Belinda, 82 Years Old
Congestive Heart Failure
Belinda was admitted to hospice services in 2020. This is but one of our case study examples detailing the care we provide. She had a primary diagnosis of congestive heart failure. She had been a long-term resident of a skilled nursing facility local to one of her daughters, who visited regularly. Upon COVID 19 visitation restrictions, the family began to do window and telehealth visits. As the patient’s condition began to deteriorate, hospice staff coordinated in-person visits with the facility, following guidance from the Centers for Disease Control (CDC) allowing for compassionate care visits in addition to end-of-life care. Hospice staff advocated for in-person visits on a weekend when her other daughter was going to be in town, as the patient’s condition had changed to the point staff felt she was beginning to transition. At this same time, the patient was diagnosed with COVID-19 and per facility, the procedure was transferred to a facility approximately two hours away from her home facility. The patient subsequently passed while she was there. The day that she passed, hospice social work and nursing were able to see her. Social work identified that patient was imminent, and placed a call to Chaplain to provide spiritual services and end of life prayer to the patient, as she herself and her family had previously identified strong religious beliefs and prior to facility lockdowns had been receiving spiritual care from her longtime local pastor.
The initial contact consists of sending sympathy cards and making condolence calls within 48 hours of a patient passing with a goal of most calls occurring within 24 hours. The assigned social worker placed a call to the patient’s family, who had expressed concern that they believed Belinda had not been able to receive spiritual care as part of her compassionate care as she passed. The social worker was able to report to the family that patient had in fact received prayer from Chaplain as well as emotional support and companionship from social work in addition to a nursing visit only hours prior to her passing. There was a noticeable change in the family’s voice that can only be described as a sigh of relief, and they expressed gratitude that she had received spiritual support, as that was their primary concern outside of pain control. The family expressed that they had felt a great deal of guilt over not being able to be with her and provide her with spiritual support and companionship, and knowing that hospice had been able to provide compassionate care and spend quality time with her the day of her passing helped to alleviate some of those feelings. This case study example is just one story of many.
Belinda’s case demonstrates the importance of the role of bereavement services and follow-up services. Without the follow-up contact from hospice staff, the family would not have known of the services provided to the patient on the day of her passing and would be left with complicated grief issues due to guilt. Being able to address those issues immediately is a keystone of bereavement services, as it is the first chance to establish a rapport based on the needs of the caregiver and not involving the patient, and grief work can begin and any issues that exist can begin to be identified.