Hospice Chaplain visits and COVID-19

Saul Ebema, DMin

On Friday March 13 2020, president Trump declared COVID-19 a ‘national emergency.’ So what does this mean for hospice chaplains? I think there is no clear-cut answer to this question.

President Donald Trump holds a news conference about the ongoing global coronavirus pandemic in the Rose garden at the White House, March 13, 2020 in Washington. Trump declared a national emergency. Drew Angerer/Getty Images

The truth is, we are all trying to reduce the risk of spreading this contagion. Many hospice agencies will be limiting hospice visits this week for none-essential visits, some nursing homes in Illinois are totally shut down and not allowing any visitors.

Here at hospice chaplaincy, we believe that hospice chaplains have to limit their visits to hospice patients at nursing homes and private homes unless it is a spiritual care emergency. We recognize that this might be harder for part time and cost per call chaplains who depend on those visits to earn an income but it is time to be practical for your wellbeing and also to contain this contagion.

If you are part-time or cost per call and still want to make visits, please follow your company’s protocols and most nursing facilities have protocols you have to follow. Most facilities that we have visited last week had questionnaires and take temperatures before letting you in to visit a patient. Here is what some of the questionnaires look like;

COVID-19 Questionnaire

Do you have a fever AND respiratory symptoms like cough or shortness of breath?
Have you recently traveled to an area with known local spread of COVID-19 in the last 14 days?
Have you come into close contact (within 6 feet) with someone who has a laboratory confirmed COVID – 19 diagnosis in the past 14 days?
Are you over 65, pregnant, or have a chronic lung condition, heart disease, diabetes, or on an immunosuppressive medication?
Are you having difficulty breathing, unable to eat or drink, or too weak to care for yourself?

We recognize that hospice patients greatly benefit from your spiritual care visits. Many of our research studies indicate that those who are spiritual and receive regular spiritual care visits tend to have a more positive outlook and a better quality of life.

However, these benefits do not outweigh the risks associated with hospice chaplain visits while COVID-19 is still spreading. Nursing homes have been identified as ‘ground zero’ for COVID-19 by former center for disease control Tom Frieden.

So what should you do?

  • Call patients and their loved ones and provide support over the phone, assess their concerns or needs and document.
  • If they want you to visit, then follow protocol and have all equipment and sanitary stuff with you.
  • Some nursing homes already have restrictions and only allow hospice nurses to visit so you can easily document, “unable to make visit due to facility restrictions for COVID-19.” This should cover your required visit frequency.
  • Because containment of this contagion is key, you can call and tell your patients and their loved ones that you are reducing your visits as a precaution.

We know that your spiritual visit are vital,in fact a random Gallup poll asked people what concerns they would have if they were dying. Their top issue was spiritual comfort—chosen over such things as advance directives, economic/financial concerns, and social concerns. Those who were surveyed cited several spiritual reassurances that would give them comfort. The most common spiritual reassurances cited were beliefs that they would be in the loving presence of God or a higher power, that death was not the end but a passage, and that they would live on through their children and descendants.

But there are a few reasons to reduce or suspend visits, including our mandate to “do no harm”. Over the last week, you have heard a lot about social distancing, we therefore urge you to practice discernment on whether to continue visits regularly, reduce visit frequencies or to suspend visits all together.

But we believe that if your area is infected, the chances of you transmitting the disease increase if you are visiting the elderly- making the short term potential for harm greater.

What are your thoughts?

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