis.

"Spending one's last months or weeks in a hospital is never ideal. One of the major benefits of hospice care is that it can often take place in a patient's own home, whether that is their house, an assisted living community, or a skilled nursing facility. In other instances, a patient can go to a freestanding hospice center, where all medical issues can be treated but which has a homier, more comfortable atmosphere than a hospital," said Haglind.

Medicare will pay for some hospice under the rules they have in place. Many Long-Term Care Insurance policies will for hospice either in a person's home or in a facility. Expressing your wishes and planning in advance is always essential to make sure your preferences are considered.

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