A national study of palliative care social workers indicated that the coronavirus pandemic has resulted in isolation issues, communication barriers and grief-related issues for patients and their caregivers. As hospice providers exploit the text of COVID-19, these issues highlight the increasing need to activate leisure care in the home, with social workers playing a key role in building construction.
The World Health Organization has reported that one in five people have so far been seriously ill with COVID-19, with recent data showing more than 1.5 million confirmed deaths worldwide. According to the United States Disease Control and Prevention (CDC), more than 280,000 people have died in the United States alone since January. The deadly pandemic has engulfed the entire healthcare system, with severe consequences for end-of-life care.

“Hospice patients are an extremely vulnerable population, and one of the things we know about COVID is that home emissions are rampant” said Megan Kale-Cheever, study co-author, head of Quality and Safety at Hospice and Hospice at Mount Carmel Health System in Columbus, Ohio. “Palliative care teams work with families to put in place back-up care plans or home isolation plans in case someone gets sick. Everything is more complicated”.
The study, conducted between May 15 and June 15, 2020, examined the trajectory of the pandemic during what researchers have called a transition period for hospice providers. The study authors interviewed more than 200 hospice social workers who are members of the National Association of Social Workers’ server list, as well as social networking sites associated with the social work community at the Society for Social Worker Leadership, Social workers in nursing and health establishments and the network of palliative care and social work hospices.

The results suggest that increased access to respite care would benefit patients and their families affected by the pandemic. The COVID-19 pandemic has complicated the ability of hospices to provide respite care. Limited access to nursing homes, fear of spreading the virus, and growing demand are hampering provider respite programs.
Medicare typically allows inpatient respite care for up to five days when your caregivers become ill or need rest or other priorities. Providers often provide this care in a hospice, hospital or retirement home. There are four levels of polycarbonate care covered by Medicare as well as routine home care, home care and general hospital care.

“The expansion of respite benefits will be important,” said co-author Erika Gergerich, a registered clinical social worker and associate professor at New Mexico State University. “At a time when hospitals and nursing homes are overwhelmed by COVID-19, being able to bring loved ones home to die in peace with family is a blessing.
Congress is currently considering legislation that, during any national emergency declared by the federal government, would increase the maximum length of stay for a hospice respite to 15 days, from five days. If passed, the bill would also allow hospices to provide respite care in the patient’s home. However, at the moment, many hospices are between a rock and a hard place when it comes to respite care, in part because of the huge needs fueled by the COVID-19 outbreak.

Respondents also cited isolation as a major problem for patients, their families and caregivers, both in facilities and in community settings, with some reporting a delay of 10 to 12 weeks for patients seeing loved ones.

Isolation is a growing barrier as the virus continues to spread, and many hospice providers face the challenge of keeping patients and their families connected, often at a distance through telehealth and other forms of virtual communication. According to Kale-Cheever, for families of patients residing in group care facilities with visitation restrictions, palliative care provides a crucial bridge between the ill person, the facility and the family. The palliative care team provides updates, facilitates video conferencing, and advocates for the patient on behalf of the family.

The results of the study suggest that there is a need to focus on virtual communication, emergency planning by social workers and evidence-based interventions for complex and persistent bereavement disorders to help patients, families and staff. Palliative care social workers will need to play a key role in complementing support for patients and their families struggling with isolation, limited communication and pain, according to the study researchers.

“Social workers in hospices have a lot of practical knowledge about bereavement and complicated bereavement that requires wider application,” said Gergerich.

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