Hospice services available despite pandemic

By Patrick Mcardle
[email protected]
Local agencies are still providing hospice care but adjusting their procedures to slow the spread of the novel coronavirus and the disease it causes, COVID-19.

Nicole Moran, a nurse and director of hospice and palliative care for the Visiting Nurses Association and Hospice of of the Southwest Region, or VNAH, said the service is still available for terminally ill patients, even if the reason for that diagnosis is COVID-19.

VNA staff members are taking steps to offer care in ways that will not encourage the spread of the virus. While initially the information about COVID-19 was coming at health care professionals in a way Moran described as “fast and furious,” they soon get a handle on what measures needed to be taken.

At VNA, staff members are required to monitor their own health before they see patients. They also screen patients and family members before they are admitted for services and before every visit, Moran added.

“We’re ensuring that we have up-to-date information on our patients and families so that we can put the necessary protection in,” she said.

VNA does not have a hospice facility but provides hospice care at sites like the patient’s home or residential-care facility.

Moran said as medical care providers, staff were already exercising precautions such as hand-washing but with the pandemic, new measures, like masks, gowns, respiratory protections and face shields, have become more common.

Rich Marantz, a registered nurse who provides hospice care for VNA, said nurses are using specialized sanitizing cloths on any equipment they bring into a patient’s home.

Marantz is among the nurses traveling to see patients who might have COVID, entering their homes and providing care, at a time when Vermonters are under an order to generally stay home and avoid contact except with immediate family.

But he says the work he and other visiting nurses do is “incredibly meaningful to provide the care that all of us do for our patients.”

“You don’t do this work unless you find it really meaningful and important and useful,” he said.

What has changed is an added layer of critical thinking throughout a work day about what needs to be done to keep patients, family and the nurses themselves as healthy as possible.

“We have to do a lot more thinking and really take our time to make sure all the steps are in place to protect that family and protect that patient,” he said.

While Marantz recognizes the unusual circumstances of a pandemic, he pointed out that hospice work has never been easy.

“It’s always challenging work. It’s not easy work, but we do it because, like myself, I feel called to do it. You just do that because it’s important,” he said.

Marantz added that self-care was vital for health care providers right now so that “the next day we can get up and do it again.”

In a prepared statement, staff members at BAYADA Hospice said their service was still available but Jessica DeGrechie, division director, pointed out the pandemic presented a new challenge for which end-of-life care providers “don’t have a textbook.”

“I think everybody is hypervigilant right now to make sure we’re checking in and how are people doing, what questions do they have, what do they need for support — being available and being present as best we can,” she said in the statement.

Moran said hospices across the country had the challenge right now of working with patients who are living in a residential facility. As a result, the hospice care provider has little control over the environment.

At many residential facilities, the number of visitors admitted has been restricted, even for those receiving end-of-life care. Moran said hospice workers have tried to provide additional emotional support for the families and patients who feel isolated.

For patients living at home, VNA staff are doing their best to educate families about the value of limiting their contact.

“We’re really emphasizing that education with patients and families but encouraging them to continue to have those relationships and support each other because that’s so important especially now more than ever,” she said.

Also, BAYADA staff have developed ways to coordinate virtual visits through video chat.

Moran pointed out one change to VNA hospice services people may want to know is that the volunteer services are temporarily suspended.