National Healthcare Decisions Day and Palliative Care in the COVID-19 Pandemic

Categories: Opinion.


If I had the ability to know exactly how many people around the world have been and are infected by the novel coronavirus as I write this piece, the numbers would be different by the time of publication and when you would read it. I am grateful for the exigence that the media assigns to reporting on the COVID-19 pandemic as they report statistics and share models to aid us in understanding the seriousness of the pandemic and what the spread of COVID-19 can do if not mitigated and contained.

When I listen to the updates about the pandemic, I hear more than numbers. Each number reported represent a person. And, the number indicates that other individuals that share relationships with the person infected by the virus are being affected by the pandemic even though they may never contract the illness. Palliative medicine may provide care that is crucial to the people that become ill with the virus and their “family” units.

People often associate palliative care with hospice. Hospice is part of palliative care, but palliative care is not completely defined by end-of-life care. Palliative care is delivered to the person that is identified as the patient along with his or her “family” unit that are confronted with an illness that threatens the patient’s life over time. Palliative care ideally begins when a person is diagnosed with a chronic illness and can be administered concurrently with curative care. Palliative care endeavors to assess and treat the ill person holistically with the simultaneous goals of preventing and alleviating suffering where possible. The earlier an illness is diagnosed; the sooner efforts can be made to treat and limit the effects of an illness over time.

In the COVID-19 pandemic, some community members are more susceptible to the virus than others including those that are older, have one or more chronic illnesses and/or are immunocompromised. An older person is not just defined by the number of years lived, but also by physiological age. People of similar chronological age are not automatically equipped physiologically to deal with coronavirus. When one layers an acute illness on top of a chronic illness(es) the severity of the illness and a person’s ability to fight it are compounded.

Palliative practitioners can continue to manage symptoms of the chronically ill that are diagnosed with coronavirus. Thy can help meet their needs and answer questions about the impact on quality of life. If the COVID-19 virus progresses to the point it becomes obvious that a person is not going to survive, palliative care is in a position to intervene in a manner defined by the individual or his appointed surrogate(s). Palliative care can help bring in spiritual resources if they are desired and help with grief counseling; anticipatory and after death.

Many health care practitioners are having difficult, but needed, conversations with individuals and their family units that were not expected at this time. Life presents us with realities for which we can prepare as much as possible. This is where palliative care adds another layer in helping people take charge of health care interventions.

April 16, 2020 is National Healthcare Decisions Day; a day that educates people about and seeks to motivate them to do advanced care planning. While we are hearing a lot about the availability of ventilators, you may or may not want to be intubated and placed on such a device depending on many factors. If you are in a position of not being able to make healthcare decisions for yourself, whom do you trust to make those decisions for you? Do you have a plan in place for your healthcare that you can continue to refine over time, but will also make your desires known if the unexpected arises? End-of-life decisions are personal and complicated, therefore why not make those decisions while you can on April 16th or someday soon?

— Gary Dodd works as a board-certified Advanced Practice Nurse providing hospice care and opioid addiction recovery.

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