Covid-19
As we are all facing an unprecedented time in healthcare with regards to the COVID-19 pandemic, the antecedent implication for Palliative Care teams and Hospices may be very dramatic.
Please find here practical tips/pointers to consider, as we try to prevent further spread and protect ourselves as we serve as resources to our colleagues on the frontlines.
- Review any advance directive documents prior to intubation of elderly sick patients to make sure we are providing patient centered care.
- Goals of care discussion, by EM/ICU doc or hospitalist prior to intubation, RE: harm/benefits (if any exist at all), of this intervention with patient/family or surrogates. Thanks to VitalTalk for providing this.
- Consider telemedicine for family meetings if/when needed to avoid large groups if such discussions are needed for goals of care conversations. I believe most hospitals already have a visitor restriction policy in place. (Telemedicine Resources).
- Coordination with pharmacy to ensure comfort medications are available and IT to make sure order sets are available across all sites should the need arise.
- Involvement and Coordination with local Ethics teams, Pharmacy, Critical Care, Hospital Medicine and of course Palliative Care as the need arises.
- Working with home care and hospice closely may be very key also in:
- Keeping those sick at home and not bringing them to the hospital if not needed
- Transitions from the ED to home if possible once it is determined being admitted isn’t beneficial
- If we have to place people on comfort measures, who are at the end of their life, it will be very lonely for them being in isolation and I wonder how we can help make it less so without putting staff, especially nurses at risk. Different facilities have different policies and most are making exceptions for dying patients so make sure to have clear communication with the facilities and health systems about what PPE is required and how to best support the dying patient.
Here is a list of Hospice and Palliative Care specific resources which may be helpful to you all.
- Centers for Disease Prevention and Control (CDC) – Coronavirus (COVID-19)
- Medical College of Wisconsin
- Clinician Burnout and Resiliency
- Wisconsin Department of Health Services – COVID-19 (Coronavirus Disease) page
- Wisconsin Medical Society – Physician resources for COVID-19
- Center to Advance Palliative Care (CAPC)
- Webinar – Briefing: Palliative Care and the Impact of COVID-19
- CAPC COVID-19 Response Resources (This already includes most of the ones listed below)
- Supportive Care Coalition (SCC) – COVID-19 RESOURCES includes link to recorded webinar from 3/25/2020 – “Palliative Care and COVID-19: Implications for Clinical Practice, Part One”
- Catholic Health Association of the United States – CORONAVIRUS RESOURCES
- Statement – Catholic Health Care’s Responsibility to COVID-19 Patients at the End of Life
- Webinar 3/25/2020 – Lessons from Ground Zero
- National Coalition of Hospice & Palliative Care (NHPCO) – COVID-19 Resources
(This already includes most of the ones listed below) - American Academy of Hospice and Palliative Medicine (AAHPM) – Resources to Address Coronavirus Disease 2019 (COVID-19)
- VitalTalk – COVID-19 communication skills: a VitalTalk open source primer
- Serious Illness Conversations – COVID-19 Tip Sheet
- The California State University Shiley Institute for Palliative Care (CSU)
- The Role of Palliative Care in a COVID-19 Pandemic
- Select Palliative Care Courses Free Until June 30 (requires subscription)
- National Hospice and Palliative Care Organization (NHPCO) – COVID-19 Information
- Society of Critical Care Medicine (SCCM)
- University of Washington Medicine
- Brigham and Women’s Hospital – COVID-19 Critical Care Clinical Guidelines
- Journal Articles & Book Chapters
- Palliative care considerations in mass casualty events with scarce resources.
- Palliating a Pandemic: ‘‘All Patients Must Be Cared For’’
- Principles for allocation of scarce medical interventions
- Palliative Care Needs of People Affected by Natural Hazards, Political or Ethnic Conflict, Epidemics of Life-Threatening Infections, and Other Humanitarian Crises
- What Should Palliative Care’s Response be to the COVID-19 Epidemic?
- Creating a Palliative Care Inpatient Response Plan for COVID19 – The UW Medicine Experience
- Pandemic palliative care: beyond ventilators and saving lives
- Telemedicine in the Time of Coronavirus
- Advanced Care Planning Resources
- Blog Posts
- Podcasts
- GeriPal – Rationing Life Saving Treatments in the Setting of COVID Pandemics: with Doug White and James Frank
- Social Media Links
- Caring for Yourself and Caring for Others During a Disaster/Epidemic
- Twitter – Follow the #pallicovid hashtag
- What is the importance of Palliative Care during a viral epidemic such as COVID-19?
- @GraniteDoc’s Palliative Care Pandemic Planning and Response Resource List (includes most of the ones listed here) (NEW)
- Facebook group – COVID-19 Palliative Care Providers, has information being added on a continuous basis.
- The Ink Vessel – Nathan Gray M.D Cartoons on Life & Medicine – Palliative Care in the time of COVID (NEW)
- Meetings/Forums/Discussions/Webinars
- Social Work Hospice and Palliative Care Network (SWHPN) – COVID-19 Social Work Open Discussion – FREE (click to register) (NEW)
- Supportive Care Coalition (SCC) webinar – Palliative Care and COVID-19: Implications for Clinical Practice (NEW)