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J Pain Symptom Manage · Feb 2024
The COVID-19 pandemic: Bereavement outcomes between hospital and home deaths in palliative care.
- Elizabeth Lobb, Fiona Maccallum, Jane L Phillips, Meera Agar, Annmarie Hosie, Lauren J Breen, Jennifer Tieman, Michelle DiGiacomo, Tim Luckett, Jennifer Philip, Serra Ivynian, Sungwon Chang, Ann Dadich, Janeane Harlum, Imelda Gilmore, Irina Kinchin, Christopher Grossman, and Nicholas Glasgow.
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology (E.L.), Sydney, New South Wales, Australia; Department of Palliative Care, Calvary Health Care (E.L.), Kogarah, New South Wales, Australia. Electronic address: Elizabeth.Lobb@uts.edu.au.
- J Pain Symptom Manage. 2024 Feb 1; 67 (2): 147156147-156.
BackgroundAustralian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends.AimTo understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home.DesignA cross-sectional online survey was completed by bereaved adults during 2020-2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin.Setting/ParticipantsOf 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home.ResultsThe COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different.ConclusionsThese findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.
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