Hospice Care During the Pandemic: What is different, and what has stayed the same.

Feb 25, 2021

Lauren R. Tschirhart, Development & Social Media Liaison

As the month of March quickly approaches, a lot of emotions flood in with it. March is known for representing a time of re-birth, and as we look forward to spring and the promise of warmer days, we also take time to reflect on the cold days behind us. March 2021 is significant for the state of Michigan as it marks the one year anniversary of the first confirmed COVID-19 case in the Great Lakes State. This year has brought a significant amount of change into our lives, but we cannot ignore all the things that have stayed the same. Birthdays have come and gone, the seasons continued to change, and life is still as precious as ever. One thing the year 2020 made abundantly clear, is that we only get one life to live, and that life can be taken from us in an instant. Death and dying is something the Angela Hospice staff deals with every day, but COVID-19 forced the masses to become more familiar with it as well.

There is no doubt that this pandemic has significantly impacted the home health and hospice care industry, but what the Angela Hospice staff would like to express is how much has actually stayed the same.

Director of Home Care Clinical Services, Joan Harold explains, “There really isn’t a big difference. We’re still providing the same level of care that we always have, supporting patients and families at end of life.”

Many hospice facilities around the United States saw a decrease in census at the beginning of this pandemic. This fact may be surprising. With so many people dying, wouldn’t the need for hospice care increase?  There are a few things that played into the decrease in admissions. Many hospice eligible patients who contracted COVID-19 never made it out of the hospital and into an appropriate hospice program. Another factor was, and still is, the ever changing visitation policies. It has been hard for families to put their loved ones in a hospice program, knowing there would be limited visitation in place during their final days.

The limited visitation policy has been very difficult on families, but enforcing it has been tough on staff as well. “It’s been really hard…having to tell people they cannot visit their dying loved one or explaining that only one or two visitors are allowed at a time, Angela Hospice’s Care Center Clinical Supervisor, Trista Happney explained, “It’s been very taxing emotionally, on everyone.”

The restricted visitation policy has really forced nurses and aides to step up. Not only have they been caregivers to these patients, but they’ve taken on the role of family as well. “We really are their support system,” Trista said.

Director of Home Care Clinical Services, Joan Harold (left) & Care Center Clinical Supervisor, Trista Happney (right).

Patients aren’t the only ones who are feeling isolated; their families are feeling it as well.

“Families that have a loved one in hospice care end up feeling very isolated, even during normal times, so it’s been nice to be able to bring quality care to them as well,” said Joan Harold. “Families still have access to our social works and spiritual care coordinators, who will call and check in to help them emotionally. I think that’s something everybody’s missing right now, all of us are feeling isolated at home.”

Due to the Care Center visitation policy, more and more families are choosing to put their loved ones in home care, but there is still a great deal of apprehension that comes along with letting caregivers into their homes, as many fear they may bring the virus along with them.

“We are sensitive to families who are concerned about visitors coming into their home,” said Joan. “All of our staff is trained in wearing appropriate PPE, and when we do go to the homes, we are wearing masks over our N95 masks. If a patient or family member is positive for COVID, we would also be wearing full PPE gowns and gloves.”

Staff change into fresh PPE between each patient they see, using a careful set of procedures to ensure everyone’s safety.

“We are very cautious going from home to home, and we’re also cautious about social distancing within the home,” Joan continued. “We may ask someone to step out of the room, so that we can maintain social distancing. That’s not only to protect that patient and family, but it’s to protect our staff, and it’s to protect the other patients and families that staff member may be going to see.”

We have also seen an increase in the use of the Angela Hospice Telehospice Program AVA (Angela’s Virtual Assist). AVA is an easy-to-use computer tablet that patients and families can use at home to connect face-to-face with an Angela Hospice nurse.

“We want to visit when families want us to, and when the patient needs it, but if there is a week where things haven’t really changed with the patient, we may decide to use other resources. If the family is comfortable, and we’re able to order supplies and medications, we may do a telephone visit or AVA visit instead… and families have been really receptive to that. Families are interested in protecting our staff as well. We may offer a visit and they’ll say, ‘No, you know, we’re actually okay this week.’

“AVA has also been a tool that we use to link family members into visits with patients who are in facilities. A lot of our facility patients are at places that do not allow any visitors right now. So families are really looking for our staff to be their eyes and ears,” Joan said.

Choosing to put a loved one in hospice is never an easy decision, and COVID-19 has made that decision even more difficult. The Angela Hospice staff is here, now more than ever, to help guide families to a decision that works best for them.

“When it comes to end-of-life care, this is our specialty; this is what we do… I hope that people trust that we will take care of their loved ones, like we would take care of our own loved ones,” Trista Happney explained, “because that is what we do here.”

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