The coronavirus pandemic is changing the face of palliative care in Quebec

Terminally-ill patients living in palliative care facilities are especially vulnerable to COVID-19.

The country’s largest private palliative care facility in Kirkland, Que., went above and beyond government protocols to keep their patients and staff safe.

The move has proven to be successful, but the concern now is that those strict safety measures are changing the face of palliative care.

“To give a patient a hug, to give a family member a hug when their mom and their dad or their sister is dying, it’s really important. We haven’t been able to do that,” said Manuella Piovesan, clinical care director at the West Island Palliative Care Residence (WIPCR).

“I believe it’s important to hold someone’s hand. It’s been very difficult for us”

Since the start of the COVID-19 pandemic, all patients are tested for the novel coronavirus on-site before admission. It’s one of the measures the WIPCR adopted that goes above the required government protocols.

“It’s all about keeping people safe,” said WIPCR executive director Dan Weil.

“We do two things: we screen our patients before they come in, and the visitors that are coming in are screened at the very beginning and then every single time they come in.”

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Patients are only allowed one visitor in their room at one time, and they must wear a mask and respect social distancing rules. Children, however, aren’t allowed in the building until further notice.

Movement within the building is being restricted and common spaces are off limits. But despite all the measures put in place, one patient and one staff member have tested positive and have since recovered from COVID-19.

The patient was immediately transferred to hospital, since the WIPCR is a designated cold zone and infected patients can’t remain on site.

In the case of the worker, however, there was no need for an intervention.

“Happily they hadn’t been working on the premises prior to them developing symptoms, so apart from them staying at home in isolation, there was nothing else that we need to do,” said Weil.

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Patients at the WIPCR are getting everything they need in terms of pain and symptom management. The ratio is still what it was pre-pandemic — one nurse to every three patients.

It’s the psychological, emotional and physical support that palliative care patients and their families often have to go without.

“We worry about the children and grandchildren who can’t come in to visit because a lot of the work we do is legacy projects” said Piovesan.

“We would love to have families in the room praying together, having their favourite songs played in their final moments. That can be really, really difficult with COVID when we’re limiting the number of people in the room.”