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Short Communication Volume 4 Issue 3
Focus of nursing care: end-of-life care during the COVID-19 Pandemic
Imelda Rahmayunia Kartika,
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Kep S, Ners M Kep
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Senior Lecturer of Nursing Department, Faculty of Health, Fort De Kock University, Bukittinggi-Sumatera Barat, Indonesia
Correspondence: Imelda Rahmayunia Kartika, Senior Lecturer of Nursing Department, Faculty of Health, Fort De Kock University, Bukittinggi-Sumatera Barat Indonesia
Received: June 13, 2020 | Published: August 26, 2020
Citation: Kartika IR, Kep S, Ners, et al. Focus of nursing care: end-of-life care during the COVID-19 Pandemic. Hos Pal Med Int Jnl. 2020;4(3):68-69. DOI: 10.15406/hpmij.2020.04.00190
Short communication
As a worldwide pandemic, COVID-19 is expected to spread widely over a long period until the end of 2020 or longer.1 The entire population is at risk of coronavirus infection (SARS-CoV-2). Even it the elderly, adults, and children show vulnerability to the outbreak of this outbreak. However, the elderly and people with palliative diseases tend to be more vulnerable and at risk of developing covid-19. As we know, COVID-19 makes awareness of the importance of end-of-life care for the elderly because COVID-19 mostly concentrated in the elderly population with chronic diseases such as hypertension.2 Therefore, the focus of treatment in this pandemic is also on patients with palliative conditions. End-of-life care is needed to patients with chronic diseases to avoid covid-19 outbreak.
Palliative care is an end-of-life caring healing process for a patient and his family who have an incurable disease by maximizing the quality of life of the patient and reducing disruptive symptoms, but also through reducing pain, by paying attention to the psychological and spiritual aspects of the patient and family.3 This treatment also provides a support system to help the patient's family deal with the death of a loved family member until the end-of-life. Palliative care provides an integrated and comprehensive health approach, which is an integrated multidisciplinary and nursing included at all. The need for palliative care is due to the increasing number of patients with chronic illness. Palliative care aims to reduce the suffering of patients, improve their quality of life, and provide support to their families. So, the main goal of palliative care is not to cure the disease, but rather to improve the quality of life and to treat palliative care not only by the patient but also his family. In the end-of-life, the most important thing before dying, the patients are ready psychologically and spiritually to face the illness. When facing the end-of-life, patients are expected to get a condition of die in dignity.
What nurse should do for end-of-life care during a pandemic?
As nursing care given to the patient, nurses need to provide nursing care on focusing on the treatment of end-of-life patients during the isolation period. The isolation process will affect the patients individually where they have more time to be alone and think about their illness.4 Nurses need to assess adequately whenever end-of-life patients show the symptom of COVID-19. Symptom management is likely to assess the shortness of breath, nausea, anxiety and even pain while adhering to strict isolation. If nurses are working on a team, ask every member to assess the patient's symptoms in every interaction they do. On the other hand, emotional support is also needed. Connecting with patients through the barrier of Personal Protective Equipment (PPE) requires extra effort for the nurses. But, the patient will be more comfortable when the nurses have an interaction with them. Then, the important thing is family support. Emotional support for families will likely be provided by phone.
The focus of care in handling Covid-19 patients especially in the end-of-life terms is psychological and spiritual support. It means they become comfortable with the care given. Nurses who are caring for palliative illness must have a caring attitude towards the patient (empathy), consider the patient as a unique individual, and must consider other factors such as ethnicity, race, religion, and other cultural factors that can affect the patient's suffering. Consent from the patients and their families is necessary before treatment begins. Patients in an end-of-life condition who infected by covid-19 may choose to be given care at home, then this palliative care can be done through home care.
Then, the main role of nurses in handling Covid-19 patients especially in the end-of-life terms is basically to provide communication, information, and education about their health and how to avoid the outbreak infection. It is also important to make documentation about patient requests and make a reliable document for them. Patients with limited decision-making must be informed about the risk of Covid-19 infection and ask about their opinions and family, then it must be documented.1Palliative care services must respond quickly and flexibly, especially having a protocol instruction, and divert resources in the community.5 Also, transferring volunteers, facilitating nurse competence is needed in communicating with patients through technology and other telecommunication media. Hopefully, a nurse can give their best in palliative care during the pandemic.
Acknowledgments
None.
Conflicts of interest
None.
References
- BG Domenico, G Claudia, O Monika, et al. CoviD-19: Decision making and palliative care.Swiss Med.2020;150:2–3.
- X Xu, L Zhang, L Chen, et al. Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China?.Healthcare.2020;8(2):126.
- S Kelley, RS Morrison. Palliative Care for the Seriously Ill.N Engl J Med. 2015;373(8):747–755.
- R Armitage, LB Nellums. COVID-19 and the consequences of isolating the elderly.Lancet Public Heal.2020;5(5):e256.
- SN Etkind. The Role and Response of Palliative Care and Hospice Services in Epidemics and Pandemics: A Rapid Review to Inform Practice During the COVID-19 Pandemic.J Pain Symptom Manage. 2020.
©2020 Kartika, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.