Mohammad H1,2, Chauhan A1,2 and Tamara H3*
1Dnipro State medical University of Health Ministry of Ukraine, Ukraine
2Department of oncology and medical radiology, Dnipropetrovsk City Multi-field Clinical Hospital, Ukraine
3JMC Medical Clinic Dnipro of Ministry Health of Ukraine, Ukraine
*Corresponding author: Tamara H, JMC Medical Clinic Dnipro of Ministry Health of Ukraine, Ukraine
Submission: November 11, 2021;Published: February 25, 2022
Volume3 Issue4February, 2022
The novel corona virus (2019-nCoV or SARS-CoV-2) originated in Wuhan City of Hubei Province of China in 2019 affecting millions of lives socially, economically and mentally. According to worldometers, there are 235,955,154 total cases and 4,819,263 deaths reported till 4/10/2021. Most of patients suffering from COVID-19 are either asymptomatic or have mild symptoms, 5% require hospitalization and 1%-2%need Intensive Care Unit (ICU) admission and ventilator support [1]. Highest mortality rate was found in older adults and patients with chronic medical conditions and malignancies. As the virus is highly transmissible, many people were devoid of meeting or even performing traditional rituals on the death of their loved ones. During these hard times, palliative care workers had to push their limits for the betterment of humankind. They had to support patients as well as their families emotionally during ailment or bereavement.
Palliative care is a way of thinking about and providing medical care that focuses on preventing and alleviating suffering. The goal is to help patients and their families achieve their best possible quality of life. Those who work within a palliative care team assist with decision making for patients with serious illness. As the number of COVID-19 cases started rising in the world, many palliative care and mental health professionals collaborated for providing some insights on the management of covid-19 through palliative care. They created algorithms which were published as an E-book. Various training programs were conducted over the ECHO platform with webinars by eminent faculties to train frontline health-care providers in palliative care [2]. With the increasing risk of Covid-19, social distancing and visiting restrictions have been implemented. These changes may easily trigger the chances of depression, anxiety, loneliness, distress and confusion [3] Therefore, palliative care comes to the rescue. Palliative care including psychological support and also relief of physical symptoms should be practiced for COVID-19 patients [4]. Caring for COVID-19 patient starts with controlling symptoms like dyspnea, fever, cough, Anxiety, depression, sleep disturbances and spiritual suffering.
According to WHO’s management guidelines, the use of opioids for the relief of dyspnea that is refractory to treatment of the underlying cause, such as oxygen therapy, respiratory support and corticosteroids is recommended [5]. Parenteral and oral opioids have shown better reduction in dyspnea without any deleterious effect on oxygen saturation [6]. Whereas, For post-COVID chronic dyspnea, oral mirtazapine can be prescribed [7].
The guideline of NICE (The National Institute for Health and Care Excellence) 2020 recommended codeine phosphate tablets or codeine linctus as the first choice in the pharmacological management of distressing COVID-19 cough; and oral morphine as second choice [8] Whereas, for post-COVID cough, tiotropium could be useful [9].
The use of NSAID drugs like ibuprofen was not associated with adverse outcomes [10]. Moreover, paracetamol or acetaminophen could also be taken when the fever is associated with body ache or headache if there is no contradiction.
Muscle relaxation techniques, breathing exercises and psychological support could help patients to improve psychological outcomes of COVID-19 [11]. Treatment of geriatric anxiety involves more of non-pharmacological approaches like modification of lifestyle such as regular physical exercise, sleep, nutrition, behavior and cognitive therapy which are first recommended rather than pharmacological approaches [12]. As the palliative care also deals with improving the quality of life, communication skills play a major role. There should be honest and open communication between physician and the patient for better understanding of patients’ suffering. WHO recommended exploring COVID-19 patients’ needs and concerns around the diagnosis, prognosis, and other psychosocial issues via careful listening, and addressing them by giving accurate information on their condition and treatment plans, helping them with decision-making, and connecting them with their loved ones and social support [13,14].
Accurate medical information should be communicated to the patients and their families to minimize the risk of disease transmission and psychological issues. This could be done through telemedicine or through PPE. Training in mindful communication based on an ABC mnemonic to improve communication through PPE could be used to overcome the challenge of communication [15]
The ABC mnemonic refers to
1. Attend mindfully: display of photo and name on the PPE for better interaction with the patients.
2. Behaving calmly: avoid body language that shows frustration, anger or impatience and stay calm.
3. Communicating clearly: giving good introduction of oneself Use short, simple sentences and underline your words with gestures.
Make your statement or ask your question and then pause. Keep your voice even, tone gentle, and speech slow.
The world has rarely experienced a simultaneous, global shock as complex as COVID-19 which spared no country. Palliative care could be used to relieve sufferings of COVID-19 patients and people caring for them. It could help sufferers deal in a better way mentally, spiritually and physically.
© 2022 Tamara H. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.