End-Of-Life Care in the Time of COVID-19: Communication Matters More Than Ever

Ersek, Mary; Smith, Dawn; Griffin, Hilary; Carpenter, Joan; Feder, Shelli; Shreve, Scott; Nelson, Francis; Kinder, Daniel; Thorpe, Joshua M.; Kutney‐Lee, Ann

doi:10.1016/j.jpainsymman.2020.12.024

Cited by 85 publications

(74 citation statements)

References 35 publications

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“…Open dialogue between health care professionals, relatives, and if possible, the resident can relieve the pain and decrease the caregivers' despair during the resident's terminal phase and death from COVID-19. These results are in line with findings from other studies, 34 reporting on a medical centers highly affected by COVID-19. Effective remote communication with the resident and with the health care team was associated with significantly better family experiences of endof-life care.…”

Section: Finding the Goal And Intrinsic Motivationsupporting

confidence: 93%

“…Effective remote communication with the resident and with the health care team was associated with significantly better family experiences of endof-life care. 34 Feder et al (2021) investigated bereaved family members' perceptions of the quality of end-of-life communication during the COVID-19 pandemic, and they emphasized communication among residents, families, and healthcare teams as critically important during times of limited in-person visitation. Low-quality communication caused profound distress that could affect the quality of the terminal phase for the residents and the bereavement experiences in family members.…”

Section: Finding the Goal And Intrinsic Motivationmentioning

confidence: 99%

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The Experience of Relatives of Nursing Home Residents with COVID-19: A Qualitative Study

Tretteteig¹,

Eriksen²,

AH³

et al. 2022

NRR

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Background:The coronavirus disease 2019 (COVID-19) pandemic had significant consequences for relatives' opportunities to communicate with and offer care to seriously ill and dying nursing home residents with COVID-19. Residents in nursing homes were urged to protect themselves through social distancing, and visits have been permanently regulated and limited. These restrictions have been challenging, and the limitations have raised many questions and led to difficult choices. The aim of this study was to explore the experiences of relatives of nursing home residents with COVID-19. We investigated the following two research questions: How did relatives of COVID-19 patients in Norwegian nursing homes experience the situation and how did the physical distancing and precepts of infection control affect the relationship between the long-term residents and the relatives?. Methods: The study has a qualitative explorative design with a phenomenological-hermeneutic approach, with individual in-depth interviews used for data collection. The study included ten relatives of nursing home residents with COVID-19. Results: Three main perspectives were identified from the participants' experiences: (1) the difficult choices; (2) maintaining the relationship; and (3) experiencing support. The relatives experienced ethical dilemmas when weighing the risk of getting COVID-19 if they visited the patient versus the consequences of not visiting their loved one. In this situation, they needed good information and support from health care professionals. Conclusion:To enable relatives of COVID-19 patients to make choices in line with their goals and intrinsic motivations, it is important that staff members possess competence in infection control, updated knowledge about the residents' situations, and the skills to facilitate a safe and confident dialogue. Trust in the care staff and a feeling of safety are essential for relatives in a stressful situation with difficult choices, while a lack of confidence, routines, and/or dialogue might increase relatives' feelings of insecurity and stress and make their caring role difficult.

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Section: Finding the Goal And Intrinsic Motivationsupporting

confidence: 93%

Section: Finding the Goal And Intrinsic Motivationmentioning

confidence: 99%

The Experience of Relatives of Nursing Home Residents with COVID-19: A Qualitative Study

Tretteteig¹,

Eriksen²,

AH³

et al. 2022

NRR

View full text Add to dashboard Cite

show abstract

“…Stakeholders also prioritized several items that may improve patient, family, and healthcare professional well-being such as videoconferencing options for family members and patients who are separated and provision of frequent medical updates. Recent studies demonstrate that families report successful remote communication (i.e., functional remote technology or staff that kept family informed) with the patient and healthcare team were associated with improved family end-of-life care experience ( 30 , 31 ) and enhanced staff morale ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

A Modified Delphi Process to Prioritize Experiences and Guidance Related to ICU Restricted Visitation Policies During the Coronavirus Disease 2019 Pandemic

Fiest

Krewulak

Makuk

et al. 2021

Critical Care Explorations

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“…67 This has forced a change in the way of communication between family caregivers and healthcare professionals by necessitating the use of remote Information and Communication Technologies. 68,69 Worthy examples of remote communication in the nursing home setting showed that bereaved family caregivers who reported effective remote communication with healthcare professionals had a better overall experience of endof-life care. 68 This suggests that despite in-person discussions remain the first choice for end-of-life communication, Information and Communication Technologies-based discussions may be a valuable alternative when family caregivers' presence in nursing homes is not possible (e.g., visitation restrictions, long distance family caregivers).…”

Section: Recommendationmentioning

confidence: 99%

Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review

Gonella¹,

Mitchell

Bavelaar

et al. 2021

Palliat Med

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Background: Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative’s care and experience high level of strain at the end of life. Aim: To gather and synthesize information on interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes and provide a set of recommendations for practice. Design: Mixed-Methods Systematic Review (PROSPERO no. CRD42020217854) with convergent integrated approach. Data sources: Five electronic databases were searched from inception in November 2020. Published qualitative, quantitative, and mixed-method studies of interventions to support family caregivers of people with advanced dementia at the end of life in nursing home were included. No language or temporal limits were applied. Results: In all, 11 studies met the inclusion criteria. Data synthesis resulted in three integrated findings: (i) healthcare professionals should engage family caregivers in ongoing dialog and provide adequate time and space for sensitive discussions; (ii) end-of-life discussions should be face-to-face and supported by written information whose timing of supply may vary according to family caregivers’ preferences and the organizational policies and cultural context; and (iii) family caregivers should be provided structured psychoeducational programs tailored to their specific needs and/or regular family meetings about dementia care at the end of life. Conclusion: The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.

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End-Of-Life Care in the Time of COVID-19: Communication Matters More Than Ever

Cited by 85 publications

References 35 publications

The Experience of Relatives of Nursing Home Residents with COVID-19: A Qualitative Study

The Experience of Relatives of Nursing Home Residents with COVID-19: A Qualitative Study

A Modified Delphi Process to Prioritize Experiences and Guidance Related to ICU Restricted Visitation Policies During the Coronavirus Disease 2019 Pandemic

Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review

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