Prohibit, Protect, or Adapt? The Changing Role of Volunteers in Palliative and Hospice Care Services During the COVID-19 Pandemic. A Multinational Survey (Covpall)

Abstract

Background: Volunteers are common within palliative care services, and provide support that enhances care quality. The support they provided, and any role changes, during the COVID-19 pandemic are unknown. The aim of this study is to understand volunteer deployment and activities within palliative care services, and to identify what may affect any changes in volunteer service provision, during the COVID-19 pandemic. Methods: Multi-national online survey disseminated via key stakeholders to specialist palliative care services, completed by lead clinicians. Data collected on volunteer roles, deployment, and changes in volunteer engagement. Analysis included descriptive statistics, a multivariable logistic regression, and analysis of free-text comments using a content analysis approach. Results: 458 respondents: 277 UK, 85 rest of Europe, and 95 rest of the world. 68.5% indicated volunteer use pre-COVID-19 across a number of roles (from 458): direct patient facing support (58.7%), indirect support (52.0%), back office (48.5%) and fundraising (45.6%). 11% had volunteers with COVID-19. Of those responding to a question on change in volunteer deployment (328 of 458) most (256/328, 78%) indicated less or much less use of volunteers. Less use of volunteers was associated with being an in-patient hospice, (OR=0.15, 95% CI = 0.07-0.3 p<.001). This reduction in volunteers was felt to protect potentially vulnerable volunteers, with policy changes preventing volunteer support. However, adapting was also seen where new roles were created, or existing roles pivoted to provide virtual support. Conclusion: Volunteers were mostly prevented from supporting many forms of palliative care which may have quality and safety implications given their previously central roles. Volunteer re-deployment plans are needed that take a more considered approach, using volunteers more flexibly to enhance care while ensuring safe working practices. Consideration needs to be given to widening the volunteer base away from those who may be considered to be most vulnerable to COVID-19.

Symptom Control and Survival for People Severely ill With COVID: A Multicentre Cohort Study (CovPall-Symptom)

“…1 There is scant evaluation of symptom treatment effectiveness in severe COVID, nor an understanding of patient trajectories over time, especially for patients who are sick enough to die. [3][4][5][6][7] Information on optimal symptom management and timing of referral to palliative care, including factors associated with worse symptoms or shorter survival, are vital to improve clinical management in COVID and in SARS and similar respiratory illnesses. Differences between pandemic waves in presenting symptoms, infectivity and other epidemiological characteristics are described, probably influenced by prevention, SARS-CoV-2 variants, treatments and population characteristics.…”

COVID‐19 and hospice community palliative care in New Zealand: A qualitative study

“…Many hospices rely on a significant volunteer workforce to deliver their services and support people in the hospice and community. During the COVID‐19 pandemic, hospices found tension between the need for volunteers and the infection risk (Walshe et al., 2021 ). Previous research has demonstrated that some hospices could redeploy volunteers to new roles that support service users (Walshe et al., 2021 ).…”

“…During the COVID‐19 pandemic, hospices found tension between the need for volunteers and the infection risk (Walshe et al., 2021 ). Previous research has demonstrated that some hospices could redeploy volunteers to new roles that support service users (Walshe et al., 2021 ). Similarly, in the current study, volunteers at one hospice rallied to produce cloth masks.…”

Policies of voluntary services involved in public health emergencies in China: Evolution, evaluation, and expectation

“…A multinational survey that investigated voluntary services in palliative and hospice care during the COVID-19 pandemic demonstrated that volunteers were mostly prevented from supporting these services with the policy changes. The researchers also proposed that re-deployment plans are needed that take a more considered approach, using volunteers more flexibly to enhance care while ensuring safe working practices ( 31 ).…”