Oxford LibGuides: COVID-19 information resources for the OUH: Palliative Care

Evidence

Characteristics of COVID-19 patients dying in Italy Report based on available data on March 26th, 2020
Report in English. The present report describes characteristics of 6801 COVID-19 patients dying in Italy.
Response and role of palliative care during the COVID-19 pandemic: a national telephone survey of hospices in Italy
Article. Palliative care is an important component of healthcare in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making.
What we know so far: COVID-19 current clinical knowledge and research
This article will review the new knowledge of SARS-CoV-2 COVID-19 acute respiratory disease, and summarise its clinical features.
Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection
Article. We performed a systematic review and meta-analysis to identify the symptoms and comorbidities predictive of COVID−19 severity. This article is a preprint and has not been peer-reviewed.
The challenge of providing holistic care in a viral epidemic: opportunities for palliative care
Article from 2004 looking to determine, using the perspective of a hospital-based palliative care service (PCS), the spiritual and psychosocial impact of a novel and potentially fatal viral epidemic on patients, their families and health care workers.

Guidance

NICE COVID-19 rapid guideline (NG163): managing symptoms (including at the end of life) in the community
The purpose of this guideline is to provide recommendations for managing COVID‑19 symptoms for patients in the community, including at the end of life. It also includes recommendations about managing medicines for these patients, and protecting staff from infection.
Covid-19 - Our Response
Scottish Palliative Care Guidelines - Temporary guidelines are now available for symptom management for when a person is imminently dying from COVID-19 lung disease and for supporting end of life care when alternatives to medication normally given through syringe pumps are required.
COVID-19 pandemic: palliative care for elderly and frail patients at home and in residential and nursing homes
Article looking at how severe illness with an uncertain outcome and end-of-life situations calls for good palliative care for the patients concerned. These circunstances have prompted the FGPG to prepare these recommendations for practice.
COVID-19: Managing the COVID-19 pandemic in care homes
British Geriatrics Society. This guidance has been developed to help care home staff and NHS staff who work with them to support residents through the pandemic.
End-of-life care in the Emergency Department for the patient imminently dying of a highly transmissible acute respiratory infection (e.g. COVID-19)
Article on a framework for health care providers caring for Emergency Department (ED) patients with confirmed or suspected COVID-19 who are nearing end of life. The safety and health of care providers and family members of a patient with COVID-19 must be carefully balanced with meticulous symptom assessment and management to allow the patient to die comfortably and with dignity.
The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19)
JAMA article. The COVID-19 pandemic is raising important ethical issues, including the potential need for rationing health care. One priority should be addressing goals of care in the setting of acute life-threatening illness, especially for patients with chronic, life-limiting disease.
iPal Global Point of Care app
iPal Global is a free, downloadable app that provides access to essential palliative care information.
NHS: Clinical guide for the management of palliative care in hospital during the coronavirus pandemic
This guidance is aimed at all professionals looking after patients with coronavirus, and their families, in the hospital setting. This guidance does not replace evidence based local guidelines for palliative care. It is intended to support practice where local guidance does not already exist.
Palliative care and COVID-19
Glasgow End of Life Studies Group. Insights and observations based on a rapid, non-systematic review of key literature on palliative care in pandemic and related contexts, such as humanitarian disasters of various kinds.
Responding to COVID-19: the ethical framework for adult social care
Department of Health and Social Care. This framework intends to provide support to ongoing response planning and decision-making to ensure that ample consideration is given to a series of ethical values and principles when organising and delivering social care for adults.
Role of the specialty and guidance to aid care
Association for Palliative Medicine page on COVID-19 and Palliative, End of Life and Bereavement Care in Secondary Care.

Theraputics

Therapeutic measures in patients with COVID-19 with expected unfavorable prognosis
This Swiss resource serves as a recommendation for patients, who will not receive life-sustaining treatments such as intubation and resuscitation.
Symptom Control in the last days of life during COVID-19 pandemic - Worldwide Hospice Palliative Care Alliance
For community professionals, this is a comprehensive list of medications that can be administered by alternative (i.e. non-oral / non-subcutaneous) routes for symptom control.
Symptom management for adult patients with COVID-19 receiving end-of-life supportive care outside of the ICU
Canadian flow chart. Can be used to inform writing of own guidelines
Self-management of breathlessness
King's College London symptom led research on breathlessness in palliative care. Not specifically COVID-19.
COVID-19: Evidence to support use of alternative drugs and routes of administration for management of End of Life symptoms
From Future Planning. Evidence and guidance for the administration of medication in community settings.

Training Resources

COVID-19 Response Training - CAPC (Center to Advance Palliative Care)
Training for any clinician caring for patients in the context of COVID-19. Includes continuing education courses and downloadable protocols for crisis symptom management, and communication resources specific to conversations with patients and families about COVID-19.
Coronavirus (COVID-19): End of Life Care COVID-19
Health Education England online training resources. Includes recently updated courses.
Primary Palliative Care for COVID-19
Stanford Health Care - Pocket Card resource with quick access information on dyspnea, opiods, and communication.

Communication

COVID-19: Effective communication for professionals
Effective Communication for Healthcare (NHS Scotland). During this emergency, we need to talk with people who are deteriorating due to underlying health problems and/ or infection with COVID-19 and their families using clear, sensitive and effective language.
COVID-Ready Communication Skills
This playbook from VitalTalk Tips is a super-concentrated blast of tips that will enable you to navigate through your day with honesty, empathy, and compassion—in a way that is sustainable.
Video Wall: Bereavement films for professionals
Support Around Death. This NHS Education for Scotland website aims to support healthcare staff who are working with patients, carers and families before, at, and after death. It provides key information on the clinical, legislative, and practical issues involved.
Communication in the COVID-19 Emergency
From Italy: Basic tips for managing communication with families and patients who are deteriorating, aimed at helping colleagues heavily occupied with the emergency

Experience

From the front line: Palliative care in Bologna during the COVID-19 crisis
Blog of the European Association for Palliative Care which explains some of the main challenges facing us in health care during the coronavirus crisis and shares advice for others who are approaching a similar situation in their country.
Time to talk: Weekly zoom calls on Fridays 1300-1400 BST
WHPCA, Palliative Care Voices, ICPCN, IAHPC, PALCHASE are organising weekly Zoom calls on Fridays, 1300-1400 UK time. Videos of previous calls available.
Palliative Care in the Time of Covid
Powerful comic strip on the role of palliative care medicine at this time.

Information for patients and families

COVID-19 Care and Inform
Irish Hospice Foundation. Information on: Grieving in Exceptional Times, Helping Children Grieve During COVID-19 Restrictions, Planning a Funeral in Exceptional Times
Covid-19: information for bereavement services
National Bereavement Alliance. Information for people and organisations working with bereaved people
Talking about death and dying
Justin Amery Video 4 – YouTube video series from an expert in end-of-life care.
Palliative and End of Life Care Toolkit
Royal College of General Practitioners. a collection of tools, knowledge, and current guidance to support patients nearing the end of life to live well until they die.
Coronavirus: dealing with bereavement and grief
Cruse Bereavement. These resources show how bereavement and grief may be affected by this pandemic. They cover some of the different situations and emotions bereaved people may have to deal with.
Coronavirus (Covid-19) if you’re affected by terminal illness
Some people living with a terminal illness may be at higher risk of experiencing more serious complications from coronavirus. We have some general information on this page that you might find helpful.