In hospice, treating COVID symptoms requires a different approach. Unlike acute medical centers, our priority is the patient’s comfort. When families come to us, they are not seeking a cure; they want to make sure their loved ones pass peacefully, without any pain. That is why, when dealing with COVID, we focus on managing symptoms, not curing the disease.
How Hospice Treats COVID Symptoms
COVID symptoms differ from person to person. Some people who contract the virus do not experience any side effects. Others experience great discomfort. On top of that, hospice patients are already dealing with life-limiting illness; COVID is normally a secondary infection, but one we take seriously.
A common symptom of COVID, pneumonia is most concerning to hospice workers when it leads to severe breathlessness (dyspnea), also called air hunger. Imagine being underwater, holding your breath while struggling to the surface. Because we cannot let patients suffer like that, we have a series of remedies we employ.
First, we use steroids to reduce inflammation in the lungs, in order to relieve pain when the patient breathes. Next, we administer short-acting drugs to open the airway. These are given in either a tablet or a spacer. Finally, in severe cases, we use opioids, such as morphine to help patients return to normal breathing.
In less severe cases, we may administer anti-biotics to cure pneumonia. COVID is a virus, so anti-biotics will have no effect on the underlying condition. However, our goal is always to eliminate symptoms that upset the patient. In this case, pneumonia would be considered a secondary disorder requiring curative medicine.
Fevers are treated with simple, over-the-counter drugs, such as Tylenol. We prefer to let the patient swallow Tylenol tablets, but if necessary, we have suppositories as well.
This is a symptom we watch for after a patient develops pneumonia. Phlegm buildup in the lungs can drip into the stomach and cause illness. Each medication we use has many different routes, which we choose depending on the patient. However, if symptoms are mild, we may try home remedies such as jasmine or ginger tea instead. It must be remembered the goal is not to cure COVID but comfort the patient.
Around a third of COVID patients develop diarrhea, which we treat with medication. In such cases, we also make sure the patient can relieve themselves hygienically and has clean bedding.
Hospice & COVID: Honoring the Family’s Wishes
Because of current COVID restrictions, hospitals are not always the best option for families dealing with life-limiting illnesses. In order to protect other patients, families may be prevented from visiting their loved ones.
In addition, hospitals always take action to cure the patient, even if they already have an array of diseases. This can be a burden to persons coping with serious illness. COVID patients are normally vented and intubated, which is an uncomfortable way to pass, especially if your family cannot come and see you.
For this reason, many families are treating COVID symptoms in hospice. It gives them a chance to stay close to their loved one while they transition. With COVID, like any other disease, our RN case managers and social workers discuss the family’s options with them, to help them understand the decisions they make. If they opt for hospice care, we do everything we can to ensure the patient transitions with grace and dignity. If they prefer a hospital, we support them as well.
Jose Escobar is the Hospice Executive for Parentis Health. He works with patients and families across Southern California, providing support and education, in order to alleviate the pain and suffering of chronic and terminal illness.