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Costeira C, Dixe MA, Querido A, Rocha A, Vitorino J, Santos C, Laranjeira C. Death Unpreparedness Due to the COVID-19 Pandemic: A Concept Analysis. Healthcare (Basel) 2024; 12:188. [PMID: 38255076 PMCID: PMC10815185 DOI: 10.3390/healthcare12020188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant's method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences.
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Affiliation(s)
- Cristina Costeira
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal; (M.A.D.); (A.Q.); (C.S.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
- The Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Maria Anjos Dixe
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal; (M.A.D.); (A.Q.); (C.S.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
| | - Ana Querido
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal; (M.A.D.); (A.Q.); (C.S.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Ana Rocha
- Nursing School of Coimbra, Avenida Bissaya Barreto s/n, 3004-011 Coimbra, Portugal;
| | - Joel Vitorino
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
- Palliative Care Unit, Portuguese Institute of Oncology of Coimbra, 3000-075 Coimbra, Portugal
| | - Cátia Santos
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal; (M.A.D.); (A.Q.); (C.S.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
| | - Carlos Laranjeira
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal; (M.A.D.); (A.Q.); (C.S.)
- School of Health Sciences, Polytechnic University of Leiria, Campus 2—Morro do Lena, Alto do Vieiro—Apart. 4137, 2411-901 Leiria, Portugal;
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Frey R, Balmer D. Psychosocial well-being in Long-Term Care in the Wake of COVID-19: Findings from a Qualitative Study in New Zealand. J Cross Cult Gerontol 2023; 38:263-283. [PMID: 37466844 PMCID: PMC10447292 DOI: 10.1007/s10823-023-09485-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 07/20/2023]
Abstract
Drawing on Mason Durie's (1985) New Zealand Whare Tapa Whā model of health (spiritual, emotional, physical, and family domains), the goal was to link a model of well-being with the lived reality for long-term care residents and bereaved family members during COVID-19. Interviews were conducted with five residents and six family members of previous residents of one long-term care in one urban centre between July and September 2020. The increased demands imposed by the pandemic highlighted the gaps in well-being for residents and families. In particular, the inability to connect with family during COVID-19 restrictions reduced perceptions of well-being for residents. Study findings indicate that the provision of well-being for older adults and families in long-term care extends beyond the narrow bounds of the biomedical model. The Whare Tapa Whā model provides a valuable framework describing the holistic balance needed between the four health domains.
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Affiliation(s)
- Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand.
| | - Deborah Balmer
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
- Western Australian Centre for Rural Health (WACRH), University of Western Australia, Geraldton, Australia
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Spacey A, Porter S. Understanding advance care planning in care homes throughout the COVID-19 pandemic: A critical realist review and synthesis. Palliat Med 2022; 37:663-676. [PMID: 36373288 PMCID: PMC9659704 DOI: 10.1177/02692163221137103] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. AIM To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. DESIGN A critical realist review and synthesis. DATA SOURCES MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. RESULTS Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff's concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff's confidence and readiness to engage in care planning during pandemic conditions. CONCLUSION Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.
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Affiliation(s)
- Adam Spacey
- School of Health and Society, University of Salford, Salford, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
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Moya-Salazar J, Zuñiga N, Cañari B, Jaime-Quispe A, Chicoma-Flores K, Contreras-Pulache H. The End of Life Accompanied by COVID-19: A Qualitative Study on Grief During the First OutBreak In Peru (Part I). OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221134424. [PMID: 36226870 PMCID: PMC9561526 DOI: 10.1177/00302228221134424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Due to the massive deaths and high level of contagion brought about by COVID-19, burial practices and the way we bury our dead are being affected by SARS-CoV-2 confinement and control measures. Here, we aimed to examine the changing of death, dying, and mourning during the first wave and quarantine applied in Peru with the arrival of COVID-19 in 2020. Using a qualitative approach, 15 participants who lost a family member because of COVID-19 were interviewed by telephone and video call. Our results revealed that death in isolation, the loss of rituals, and the farewell to relatives have dramatically affected family members. Peruvian funeral practices were altered by health provisions, making it a challenge to accompany relatives at the end of life. This way of coping with death can affect family wellbeing, for which no interventions have yet been proposed to improve the quality of life during bereavement.
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Affiliation(s)
- Jeel Moya-Salazar
- School of Medicine, Faculties of
Health Science, Universidad Norbert
Wiener, Lima, Peru
- Hospital Nacional Docente Madre Niño
San Bartolomé, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Nahomi Zuñiga
- School of Medicine, Faculties of
Health Science, Universidad Norbert
Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Betsy Cañari
- School of Medicine, Faculties of
Health Science, Universidad Norbert
Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Alexis Jaime-Quispe
- School of Medicine, Faculties of
Health Science, Universidad Norbert
Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | | | - Hans Contreras-Pulache
- School of Medicine, Faculties of
Health Science, Universidad Norbert
Wiener, Lima, Peru
- South America Center for Education
and Research in Public Health, Universidad Norbert
Wiener, Lima, Peru
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