Uncertainty, COVID-19, dignity and palliative care
Since the lifting of all COVID-19 restrictions, the UK Government appears to suggest that the pandemic is over; yet more people are still testing positive and some are falling ill from the latest variant. There is a contrast in the statements issued by the public health experts and those being put to practice by the government; for example: limiting infringements on personal freedoms, minimising the spread of the virus and getting the economy moving again by getting people back to work, and encouraging socialising. Such contrasts have a potential to cause emotional and psychological distress, especially on dying patients and their close relations and its impact can be associated with poor dying experience, leading to undignified death (Pfefferbaum and North, 2020). It is an acceptable argument that death is the only certainty, but healthcare professionals, and community nurses in particular, can improve the actual process and experience of dying for both patients and their close families/friends. The Parliamentary and Health Service Ombudsman (PHSO) report (PHSO, 2015) concluded most people were dying without dignity. While it may not be clear where these deaths occurred, the fact that there were undignified deaths is a cause for concern, as the principles of palliative care should be applied to all. The proponents of palliative care would view dying without dignity a major indictment on palliative and end-of-life care providers. The concept of dignity has been discussed and practised for over a decade now (Marley, 2005). The advent of COVID-19 has added another dimension, contributing to poor dying experiences, where death occurred without loved ones around and healthcare professionals were forced to socially distance. This removed the fundamental connection advocated in palliative care to ensure emotional support leading to dignified death.
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