by Cowichan Hospice Palliative Coordinator, Shelley Kuecks

People often describe the palliative journey as one of continuously adapting to a “new normal.”  Things change with someone’s physical health, as well as their emotional, mental and spiritual balance, on a regular basis.  Some changes are slow, some are quick, some expected and some not, but the constant is change and uncertainty.

Now add COVID-19 to this journey of change. Add new fears, uncertainty, unknowns and stresses.  These things are already present for many people living with a palliative diagnosis or caring for a terminally ill person.   “And now this?” is something I have heard more than once in the past few weeks.

So, what are some of the “new normals” people are seeing?

Medical visits by phone. Doctors can still be accessed but unless an in-person visit is necessary, they may schedule the visit as a remote/phone visit or even a virtual visit using video conferencing.  This is a time where medications can often be renewed over the phone and in some cases (e.g. chronic illnesses) prescriptions can be renewed by the pharmacist.

Pharmacies are open and able to give out medications, but hours are adjusted. There may be limits to how many people are allowed in the store.  Always check that before you go, and remember that many pharmacies have delivery options as well as certain shopping times for people at high risk.

Home nursing and home support both continue to provide services but with some changes.  Nursing may be doing more visits by phone to help keep everyone safe from unnecessary contact and home supports may be on hold in cases where the services are not essential.  Families are being asked to do as much as possible in order to keep unnecessary visits to a minimum.

Hospitals and facilities have a no visitor policy. In the case where someone is imminently dying, there may be an exception granted where one family member may visit if they pass screening.

What do some of these changes mean for palliative patients and their families?

Many people are having to take over more responsibility for the care of their family member.  For some this creates stress and a heightened sense of responsibility, an increase in feelings and symptoms of burnout, fears about themselves or their loved one getting Covid-19 in their already compromised states, and increased feelings of isolation and loneliness.

For others it seems to be allowing them to hunker down and live day-by-day, focusing on spending quiet time with their loved one and keeping in touch by phone or video with family and friends.  It can feel like a reprieve from the busy-ness that can sometimes take over people’s lives in these situations.

What can Cowichan Hospice do?

We continue to provide emotional support for people with life-limiting illness and their families, as well as those grieving a loss.  Instead of doing face-to-face visits we are reaching out by phone, and for some techy people, by video.  In place of the wellness sessions we offered to clients in the office or their homes (Reiki or Therapeutic Touch), we are now offering guided relaxation sessions over the phone. 

Cowichan Hospice is also offering virtual support to those wishing to talk about or begin an Advance Care Plan. Advance care planning is a process of thinking and talking about what’s important to you regarding your future health care decisions. This can help you, and those closest to you, understand what would be important to you if you were unable to speak for yourself.

How to access palliative support?

If you are already connected with Home and Community Care, they can be an excellent source of support for any medical concerns.  Please keep them informed of concerns or changes in symptoms or health.  This is especially important if they are not laying eyes on the patient as much. Keep a notebook tracking symptoms and changes in between the in person or remote visits so you remember to relay all the information. 

If you are not connected with Home and Community Care but think you should be, contact your GP to ask for a referral, or you can call them yourself.  They will determine eligibility and pass your information to the appropriate office.  Your needs will be assessed and necessary supports set up. They can be reached at the following:

Nanaimo Community Access Centre (for Central Island):

1-250-739-5749
1-877-734-4101

Serving all communities from Mill Bay to Deep Bay, including Gabriola Island, and from Parksville on the east coast to beyond Tofino/Ucluelet on the west coast.

For hospice support inquiries as well as information and resource questions, you can contact our office (phones and fax are checked twice daily during the week) and a staff member will be in touch with you.

As much as these times are stressful and uncertain, they also seem to be bringing other things to the forefront of people’s awareness… reminders of the importance of those we love and the things in our lives to be grateful for… creative ways of connecting with people we may not be able to see, and with those we may have been out of touch with for a long time… an experience of time with fewer demands on us from external sources, giving us the opportunity for quiet and reflection. 

All this and a deep gratitude to those essential workers who are keeping things going for the rest of us.