End-of-life Care during the COVID-19 Pandemic

Could the COVID-19 pandemic change our vision of the care for the dying or for people at the end of their life?

The COVID-19 crisis has sparked a significant and genuine thinking on our relation with the dying, especially in the institutional and hospital settings.

As several clinicians and social studies specialists have pointed out, we have suddenly become more conscious of some “imperceptible” basic parameters that regulate our lives when we are healthy and safe (family, social ties, funeral rites,…). Ordinary routines, which were previously taken for granted, suddenly seem more valuable, when they must be relinquished due to the emergency health provisions.

The pandemic deprived families from being with loved ones at the end-of-life. Thus, doctors and caregivers were assigned this additional role to help the dying during their last lonely moments, despite the protective barrier of masks and equipment, which do not help for the communication between caring people and people who being cared for.

Over the centuries, death was historically a “family affair” where “dying well” meant dying at home with bereavement rites performed according to the family’s customs, religion, and/or tradition. Nowadays 80% of deaths occur in institutions (medico-social establishments and hospitals) where, most of the time, the care for the dying person is delegated to healthcare professionals. By medicalizing the act of dying, it has become more or less a “foreign affair” for the family members.

In a recent article, psychologist, Marie de Hennezel, describes three consequences of denying death:

On an individual level, it has negative impacts on one’s life:

  • It maintains the erroneous belief that scientific and technological omnipotence will eventually triumph over death.
  • It makes us less humane since it rejects the idea of vulnerability.

The collective fear of our human condition as vulnerable and mortal beings comes from the fact that death is concealed in contemporary society.

The pandemic headlines report death on a daily basis. Could this put an end to the idea that death is taboo? Damien Le Guay, President of the National Funeral Ethics Committee voices his disagreement. He laments that the dead are only anonymously tallied. “All the news reports revolve around anonymous COVID-19 death statistics, without mentioning their names, and without developing a way to demonstrate a national tribute to them and their families.”

He points out that our fixation with the virus has obliterated the “anthropological necessities” for dealing with death: the necessity to pay our respects to the deceased, to bond together to honor them through ceremonies that help mitigate the terrible grief.

Thus, the COVID-19 pandemic simultaneously focuses on our confidence in the technological resources (respirators, etc.) as well as on the indispensible role of human relationships in accompanying the dying and the bereaved. Both are necessary for training caregivers. Being listened to during the bereavement process can help circumvent depression, suicidal thoughts … and can eventually help the bereaved person find a renewed happiness in the simple things in life, such as admiring nature and appreciating human fellowship.

Due to this unprecedented situation, the listeners at Alliance VITA’s SOS End of Life Listening Service are participating in the listening platform “How to get through mourning” which is available 24/7 to help bereaved persons cope with the loss of a loved one.

 

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