Open Letter re: COVID-19

Call to Action

I heard the story today of an 85-year-old man who is quarantined in a hospital room.  He isn’t infected with COVID-19. He is, however, in the last period of his life and he is unable to see his wife of over 50 years or his daughter.  I spoke with his daughter who described her father weeping to her on the phone, overwhelmed by the sadness and fear. I hear the frustration of the daughter not being able to go and get him, to bring him home, or even simply to go be with him.

As an increasing number of Canadian citizens are facing the reality of possibly contracting COVID-19. The medical system has stepped up its response to flatten the curve of this pandemic.  Doctors and nurses as well as many others are trying to protect us all, with risks to their own health. We applaud the Chief Medical Officer and the Ministry of Health for all the information and guidance that has been provided.  

At the End of Life Doula Association of Canada, our mission is to raise the standard of End of Life Care in Canada.  At this time, we are compelled to rally around our families, communities and country to provide support as well as advocate for those who are affected by COVID-19.  We are asking that all persons – whether they have been identified as having the virus, or who have life limiting illness – have the right to receive quality palliative care.  A palliative approach to care would not only meet the medical needs of the patient, but also their emotional and spiritual needs. As an Association, we are concerned with the arbitrariness around who is deemed palliative and worthy of compassionate care.  Those who face the end of life ideally should be cared for emotionally and spiritually.

In this, we are asking that:

•  When possible, and personal protection equipment is available, that one person per-patient receives training and education to take all precautions necessary to attend bedside so that they can provide support and comfort to their loved one and then return safely back into the community. 
• Until such time, we ask that resources and space for creativity be provided and encouraged to health care staff, families and the community. There are many ways to use approaches that do not jeopardize the health and safety of Canadians including using technology, outside spaces or windows, meal deliveries of favorite dishes and other ways that the isolated can connect with the outside world.   

Using a creative palliative approach to care will ideally provide some support and relief to medical staff who are already overburdened with responsibilities and emotional conflicts with providing care while risking themselves and their families to exposure to COVID-19.  Ultimately, such an approach would provide relief and support to the dying person. Dying alone is one of the biggest fears identified by the dying. Easing this fear by allowing one family member to sit vigil with their loved one, even if it is through a window or across a garden, will relieve their fear and lessen traumatization of the family who is sitting, waiting and unable to provide face to face connection with their loved one.  

The medical norms and structures are, with good reason, protecting us from becoming sick and we acknowledge the difficult balance that health directors and authorities are trying to make during this time. Some of the decisions made will not seem right to everyone, however, the current situation can be improved.  Together, let’s do our best to focus on how to create connections with patients and their loved ones without putting others at risk.  

Sincerely,

Jennifer Mallmes

President and Co-Founder

End of Life Doula Association of Canada