These are very challenging times for everyone, but for people whose loved one is dying or those who have already lost someone close to them, they are especially tough.

With this in mind, Jutta Maria Widlake, Head of Social Care at St Luke’s Hospice Plymouth, has drawn on her many years’ experience of listening to, and supporting, terminally ill patients and their families to provide guidance she hopes will help anyone struggling with feelings of sadness, anxiety or loneliness at such a vulnerable time.

If you can’t visit your loved one…

The stringent safety measures to help stem the spread of COVID-19 mean the unthinkable has happened and many families are unable to visit their loved ones in hospital or in care homes. Understandably, this is one of the most frightening situations facing people, particularly if their relative is critically ill or dying.

The current crisis means that patients and their families no longer have the choices previously available to them, but some creative thinking can help you and your relative keep in touch even though you can’t spend time together in person at the moment.  Favourite music, poetry, films and prayers can be shared electronically, for example, and you could arrange for staff to place much-loved photographs or other comforting objects from home in your loved one’s room.

While using technology to stay in touch with that special person doesn’t take away the pain of not being physically there beside them, phone calls, or using Facetime or Skype, can help make this very difficult time a little easier, as can recording messages for them and using electronic cards to share memories.

It is also very challenging for hospital and care home staff when there are no family or friends there to help support the person they are looking after. Try to work with those involved in the care of your loved one by keeping in touch with them, and bear in mind that the pandemic situation is fast changing so their organisation’s visiting policy may allow for some exceptions. It’s important to check with them on a regular basis if you are unsure.

If you’re bereaved and feeling isolated…
The social distancing brought about by measures to protect people from COVID-19 mean there are limitations on the everyday activities that bring us into contact with each other. In addition, with each new day seeming to bring more distressing news, feelings of anxiety can be exacerbated.

If you have been bereaved, physical isolation and personal distancing can add to you feeling alone and make grief seem even more overwhelming. In addition, practical concerns and worry about the current situation may make it harder for you to address your grief, which can result in it getting stifled. Remember though, that there are things that can help.

• Use the technology available to you to keep in regular contact with friends and family by phone, text messaging, email, video calls or social media. Make a commitment to initiate contact with at least one person in some way each day.
• Look after yourself by getting some fresh air and exercise every day.
• Try to keep to a regular routine, which can help you sleep better.

St Luke’s bereavement service is here to help you if your loved one had links with our hospice. We can be that listening ear for you over the phone and provide emotional and practical support. There are other services available, too – a good place to start is Cruse Bereavement Care, which has a free helpline on 080 8808 1677, or the Good Grief Trust at www.thegoodgrieftrust.org.

Funerals

Physical distancing is having an impact on how funerals are conducted and the participation of mourners, which is exceptionally distressing when your loved one has died. It may be that very few people are allowed to attend a funeral or that you choose to hold a private funeral  or cremation.

If you can’t attend the funeral, you might want to write or record a message that can be read out by someone who will be there – contact the funeral director for information.

After the funeral, check in with people by telephone, social media or a video call. This is a good opportunity for you to talk about the deceased and share your memories.

You might find it helpful to set some time aside to have your own personal memorial at home. You could take some time looking at photographs of the person who has died, light a candle, write a message to them, or follow any of your own cultural or spiritual rituals.

Providing it is safe to do so, you may be able to visit somewhere meaningful to you and/or the person who has died, keeping in mind current physical distancing rules.

Sending flowers is a simple, yet meaningful, gesture. You can send them to the funeral home or the home of the bereaved.

If you’re sending a sympathy card, you may choose to share a favourite memory of the deceased. A short, simple note can provide comfort and let’s those who are grieving know that you’re thinking of them.

You could also ask if there is an online book for friends and family members to sign and offer their condolences. Family members often find comfort in reading these messages and having them available online makes it easy to look back on them at a later time. In addition, if the social media account of the person who died is still active, you could post a message in memory of them there.

Making a donation in the name of your loved one not only pays tribute to them, but also creates a positive impact on the lives of others.

If you would like support, please call 01752 964200 or email bereavement@stlukes-hospice.org.uk

Across the UK, hospices are pulling out all the stops to keep running their vital service for people at end of life – and the loved ones around them – despite the many challenges presented by the COVID-19 pandemic.

Just as with their NHS counterparts, recent events have meant these charities have had to take very tough decisions in order to protect patients and their families, plus staff, volunteers and the wider community, from infection, as well as fast develop new ways of working that ensure their specialist care continues to reach those who desperately need it.

As pressure mounts on our at home team to make its limited resources stretch further during these difficult times, St Luke’s IT department wasted no time in collaborating with their clinical colleagues to hone an innovative solution that’s helping the multidisciplinary team of doctors, nurses and occupational therapists carry out their crucial work both safely and speedily.

With the NHS granting permission for us to use its tried and tested accuRX system – already used by many hospital trusts and GP surgeries for online consultations and text messaging with patients – St Luke’s has worked across teams and around the clock to adapt the system so patient-centred care can be provided remotely when it is not safe to visit patients at home or when the caseload makes this difficult.

AccuRX video-conferencing is user-friendly and works in much the same way to Skype, making it accessible to patients as well as the professionals responsible for their care. Crucially, though, the information shared – be it a video consultation, a patient’s scan or the details of their prescribed medication – is encrypted so that it cannot be deciphered until it is received by its intended recipient.

Aaron Smallshaw, Group Head of IT for St Luke’s and Rowcroft Hospice in Torbay, said: “Given the very serious nature of COVID-19 and the threat it presents to vulnerable patients in particular, we were determined to act quickly to do whatever we could to help ensure their safety and that of our staff looking after them.

“The beauty of accuRX is that it’s already working really well within the NHS as a safe and secure way of sharing information between clinical staff and between them and their patients. Our focus has been on adapting and testing it so that it works equally well for our hospice team, enabling them to provide their outstanding patient-centred care remotely, and reducing unnecessary visits to patients’ homes, which helps keep everyone safe.

“In usual circumstances, it could take months to consult with our stakeholders and build, configure and test a new system, but with the endorsement of the senior management team at the hospice we were able to prioritise our work on accuRX above other duties and fast-track its implementation here within just a couple of weeks.

“It has taken a phenomenal hospice-wide effort and the fact that the system is already helping staff work even more efficiently in ways that ensure their patients’ peace of mind is testament to fantastic inter-departmental working, particularly between IT and our clinical colleagues in the frontline of caring for patients in these challenging times.”

Jen Nicholls, Clinical Nurse Specialist at St Luke’s, is among the first of our clinical staff to use the new system from her home. She said: “Now more than ever, it’s really important we keep as much contact as possible with our patients and their families.

“I’ve already used accuRX with a patient and was delighted it was so easy for them to connect. The picture and sound were clear and I was able to carry out my assessment by them pointing to the site of their pain and from me observing their skin colour and general appearance. I was also able to see their medication boxes on screen and check the dosage, and the patient’s wife held his prescription chart in front of the screen so I could confirm it was correct and up to date.

“I was really impressed by how straightforward everything was and I can see how using the system both now and in the future will have benefits for our service and the people we look after. It’s a game-changer that will enhance our specialist end of life care.”

Sioned Evans, Community Consultant at St Luke’s, said: “Through Project Echo we’ve already been using technology to share our specialist skills with local care home staff and the South Western Ambulance Service NHS Foundation Trust. Now accuRX will help us in our one-to-one consultations with our patients in a way that is reassuring to them and their families while easing pressure on our precious resources. I couldn’t be more proud of the way our teams have risen to the challenge and come together to make it happen so quickly.”

The outbreak of coronavirus – and the speed at which the situation is unfolding – mean we are all living in unprecedented times, but I want to reassure you that my colleagues and I are doing everything possible to ensure St Luke’s vital service for patients and their families continues. Protecting their safety and well-being, and that of our staff and volunteers, is always our top priority and we are closely monitoring the rapidly changing situation, assessing its implications for our service and making decisions based on official advice from Public Health England.

In common with many organisations, one of the biggest challenges we face is the inevitable drop in funding as a result of the outbreak.

As a charity with only 23% of our annual income coming from the NHS, we rely on the kindness of our community to help us continue making an important difference to local families facing a very challenging time. It is now, more than ever, that we need your generous support to ensure we keep our nurses on the wards and on the roads visiting patients at home in the weeks and months ahead.

Over the years, I have been very touched to see how much St Luke’s means to so many and, while we never take your support for granted, I know you will rise to the challenge. There are lots of ways you can do this, from donating to our charity shops, playing our weekly lottery or sponsoring a nurse to dedicating a leaf on our beautiful Memory Tree. Or, if you’d rather, you can simply make an online donation here.

If you would like to join us as a volunteer, there couldn’t be a better time and we have a wide variety of roles. So, whether you want to give a few hours or a day or two a week, please don’t delay. Apply here.

However you choose to show your support for St Luke’s, please know your kindness counts and is greatly appreciated.

Thank you for your continued understanding and support.