Experts have released a new guide on deathbed etiquette to help people adapt to saying goodbye to their loved ones during the coronavirus crisis.
Final goodbyes have been transformed by the Covid-19 outbreak, with some families unable to be by the sides of their loved ones as they die.
The Centre for The Art of Dying Well at St Mary’s University, Twickenham, has launched the new guide to help families and friends feel close to a loved one if they cannot be physically present.
Informed by palliative care consultants and hospital chaplains, the guide advises people to think about communicating virtually, consider what their loved one would think and say, and not to succumb to feelings of guilt.
The guide also says people should trust that doctors and nurses will provide good care, and seek support from friends and family.
While physical visits may be more challenging, Dr Amy Gadoud, a consultant at Trinity Hospice and Blackpool Teaching Hospitals, said “healthcare professionals are never going to desert the dying”.
“I think that’s the bombshell that we’ve all been hit by in this coronavirus crisis,” she said.
“If people are dying of some other disease at this time, it’s possible that one relative may be allowed into the hospital or care home. It’s possible. It’s also possible you may not.”
Some families may be unable to visit loved ones because they live in another part of the country, have Covid-19 symptoms themselves, or are in the vulnerable group advised to shield.
Dr Jo Elverson, a consultant in palliative medicine at St Oswald’s Hospice in Newcastle, said guidance and public messaging about visiting “is changing all the time” and being interpreted differently across the country.
Last month, Health Secretary Matt Hancock said “wherever possible” people will be given the “chance to say goodbye” to loved ones dying with Covid-19, after reports of the elderly dying alone in care homes and some hospitals banning all visitors.
He said “wanting to be with someone you love at the end of their life is one of the deepest human instincts”.
Visitors to St Oswald’s Hospice are asked to wear protective gear, such as a mask, when the person they are visiting has Covid-19 symptoms.
And the team is giving patients phones and tablets if their loved ones cannot be present.
Dr Elverson said she asks relatives “what’s important to you about being there, and how can we replicate that in a different way”.
“It’s not the same, but actually sometimes there are parts of that being present that we can do in a different way,” she said.
“Yes, you might not be able to be sitting right at their bedside holding their hand, but actually if they can hear your voice, if they can see your face, that can give them the comfort you’re hoping to give them.
“The reason people want to be there at the bedside is to make sure their loved one is okay, to make sure that they are present to comfort and reassure them, to say the things they want to say to them, and actually if it comes down to those core things, yes it’s a compromise, but actually we can still do those things from a distance.”
Dr Sarah Holmes, medical director at the Marie Curie Hospice Bradford, said: “As the nation’s end of life care charity we encourage people to plan conversations with loved ones at the end of life, as it provides an opportunity to discuss topics and ask questions that you might never have the chance to talk about again.
“Having these conversations can help avoid long-term psychological damage and complicated grief.”
She added: “It’s a very human need to want to be with the people we love when they are dying, to care and comfort them, to hold their hand and let them know they are loved.”
Retired hospital and hospice chaplain Dr Lynn Bassett said the deathbed etiquette for Covid-19 can be summed up by “three quite simple things; the dying person, yourself, and then looking out towards friends and family”.
To read the deathbed etiquette see: https://www.artofdyingwell.org/caring-for-the-dying/deathbed-etiquette/deathbed-etiquette-and-the-coronavirus-covid-19/
Deathbed Etiquette for Covid-19
• Do what you can to help you feel close to your loved one even if you are apart.
• Think about what your loved one would think and say. They will not want you to worry.
• Communicating virtually may be an option.
• What can I say? Speak from the heart.
• Trust in the good care of the doctors and nurses. They are there for your loved one and for you.
• Take care of yourself. It is important that you keep well.
• Draw on your inner strength. Do what is helpful to you.
• Don’t let feelings of guilt take over. Accept your feelings and let them pass. Think of the good advice you might give to someone else and then take it yourself.
• Keep up with family, friends and those who will lift your spirits.
Picture: A new guide on deathbed etiquette to help people adapt to saying goodbye to their loved ones during the coronavirus crisis. (The Centre for The Art of Dying Well at St Mary’s University, Twickenham).