• Bregje D Onwuteaka-Philipsen, Pasman H Roeline W HRW Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU U, Ida J Korfage, Erica Witkamp, Masha Zee, Liza Gg van Lent, Anne Goossensen, and Agnes van der Heide.
• Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands.
• Palliat Med. 2021 May 1; 35 (5): 830-842.

BackgroundDuring the COVID-19 outbreak restricting measures may have affected the provision of good end-of-life care for patients with and without COVID-19.AimTo describe characteristics of patients who died and the care they received, and to examine how patient characteristics, setting and visiting restrictions are related to provided care and evaluation of the dying process.DesignAn open observational online survey among healthcare professionals about their experience of end-of-life care that was provided to a patient with or without COVID-19 who died between March and July 2020.Setting/ParticipantsHealthcare professionals (nurses, physicians and others) in the Netherlands from all settings: home (n = 163), hospital (n = 249), nursing home (n = 192), hospice (n = 89) or elsewhere (n = 68).ResultsOf patients reported on, 56% had COVID-19. Among these patients, 358 (84.4%) also had a serious chronic illness. Having COVID-19 was negatively, and having a serious chronic illness was positively associated with healthcare staff's favourable appreciation of end-of-life care. Often there had been visiting restrictions in the last 2 days of life (75.8%). This was negatively associated with appreciation of care at the end of life and the dying process. Finally, care at the end of life was less favourably appreciated in hospitals and especially nursing homes, and more favourably in home settings and especially hospices.ConclusionsOur study suggests that end-of-life care during the COVID-19 pandemic may be further optimised, especially in nursing homes and hospitals. Allowing at least some level of visits of relatives seems a key component.

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