Do COVID-19 Patients Really Have to Die Alone?

By Dennis Thompson
HealthDay Reporter

MONDAY, July 13, 2020 (HealthDay News) – Hospitals have implemented strict no-visit rules to prevent the spread of COVID-19, but these precautions have led to another heartbreaking dilemma.

People die alone, gasping for their last breath without family or friends there to comfort themselves.

Now, some experts argue that this should not be the case and that hospitals must come up with plans that allow dying people to feel comforted when they die.

“We firmly believe that it is a horrible experience to have a loved one who is so seriously ill, but to be alone and separated and not to be able to be with them while they die,” said Martha Curley, President of pediatric nursing at Children’s Hospital of Creme Philadelphia. “We really have to think about how to change that. So, when possible, a person who leaves the world can have someone who loves them and takes care of them at their bedside.”

It won’t be easy, admitted Curley in an editorial recently published in the journal Intensive care medicine.

And some experts believe that the chances of such visits spreading with COVID-19 are simply too great.

Families Entering Hospital Will Endanger the Health of Doctors, Nurses, and Caregivers, and Dozens of Others Who Are Very Ill, said Dr. Lewis Kaplan, President of the Society of Critical Care Medicine.

“Every additional risk to the person providing bedside care that is avoidable should be avoided,” said Kaplan. “All the essential health workers who have been hailed as health heroes – you see the signs,” The heroes work here. “They do. But you have to keep them healthy so they can keep working, so if you get sick, there is someone to provide care.”

Families Must Follow Infection Control Rules

For work visits, families must choose one or two representatives who will be allowed into the hospital, and those close to them will need to demonstrate that they can learn and follow all of the facility’s infection control rules, said Curley.

Continued

“The whole family coming in, you can’t have that because you would just expose a lot of people to it,” said Curley. “Within a family, there may be one or even two people who could understand the importance of being there and who could learn to protect themselves and enter the room and be there with the family member . “

A hospital will need to be able to quickly test these family members for COVID-19, have a cadre of facilitators to guide them through infection control procedures, and provide each visitor with adequate personal protective equipment such as masks. and dresses, said Curley.

All of these steps will be difficult for hospitals already struggling to keep up with COVID surges, says Kaplan.

Testing will be necessary because many people do not wear masks or maintain social distance in public, but most facilities still struggle to keep the materials needed for rapid testing in stock, said Kaplan.

In addition to this, hospitals will need to provide extra masks and gowns to visitors at a time when PPE supplies are running out, and find available staff who can devote time to monitoring visitors, added Kaplan.

Worse still, hospitals will have to make sure that families choose who can see a dying person, and then judge whether the chosen people will be able to comply with infection control rules, said Kaplan.

“We are going to set up the potential for an adversarial system that this family member can visit, but this other family member, they cannot,” said Kaplan. “Visits so popular to help heal and comfort people really can’t please everyone.”

There is also the fear that a visitor will simply decide to stop wearing their mask or wash their hands, said Kaplan. What should staff do if this happens?

Some hospitals are already doing it

But some hospital systems make it work.

Prisma Health in South Carolina has allowed visitors to see dying patients for the past few months now, said Connie Steed, director of infection prevention and control for the hospital system.

Continued

“We allow ourselves a period of time during which the care partner and two other family members have the opportunity to come and sit with the patient and speak and see them at least one last time,” said Steed. , President of the association. for professionals in infection control and epidemiology.

Nurses and other hospital staff explain to visitors how to don and remove protective equipment and stay with them during the visit to ensure infection control is maintained, said Steed.

“I know it sounds crazy, but there are times when some people really find it hard to understand that they have to wash their hands and put on their dresses and wear proper protection,” said Steed.

Steed admits that the process is not easy and uses hospital resources, but believes that it is worth it.

“My prayer is that more hospitals will open up to this, but I don’t think you can say that everyone can do it. I think everyone can think about it,” said Steed. “Dying patients need to be able to see and feel the comfort of their family members, and family members need it.”

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Sources

SOURCES: Martha Curley, inf. Aut., Ph.D., President, Pediatric Nursing, Children’s Hospital of Philadelphia; Lewis Kaplan, MD, president, Society of Critical Care Medicine; Connie Steed, MSN, IA, CIC, Director, Infection Prevention and Control, Prisma Health, Greenville, SC;Intensive care medicine, June 8, 2020



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