The COVID-19 Pandemic: Bereavement Experiences Between Hospital and Home Deaths in Palliative Care

Elizabeth Lobb*, Fiona Maccallum, Jane L. Phillips, Meera Agar, Annmarie Hosie, Lauren J. Breen, Jennifer Tieman, Michelle DiGiacomo, Tim Luckett, Jennifer Philip, Serra Ivynian, Sungwon Chang, Ann Dadich, Janeane Harlum, Imelda Gilmore, Irina Kinchin, Christopher Grossman, Nicholas Glasgow

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    1 Citation (Scopus)

    Abstract

    Background: Australian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends. Aim: To understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home. Design: A cross-sectional online survey was completed by bereaved adults during 2020–2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin. Setting/participants: Of 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home. Results: The COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different. Conclusions: These findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.

    Original languageEnglish
    Pages (from-to)147-156
    Number of pages10
    JournalJournal of Pain and Symptom Management
    Volume67
    Issue number2
    DOIs
    Publication statusPublished - Feb 2024

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