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What is palliative care?
The World Health Organisation describes palliative care as an approach that improves the quality of life of patients and their families facing a life-threatening illness. This is done through the prevention and relief of suffering. Our article on ‘What is palliative care‘ may be helpful to you.
The importance of delivering effective palliative care became more apparent during the Covid-19 pandemic. Covid palliative care seeks to support the physical, social, psychological and spiritual needs of patients and their close ones, across the whole trajectory of an illness.
Managing symptoms of Covid-19
The National Institute for Health and Care Excellence (NICE) has created a Covid-19 guideline for managing symptoms of Covid-19.
Communicating and minimising risk
The typical symptoms of Covid-19 are a continuous cough, fever and loss of smell or taste. It is important that the nurse or carer communicates with the patient and supports their mental wellbeing to help alleviate any anxiety and fear they may have about Covid-19.
Minimising risk by reducing face-to-face contact by cutting non-essential face-to-face consultations with your health care team. Opting for electronic prescriptions rather than paper where possible.
Treatment and planning
When possible, it is important for the nurse or carer to discuss the risks, benefits and likely outcomes of any treatments you may have with yourself, family and health care team. Therefore, preferences and escalation plans can be expressed.
General advice for managing Covid-19
When managing COVID-19 symptoms, it is important to take into account:
Dignity, respect and compassion must be adopted by the nurse or carer. As far as reasonably possible, people’s cultural and religious beliefs must be supported, explored and respected. Furthermore, that the patient’s underlying health conditions, severity of the acute illness and if they are taking multiple medicines may impact their recovery. That older patients with comorbidities, such as chronic obstructive pulmonary disease (COPD), asthma, hypertension, cardiovascular disease and diabetes, may have a higher risk of deteriorating and need monitoring or more intensive management, including hospital admission. Lastly, that patients with severe symptoms of COVID‑19 may deteriorate rapidly and need urgent hospital admission.
Managing cough
Be aware that older patients or those with comorbidities, frailty, impaired immunity or a reduced ability to cough and clear secretions are more likely to develop severe pneumonia. This could lead to respiratory failure and death. To combat this, if possible, encourage patients with a cough to avoid lying on their back because this makes coughing ineffective. Use simple measures first, including getting patients with cough to take honey (for patients aged over 1 year).
Managing fever
It is important to remember that, on average, fever is most common 5 days after exposure to the infection. Advise patients to drink fluids regularly to avoid dehydration (no more than 2 litres per day).
Managing breathlessness
Be aware that severe breathlessness often causes anxiety, which can then increase breathlessness further.
As part of supportive care, the following may help to manage breathlessness:
- keeping the room cool
- encouraging relaxation and breathing techniques and changing body positioning
- encouraging patients who are self-isolating alone, to improve air circulation by opening a window or door (do not use a fan because this can spread infection)
- when oxygen is available, consider a trial of oxygen therapy and assess whether breathlessness improves.
Managing anxiety, delirium and agitation
Address reversible causes of anxiety, delirium and agitation first by:
- exploring the patient’s concerns and anxieties
- ensuring effective communication and orientation (for example explaining where the patient is, who they are, and what your role is)
- ensuring adequate lighting
- explaining to those providing care how they can help.
Treat reversible causes of anxiety or delirium, with or without agitation, for example hypoxia, urinary retention and constipation.
Care at home
When receiving palliative care at home, it is vital that you share your wishes with your nurse or carer such as; what you want for your medical care, the things you consider important such as family and pets and the ability to continue to see them, hobbies and wherever possible continuing to have access to those hobbies and being able to with family, friends and your medical care team.
Cavendish Homecare’s approach to Covid-19 care at home
At Cavendish Homecare we understand that coping during the pandemic was very challenging and that the outbreak of COVID-19 was very stressful time for anyone. Fear and anxiety about any health condition can be overwhelming and cause strong emotions in both adults and children. However, our experienced, compassionate Registered Nurses and carers are here to provide the help and support needed.
If you, or someone you care about, are feeling overwhelmed with emotions such as sadness, depression or anxiety our caring Registered Nurses and carers are able to assist with a range of support services including phone support, video calls or home visits. Individualised access to 24/7 expertise is always available.
To find out more about how best we can help you in the days and weeks ahead please call us on 0203 008 5210 or email info@cavendishhomecare.com.