Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19

  • Kim, Yejin (Center for Palliative Care and Clinical Ethics) ;
  • Yoo, Shin Hye (Center for Palliative Care and Clinical Ethics) ;
  • Shin, Jeong Mi (Center for Palliative Care and Clinical Ethics) ;
  • Han, Hyoung Suk (Center for Palliative Care and Clinical Ethics) ;
  • Hong, Jinui (Center for Palliative Care and Clinical Ethics) ;
  • Kim, Hyun Jee (Department of Social Work, Seoul National University Hospital) ;
  • Choi, Wonho (Center for Palliative Care and Clinical Ethics) ;
  • Kim, Min Sun (Department of Pediatrics, Seoul National University Hospital) ;
  • Park, Hye Yoon (Department of Psychiatry, Seoul National University Hospital) ;
  • Keam, Bhumsuk (Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2020.11.09
  • Accepted : 2021.01.04
  • Published : 2021.06.01
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Abstract

In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

Keywords

Acknowledgement

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI20C1995, HC20C0005).

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