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  • Physical distancing and dying: When you can’t be at the bedside

Physical distancing and dying: When you can’t be at the bedside

 
If someone you care about is seriously ill or dying, the pandemic has likely affected you in ways that you may not have been able to imagine. The public health restrictions that are designed to contain the spread of the virus may stop you from being with or visiting the person who is dying. One of the tragic realities of this pandemic is that people in healthcare facilities and long-term care homes are dying without family or friends physically present. The inability to be close to family and friends when they are ill goes against the human instinct to connect with those we care about, especially when death is imminent.
 
For most people, the process of grieving starts before a death has occurred. Starting the grieving process before death can help us to prepare for loss before it happens. Normally, this kind of grieving happens when: 
  • Family and friends spend time with the person who is dying, providing assistance, comfort and support.
  • Friends and family gather to support one another.
  • Family or friends advocate for the person who is dying to help them to get the best care possible.
Unfortunately, these are NOT “normal” times. Travel restrictions and quarantine rules may make it difficult or impossible for you to be with the person who is dying. Healthcare facilities and long-term care homes have had to limit or prohibit visitors. These policies force you to be apart when the need to be close can feel overwhelming. When visits are allowed, rules about the number of visitors, time limits, and the use of protective gowns, masks, and latex gloves make final conversations and time spent together much harder. 
 
The rules used to control the virus may mean that you may not be able to:  
  • Be as involved as you want in providing comfort and care 
  • Be as aware of the treatment and care being given
  • Advocate on behalf of the person nearing the end of life 
  • See the person as often as you would want to see them or see them at all
  • Touch, hug, and hold them
  • Feel the comfort of a hug or hand squeeze 
  • Say what you need or want to say, including saying goodbye
The need to be apart at this time may complicate your opportunities to share final words and thoughts, to give and receive comfort, and to say goodbye the way you wish. Telephone calls and videoconferences can be helpful, but not being physically present can feel like another loss that complicates the process of grieving even before the person dies. 
 

What can help 

  • Make a communication plan with the healthcare team:
    • Choose one family member to be the primary contact with the healthcare team
    • Find out who to call on the healthcare team if you have questions or concerns
    • Find out when you can expect updates from the healthcare team about changes in the dying person’s condition
    • Make sure the person who is ill has a phone or tablet and a charger. If they don’t have one, ask the healthcare team if they can help. Some hospitals and facilities provide patient tablets or iPads.
  • Find out whether the hospital, healthcare facility or long-term care facility has different visiting rules for visiting patients at the end of life. Some facilities will make an exception to the no-visitor policy.
  • Hold virtual gatherings (e.g. Zoom, Skype, Facetime) of family and friends as a safe way to be ‘with’ the person while following social distancing policies. If the person who is dying is unable to place calls themselves, set up times when someone on the healthcare team can help them place or receive calls.
  • Write a letter or card to the person who is dying. Tell them what your relationship has meant to you. This letter may bring comfort to both of you. If the person is unable to read themselves, ask someone else to read it to them. There is some evidence that hearing is the last sense to go as people die. Even if the person cannot respond, they may be able to hear your words.

If you are unable to do any of the above, that's okay. Many people find it hard to think of what to say, or to say goodbye. Know that you can also send your person your good thoughts and wishes for their comfort, without having to verbally express them in any way, and in spite of being physically distanced.  

For more information about grief and bereavement and to learn how others have dealt with it, go to:

Canadian Virtual Hospice

Canadian Mental Health Association