COVID-19 is affecting the lives of every person, business and every business process in the world, in some way, shape or form. But sometimes when we aren’t directly involved in or affected by something, it stays off our radar, or we’re unaware of how extreme the circumstances may be. One example of this is hospice and palliative care. If you have a loved one in hospice, you know how much harder COVID-19 is making an already-hard situation. Patients in hospice, whether it be at home or in hospice facilities, are all high-risk patients, usually with a weakened immune system. Considering the fragile state of patients and the current intensity of the hospice industry, we wanted to learn more about how leadership teams in the industry are coping, and how COVID-19 has specifically impacted the every-day life of both staff and patients.
To get an inside look, we interviewed Robert Miller, Senior Director of Business Development at Coastal Hospice and Palliative Care in Worcester and Wicomico County, Maryland.
What is Coastal Hospice?
Coastal Hospice is a nonprofit hospice organization whose mission is to promote dignity and quality of life for patients and families who face life-limiting conditions and require end of life care.
As Senior Director of Business Development of a nonprofit, have any new challenges in procuring funds come from COVID-19?
Definitely. We had many events planned, some of which are now canceled or postponed. During this challenging time, finances are a concern for many people with furloughs and/or loss of employment. Many are reluctant to give as generously as they normally would. The fundraising helps pay for patients who require charity care, since some patients do not have insurance and need services or face room and board costs in one of our facilities which are not usually covered under Medicare or their supplemental insurance.
How have your clients been coping with the pandemic, and how has it changed the way you do business with them?
Our clients are our patients, and they receive our end of life care and support in either their own homes, in nursing facilities, or in one of our two facilities. Our staff, made up of doctors, nurses, aids, social workers and chaplains conduct face to face visits. Many patients and families are very concerned about visitations from us as COVID-19 progresses. Understandably, they’re concerned about allowing people into their homes considering they are at-risk patients with already weakened immune systems. Addressing this goes hand-in-hand with addressing the health and safety of our staff as well. We have been limiting the amount of staff visits. All our staff conduct self-screenings. We begin the day taking our own temperature and report the results to our supervisors. Along with this information, we inform our supervisor if we are experiencing any respiratory issues. This process, along with wearing PPE, gives our patients and families the comfort of knowing that we are taking appropriate precautions before, during and after going into their homes to provide care.
Since COVID-19 has progressed, how has the senior leadership team’s priorities changed?
Our priorities have changed greatly. Prior to COVID-19, our leadership had weekly meetings. We now meet daily and sometimes more than once per day regarding the ever-changing dynamic that the disease is causing. Whether it be related to PPE wear, required medical equipment or CDC standards and regulations that are constantly being updated, we have had to intensify our communication and approach to providing care for our patients.
How do the business and medical sides of this type of organization maintain good communication during this time?
We have been very successful with aligning the two sides through email, phone trees and frequent meetings. The information is disseminated by supervisors to field staff. This communication requires a lot of intention. Many more meetings are planned, and one must remember that when information is received, a phone call, email, social media post, or office visit will probably be required to pass that information along.
Are visitors allowed in the hospice facilities? If yes, what extra/different health precautions are they taking? If no, how are they helping the patients cope with lack of human contact and communication?
In our facilities, we’re currently allowing one visitor at a time. Each visitor is required to wear various PPE such as a mask, gown and gloves. Visitors are having their temperature taken by one of our screeners who also ask a few questions concerning any past exposure and personal health concerns. We recommend the same sort of precautions for in-home care and visitations from family, like wearing masks and gloves, frequently washing hands before and after visits, etc.
How are you communicating with your patient’s families?
Our nurses and aids are still performing regular at-home visits. Our social workers and chaplains are communicating and providing support through telephone calls unless the patient or family desires a visit for support. All staff are required to report and chart in the electronic medical record on their interaction, the state of the patient and any changes in their health or circumstances.
Is the leadership team finding it difficult to get medical supplies and PPE? If so, how are they coping with the lack of supplies?
Right now, we have a sufficient amount. However, with recent (and frequent) changes from our Governor and healthcare authorities, the usage is intensifying, and we are concerned that in a week or two, we will run short. We have informed the Governor’s office, as well as local healthcare officials of our concerns. Fortunately, we have very good relationships within the healthcare community and have been in conversation about sharing supplies when/if needed. We’re taking it day by day and closely watching the case numbers and potential impact the increases will have on our usage.
Any advice for those that have loved ones in hospice care during this time?
My advice would be, as best as you can, limit your visits. Utilize all other means of communication whether it be Facebook, Zoom, Face-time, phone calls, etc. And if you do go to see your at-risk loved ones, frequent hand washing and use hand sanitizer beforehand and after visitations. Limiting the exposure will be the best avenue. We know this is hard, especially in end of life care, but physical distancing will be vital in keeping cases low, especially in facilities such as ours.
Most hospice care and support services go beyond only caring for the patient but provides lots of support to family members as well. If your loved one is in hospice during this time, don’t hesitate to seek family member support if needed. Chaplains, counselors and bereavement groups are available for you throughout the entire process.