Imagine pulling up to a COVID-19 testing station, asking for an evaluation of your spouse or child and on discovery of severe symptoms of the virus having your loved one whisked away on a gurney, disappearing into the hospital with their cell phone as your only remaining method of contact. No warning, no discussion and no hugs. It’s a stark and for many people, a terrifying image. And it is happening around the world. Patients who present with COVID-19 are unable to have visitors, unable to see family or friends. After the virus has taken hold and they are close to death, there is still no interaction with other people beyond their hazmat-suited medical team.
This is not how any of us picture our end, but it is a reality for hundreds of thousands of people so far.
Small Steps for Humanity
There are people, teams of people, who are working fast and hard to bring an element of human connection to that experience. In the age of Covid19, there is so little time to stop and consider the patient’s mental health or sense of wellbeing. The full force of effort has been on their medical needs, by necessity. But some medical professionals, like Dr. Jane Meier, are adding to that experience by enabling connections with family and friends as much as possible. She talks about her experience in helping patients talk to their families in this video.
We’ve all seen the short youtube videos of doctors and nurses recounting one or another patient, close to death from COVID, saying their final good-byes to loved ones with an iPad or on a cell phone, using video calls. It is gut wrenching but so powerful, to know they were not technically alone in those final hours. Isn’t that what we need most – connection? The answer is yes.
We may not be able to replicate the physicality of a hug or holding someone’s hand. But we can be there, virtually, so that the patient knows they really are not alone. What could be more important?
Talking Is Key
So often, we fail to have these conversations ahead of time, before an emergency or a pandemic hits. But we should, early and often. Some people want to fight, are willing to accept any pain and discomfort to return to their families. Others have lived a good life and feel okay with not fighting, and allowing for whatever comes. If we have not had these conversations, we are yielding to the wishes of others. Which is also a choice.
Dr. Meier recounts from her days in the ICU, “People welcome these conversations, they want to talk about what they would want and if the patient is too sick to talk, they are relieved that someone is asking.” She goes on to say that some are very clear about not wanting to go through the pain associated with prolonged treatment for COVID and others will want to fight no matter what.
Dr. Meier is on the front line, facilitating end-of-life conversations with patients who are hospitalized with COVID-19. She is helping people who are, by necessity, alone to have some method to reach out and be able to – albeit virtually – spend some time with their loved ones.
Talk now, not later
Before the need for hospitalization, even before we ever get sick, it is important to talk with family or close friends about our own views around end-of-life care. For some, that means putting directives in place that officially protect our right to die without having to endure painful or difficult treatments. For others, it means explaining that you want that fight and you are expecting medical staff to do whatever it takes to extend your life. Most of us fall somewhere in between those two extremes. And most of us fail to act in time and end up needing to rush these important conversations.
Talking about death does not bring it closer. Not talking about it can make it harder than it has to be.
Compassion is an important aspect of medical care, whether we are close to death or not. Compassion is the whole point of palliative care, with or without a pandemic. Compassion in death, as in life, can make all the difference between pain and peace.