Pursuing a Good Death in the Time of COVID-19

摘要

Journal of Palliative MedicineVol. 23, No. 6 Letters to the EditorFree AccessPursuing a Good Death in the Time of COVID-19Samuel S.Y. Wang, Winnie Z.Y. Teo, Chee Wai Yee, and Yong Woon ChaiSamuel S.Y. WangAddress correspondence to: Samuel S.Y. Wang, BMed, MD, Fast Program, Alexandra Hospital, National University Hospital System, Singapore E-mail Address: [email protected]Fast Program, Alexandra Hospital, National University Hospital System, Singapore.Search for more papers by this author, Winnie Z.Y. TeoFast Program, Alexandra Hospital, National University Hospital System, Singapore.Department of Hematology-Oncology, National Cancer Institute Singapore (NCIS), National University Health System, Singapore.Search for more papers by this author, Chee Wai YeeGrief Matters, Montfort Care, Singapore.Search for more papers by this author, and Yong Woon ChaiPalliative Program, Alexandra Hospital, National University Hospital System, Singapore.Department of Palliative medicine, National Cancer Institute Singapore (NCIS), National University Health System, Singapore.Search for more papers by this authorPublished Online:29 May 2020https://doi.org/10.1089/jpm.2020.0198AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail Dear Editor:Dying in Isolation: How Do We Support Patients and Family through Grief and Bereavement?The ongoing COVID-19 pandemic has brought about much mental and social anguish as it has physical suffering.1 The population that has the highest rate of mortality are those who are advanced in age, have multiple comorbidities, or are at an end stage of a life-limiting illness.1 However due to the highly infectious nature of COVID-19, it often leads to patients facing their final journey in social desolation. Additionally, due to stretched health-care resources and strict infection precautions, a dignified death may be compromised.2 As health-care professionals, we should aim to provide all terminally ill patients with the basic right of a dignified and peaceful death.2 This letter aims to highlight various measures one can undertake to reduce risk of infection transmission when providing end-of-life care to COVID-19 patients.Communication OptionsThe first step is to identify patients who are at high risk of deterioration. A discussion should be held with the patient's next of kin (NOK) and the patient to explore end-of-life options within the respective settings. Depending on prevailing isolation/social distancing policies and resources, the NOK can conduct videoconferencing sessions in the hospital.3 However, briefing must be done beforehand to prepare the NOK regarding the patient's condition and possibly how they appear visually. Additionally, the meeting must be supported by professional staff, with anticipation of psycho-emotional outbursts. Subsequent follow-up of the patient's and NOK's coping post videoconferencing is recommended in order to offer optimal support.Alternatively, a call-in option may be considered.3 Other options include prerecorded messages in the form of letters or audio recordings in conjunction with comfort objects, for example the patient's or NOK's treasured items can serve as a linking object for the patient and NOK. These items can be kept in the casket to signify a continuing bond between the patient and NOK. Other technology may include employing robots with the NOK's face, with audio available.3Upon a Patient's PassingUpon passing, the team can consider providing a dignified image of the deceased's face to the NOK with permission from the patient and NOK. This is important, as this might be the only visual evidence of the patient's death and it is also cathartic for the NOK who were unable to visit or communicate with the patient prior to their passing.4 Regarding funeral arrangements, a list of certified funeral companies who are able to comply with infection precautions shou