ABSTRACT
Background/aims: Data from early in the COVID-19 pandemic indicated a major decline in palliative care volunteer numbers and their support to service provision. This may impact on the quality and safety of palliative care service provision. The aim is to identify and understand the roles and deployment of volunteers in hospice and specialist palliative care services in the ongoing response to COVID-19. Methods: Multi-national cross-sectional survey of hospices and providers of specialist palliative care services, using a convenience sample. A 68-item online questionnaire, aimed at people responsible for volunteer deployment, was disseminated via social media, palliative care networks and key collaborators from May to July 2021. Questions captured volunteer deployment pre-COVID-19, through the pandemic and future plans. Descriptive analysis and chi-square tests were conducted to compare results. Free text comments were analysed using content analysis techniques. Results: Valid responses were received from 304 organisations (35 countries, 80.3% Europe). Most cared for adults only (60.9%), provided inpatient care (62.2%) and were non-profit (62.5%). 47.0% had cared for people with COVID-19. Volunteers tended to be younger than pre-pandemic. 47.7% changed the way they deployed volunteers;the mean number of active volunteers dropped from 203 per organisation to 33, and 70.7% reported a decrease in volunteers in direct patient/family facing roles. 50.6% said this drop impacted their organisation and care provision, increasing staff workload and pressure, decreasing patient support, and increasing patient isolation and loneliness. Conclusions: The sustained reduction in volunteer deployment due to COVID-19 has impacted the provision of safe, effective palliative care. Urgent consideration must be given to the future of volunteering including virtual modes of delivery, micro-volunteering, and appealing to a younger demographic.
ABSTRACT
Background/aims: Previous research on hospice and palliative care volunteering early in the COVID-19 pandemic suggested a significant decline in volunteering activity, impacting on the range, safety and effectiveness of services offered. Aim: To explore future organisational plans for volunteer roles and deployment in hospice and specialist palliative care services in light of the ongoing response to COVID-19. Methods: Multi-national cross-sectional survey of hospices and providers of specialist palliative care services, using a convenience sample. A 68-item online questionnaire, aimed at people responsible for volunteer deployment, was disseminated via social media, palliative care networks and key collaborators from May to July 2021. Free text questions focussed on future plans for volunteering. Free text responses were analysed using content analysis techniques. Results: 64% (n=195) of organisations maintained contact with nonactive volunteers. Many services intended to return to pre-pandemic volunteering activities. 14% (n=43) of organisations reported planning a phased re-introduction of volunteers, additional training, use of risk assessments and safe working protocols related to infection control. Others intended to be more flexible, continuing face to face roles whilst increasing virtual volunteering activities. Some planned to use volunteers more effectively, ensuring that roles matched organisational needs. Increased community volunteering was also highlighted. Others were confident that volunteers would return and undertook no planning. Conclusions: The approach to planning for the future of volunteering is not consistent. It was assumed that volunteers will return to roles as before. Urgent consideration must be given to engaging with volunteers to ascertain how many will return, identifying gaps, developing safe protocols for return, assessing future support and training requirements for changed environments and new ways of working.
ABSTRACT
Background: Infection control measures during infectious disease outbreaks can have significant impacts on seriously ill and dying patients, their family, the patient-family connection, coping, grief and bereavement. Aim: To explore how family members of patients who are seriously ill or who die during infectious disease outbreaks are supported and cared for during serious illness, before and after patient death, and the factors that influence family presence around the time of death. Methods: A systematic review and narrative synthesis was undertaken. CINAHL, Medline, APA PsycInfo and Embase databases were searched from inception to June 2020. A forward and backward search of included papers was also undertaken. Records were independently assessed against inclusion criteria. Included papers were assessed for quality, but none were excluded. Results: Key findings from the 14 included papers include the importance of communication and information sharing, including new ways of using virtual communication. Restrictive visiting practices were understood by family, but the impact of these restrictions on the family experience and patient-family connection cannot be underestimated, causing distress and suffering. Consistent communication and information were critical to supporting family members including explaining personal protective equipment, which family found constraining and staff believed affected interpersonal communication. Cultural expectations and obligations associated with family caregiving and death were challenged during infectious disease outbreaks. Conclusion: Learning from previous infectious disease outbreaks about how family are supported is important and can be translated to the current COVID-19 pandemic and future infectious disease outbreaks. Consistent, culturally sensitive and tailored plans should be clearly communicated to family members, including when any restrictions may be amended or additional supports provided when someone is dying.