Strengths and Struggles for Families Involved in Hospice Care During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic presented unique health and social challenges for hospice patients, their families, and care providers. This qualitative study explored the impact of the pandemic on this population through the experiences and perceptions of social workers in hospice care. A survey was distributed through national and local listservs to social work practitioners throughout the United States between May 15 and June 15, 2020. The study was designed to learn the following: (1) Concerns patients experienced as a result of the pandemic, (2) strengths/resilience factors for patients during the COVID-19 pandemic, and (3) the personal and professional impact of the pandemic on social workers. Themes uncovered in hospice care included isolation, barriers to communication, disruption of systems, issues related to grieving, family and community support, adaptation, and perspective. The authors provide recommendations for social work practice related to virtual communication, emergency planning, and evidencebased intervention for Persistent Complex Bereavement Disorder. Recommendations for policy include uniform essential worker status for social workers, telehealth reimbursement and expanded caregiver respite benefits.

Australian and New Zealand social workers adjusting to the COVID-19 pandemic

“…In addressing our primary research question, ‘How has social work practice in Australia and New Zealand been impacted by COVID-19?’ we first address our subsidiary questions. In response to the first question, ‘How have social workers safeguarded vulnerable community members during lockdown?’, like their colleagues elsewhere ( Dominelli, 2020 ; Gergerich et al , 2020 ), our respondents noted that they have endeavoured to continue their practice using virtual means, but that their ability to assess was reduced. Australian and New Zealand social workers also reported issues with connectivity and having adequate equipment and training to undertake telehealth effectively.…”

“…For social workers, the pandemic has led to a rapid reappraisal of practice methods to deal with lockdown periods. During these periods, many workers have been working from home and engaging with clients via telephone and online methods ( Dominelli, 2020 ; Gergerich et al , 2020 ). This has created significant ethical dilemmas for social workers concerning issues such as continuity of care ( Abrams and Dettlaff, 2020 ), maintaining trusting relationships ( Banks et al , 2020 ; International Federation of Social Workers (IFSW), 2020 ) and ensuring confidentiality and privacy ( Banks et al , 2020 ; Barsky, 2020 ).…”

“…Nonetheless, social workers have demonstrated initiative by engaging with alternative methods such as the delivery of services via telehealth options ( Cook and Zschomler, 2020 ). However, despite the adaptability of the profession to the global health crisis and the increase in social issues ( International Association of Schools of Social Work (IASSW), 2020 ), researchers from across the world are noting a concerning lack of media coverage of social work in the context of the pandemic ( Gergerich et al , 2020 ; Paul et al , 2020 ; Raftery et al , 2020 ).…”

“…International researchers note that the critically altered conditions in which social workers are now operating are subject to significant practice changes at the same time as there is reduced or inadequate resourcing. For example, Dominelli (2020) in a UK context and Gergerich et al (2020) in a US context note that many workers are working remotely during the pandemic and that this is impacting service delivery. Researchers across a range of countries including the UK ( Cook and Zschomler, 2020 ; Dominelli, 2020 ), Canada ( Archer-Kuhn et al , 2020 ), Malaysia ( Azman et al , 2020 ), Netherlands ( De Jonge et al , 2020 ), Vietnam ( Dinh and Nguyen, 2020 ), Spain ( López Peláez et al, 2020 ), Poland ( Necel and Zaręba, 2020 ), Greece ( Papouli et al , 2020 ), Lebanon ( Badran, 2020 ), Italy ( Fargion et al , 2020 ) and China ( Yuan et al , 2020 ) note also that workers are using remote technologies to work with clients.…”

“…They are also struggling with understanding clear boundaries (e.g. assessing when they can use their personal devices for work-related tasks ( Barsky, 2020 )); and how to respond to an increased workload ( Gergerich et al , 2020 ).…”