Compassion at the end of life in Covid-19 times.

Palliative care specialist MICHAEL BARBATO writes and teaches about how to bring love and kindness to the dying. Here are his thoughts on the challenges to this goal with Covid-19. He also has a terrific recommendation to read, Rachel Coghlan’s piece on “small but potent acts of compassion.” See the link to this brilliant insight based on personal experience, at the end of this article.

Michael says all branches of medical practice will need to examine how end-of-life care is best delivered to those impacted directly or indirectly by the Covid-19 pandemic.

“Social distancing introduces anomalies not often associated with end-of-life care,” Michael explained.

“The opportunity to hold and cuddle the one you love, to comb their hair, wipe their brow, massage their hands and feet and kiss them goodbye are either not possible or will be tainted by the fear of contracting the much feared virus.”

“In Aged Care facilities family may be deprived of all these opportunities. Many are not permitted to visit and may not be present at the time of their loved ones dying. Depending on circumstances they may not see them after death to bid their farewell.”

“In relation to Covid-19, social distancing is a valuable public health measure, but it will add enormously to a family’s experience of grief.”

The challenge for all, not just palliative care, is how can we best deal with this?

“I have no doubt that hospital patients and residents of Aged Care facilities are getting the best medical care, but what is offered to families who have limited outlets for their grief?”

“How do we support nurses, doctors and all hospital and Aged care personnel who work tirelessly and are confronted by a situation not before encountered in their life time?”

“What about families who worry about a family member whose work exposes them to the risk of contracting Covid-19? How do we bring the best holistic care to all these people?”

“The anomalies go beyond the scenario of someone dying. How do we support an elderly or vulnerable family member at home, in an Aged care facility or in hospital?”

“Will phone calls, social media and the occasional brief visit suffice when the period of social distancing and home isolation is likely to last months rather than weeks?” 

“Do we limit visiting hours and the number of visitors to patients in Coronary Care, Critical Care or the general wards?”

“We are social beings with emotions. Our social and emotional needs are put to the test with isolation, sickness, hospitalisation and the possibility of dying, all of which are part and parcel of Covid-19.”

“Let us rise to the occasion by doing what we do best – caring for those in need.”

Sometimes it’s hard to know where to start with “small but potent acts of compassion” needed as we serve others through the PPE mask. But Michael recommends reading Rachel Coghlan’s piece suggesting how we can start.

Rachel is a member of the Australian Palliative Care COVID-19 Working Group and a PhD candidate at the Centre for Humanitarian Leadership.

Read “COVID-19: projecting compassion through the barrier of PPE”:

A great step into the unknown world of care through a mask.

For a psychiatrist’s response to the challenges of helping patients, through the barrier of Covid-19, see:

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