Palliative care goes virtual with NJ hospital visits limited
NEWARK — With access to New Jersey hospital patients strictly limited due to COVID-19, whether a patient has the coronavirus or not, comfort from family and conversations about death can come only from phone or video calls, not a gaze into a patient's eye or the touch of a hand.
With that in mind, Dr. Jenna Marcus, a gynecologic oncologist at Rutgers Cancer Institute of New Jersey and assistant professor at Rutgers New Jersey Medical School, launched a Palliative Care Mobile Unit at University Hospital in Newark.
For the past month, 24 hours a day and six days a week, the mobile unit has helped clinicians in the hospital's intensive care unit connect patients with their families through those digital means. Paul Duberstein, professor and chair of the Department of Health Behavior, Society and Policy in the Rutgers School of Public Health, calls the arrangement a "link to humanity."
"Palliative care really has a big role to play in mitigating some of the symptoms of grief as a preventive," Duberstein said, and that mitigation is hard to achieve when family members cannot see with their own eyes that a loved one is getting the best care possible.
The loneliness and isolation necessitated by COVID-19 restrictions will continue to have lasting impacts on all connected to a hospital setting or that of a nursing home, according to Duberstein, "where we've got real problems as well."
"There'll be hardships for the patients themselves, hardships for the family members of the patients, and also hardships for the staff," encompassing nurses, doctors, and physical and respiratory therapists, he said.
For some family and friends, the anxiety and uncertainty of distantly waiting for a patient's outcome may manifest in grief and post-traumatic stress disorders, increased depression, or even alcohol or drug abuse.
"I think one of the main things we really need to be sensitive to is the epidemic of grief that is going to wash over this community as a consequence of all of these deaths," Duberstein said.
Hospital and nursing home staffers are not immune to this grief, either. Many have had to pick up tasks, like feeding or even turning on a TV, usually taken care of by family members and other visitors, and these professionals grieve more, in Duberstein's estimation, when their patients are suffering alone.
"The staff themselves benefit when patients get visits from family members and friends. They know that they feel more reassured that this patient is being taken care of," he said.
With the Palliative Care Mobile Unit, the hope is that the increased duties of the hospital workers, combined with their efforts to bring loved ones as close as possible to patients, will make symptom management as normal as it can be during this time of crisis.