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Lobb E, Maccallum F, Phillips JL, Agar M, Hosie A, Breen LJ, Tieman J, DiGiacomo M, Luckett T, Philip J, Ivynian S, Chang S, Dadich A, Harlum J, Gilmore I, Kinchin I, Grossman C, Glasgow N. The COVID-19 Pandemic: Bereavement Experiences Between Hospital and Home Deaths in Palliative Care. J Pain Symptom Manage 2024; 67:147-156. [PMID: 37972719 DOI: 10.1016/j.jpainsymman.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Australian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends. AIM To understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home. DESIGN A cross-sectional online survey was completed by bereaved adults during 2020-2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin. SETTING/PARTICIPANTS Of 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home. RESULTS The COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different. CONCLUSIONS These findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.
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Affiliation(s)
- Elizabeth Lobb
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology (E.L.), Sydney, New South Wales, Australia; Department of Palliative Care, Calvary Health Care (E.L.), Kogarah, New South Wales, Australia.
| | - Fiona Maccallum
- School of Psychology (F.M.), University of Queensland, Queensland, Australia
| | - Jane L Phillips
- School of Nursing, Faculty of Health (J.L.P.), Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Meera Agar
- Research Institute for Innovative Solutions for Wellbeing and Health (M.A.), IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Annmarie Hosie
- School of Nursing, Midwifery, Health Sciences & Physiotherapy (A.H.), The University of Notre Dame Australia & St Vincent's Health Network Sydney, Darlinghurst, New South Wales, Australia
| | - Lauren J Breen
- Curtin School of Population Health (L.J.B.), enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Jennifer Tieman
- Research Centre for Palliative Care (J.T.), Death and Dying (RePaDD), College of Nursing and Health Science I RePaDD, Bedford Park, South Australia, Australia
| | - Michelle DiGiacomo
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Tim Luckett
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Jennifer Philip
- Department of Medicine, St Vincent's Hospital (J.P.), University of Melbourne, Parkville, Victoria, Australia
| | - Serra Ivynian
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Sungwon Chang
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Ann Dadich
- Western Sydney University, School of Business (A.D.), Parramatta, New South Wales, Australia
| | - Janeane Harlum
- District Palliative Care Manager & Service Development (J.H.), District Palliative Care Service, Liverpool Hospital, New South Wales, Australia
| | - Imelda Gilmore
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Irina Kinchin
- Centre for Health Policy and Management, Discipline of Public Health & Primary Care, School of Medicine (I.K.), Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | | | - Nicholas Glasgow
- Australian National University College of Health and Medicine (N.G.), Canberra ACT, Australia
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Runacres F, Steele P, Hudson J, Bills M, Poon P. 'We couldn't have managed without your team': A collaborative palliative care response to the COVID-19 pandemic in residential aged care. Australas J Ageing 2021; 41:147-152. [PMID: 34755441 PMCID: PMC8646512 DOI: 10.1111/ajag.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/27/2021] [Accepted: 10/10/2021] [Indexed: 01/10/2023]
Abstract
The global COVID‐19 pandemic has challenged healthcare, aged care and palliative care provision in ways previously unimaginable. In Australia, this has been felt particularly amongst our most vulnerable members of society, those residing in residential aged care. Currently representing the majority (75%) of COVID‐19 deaths and health‐care worker infections, this vulnerable sector has borne the greatest impact. A collaborative response comprising a tertiary hospital palliative care outreach service, residential InReach geriatric service and a community palliative care service effectively delivered comprehensive and timely specialist care to residents infected with COVID‐19. Daily videoconferencing rounds were efficient, minimised infection risk and facilitated family members attending virtually during patient assessments and care planning discussions. This model was both reactive and proactive and importantly scalable should further infective outbreaks occur in Australasian residential aged care facilities.
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Affiliation(s)
- Fiona Runacres
- Supportive and Palliative Care Unit, Monash Health, Clayton, Vic., Australia.,School of Medicine, Monash University, Clayton, Vic., Australia.,Department of Palliative Care, Calvary Health Care Bethlehem, Parkdale, Vic., Australia.,The University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Patrick Steele
- Supportive and Palliative Care Unit, Monash Health, Clayton, Vic., Australia.,School of Medicine, Monash University, Clayton, Vic., Australia.,Palliative Care South East, Cranbourne, Vic., Australia.,Peter MacCallum Cancer Centre, Parkville, Vic., Australia
| | - Jade Hudson
- Supportive and Palliative Care Unit, Monash Health, Clayton, Vic., Australia.,School of Medicine, Monash University, Clayton, Vic., Australia
| | - Maryann Bills
- Supportive and Palliative Care Unit, Monash Health, Clayton, Vic., Australia.,School of Medicine, Monash University, Clayton, Vic., Australia
| | - Peter Poon
- Supportive and Palliative Care Unit, Monash Health, Clayton, Vic., Australia.,School of Medicine, Monash University, Clayton, Vic., Australia
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