Improving end-of-life care during a pandemic or natural disaster

Marguerite Kelly, end-of-life, care, palliative, natural disaster, pandemic

Over the past two years, Australians have lived through out-of-control bushfires, floods inundating suburbs, storms causing countless damage to homes and businesses, and a pandemic.

During this time, the focus has naturally been on how to ‘continue living’ during these events. But what about dying? How do we successfully navigate this part of life during a pandemic or natural disaster? 

A recent systematic review by Marguerite Kelly, a PhD scholar from the Australian National University (ANU) Medical School, has examined end-of-life care during natural disasters including pandemics, to assess the impact on services, patients and their families, and medical professionals.

“The goal in palliative care is to improve quality of life while reducing suffering. During natural disasters end-of-life care services may be stretched, with surges in demand, and normal services often interrupted. For those receiving end-of-life care during a disaster or pandemic, their care can be severely impacted,” explains Ms Kelly.

“We don’t need to look far to see how border restrictions and quarantining requirements have impacted the dying wishes of patients and their family members.”

“The research found that during pandemics and natural disasters, patients and their families may face restricted visiting policies, isolated care conditions, and restricted bereavement or death rituals. Patients may also be less likely to have end-of-life care discussions or their end-of-life care wishes met. This does not fit with a palliative care approach.”

“Medical professionals struggle in these types of environments too. They face additional pressures as they rapidly adapt to unfamiliar work roles, and settings, and to the changing disaster situation, often with limited resources,” Ms Kelly says.

“Good disaster planning, training in disaster response, additional human resources, as well as adequate supplies of PPE and pain medications, can all contribute to provision of effective end-of-life care.”

Ms Kelly points out, “One of the most surprising findings from the research review was that if patients are provided effective end-of-life-care it can actually increase their chances of survival, even in situations when the patient is anticipated to die.”

“Therefore, it is critical within disaster contexts that all patients, including those triaged as ineligible for life-saving treatment, have access to compassionate care and symptom management.”

“The research review indicates that lack of consistent guidance is impacting stakeholders. Now is the time for policy makers, services providers, consumers, governments, researchers and medical professionals to come together and work towards clear end-of-life care guidance in preparation for future natural disasters and pandemics.”