Palliative Care Physician Confronts Pandemic with Information, Perspective C-TAC’s Dr. Brad Stuart Shares Thoughts on COVID-19, Intrinsic Hope

By Larry Beresford

When COVID-19 began to spread across the United States four months ago, hospice and palliative care pioneer Brad Stuart, MD, retreated to his home in Forestville in Sonoma County, Calif., and started studying the virus online.

Stuart was eager to read everything he could about how to slow the spread of disease and minimize the risk of infection. He planned to share what he learned with a group of long-time friends who, like him, are around 70 years old and thus at higher risk for COVID complications.

Soon, however, Stuart, who is Chief Medical Officer for the Coalition to Transform Advanced Care (C-TAC), was sharing his thoughts with a wider audience. He created a lively and informative blog, Coronavirus and COVID-19 News & Views, and updated it regularly, summarizing new studies and offering reflections on the country’s COVID-19 response.

Inevitably, threads of palliative care became part of the conversation. Treatment for COVID-19 is all about managing symptoms and the ongoing crisis has underscored the importance of palliative care across settings and disciplines.

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By Larry Beresford

Palliative care physician Martha Twaddle recently helped a primary care colleague conduct a telemedicine visit with two patients in their 80s, both of whom had multiple health problems. The visit was to talk about advance care planning, specifically what kind of treatment the pair would want should they become seriously ill with COVID-19.  

Twaddle, Medical Director for Palliative Medicine & Supportive Care at Northwestern Medicine—Lake Forest Hospital in suburban Chicago, said she felt like the wingman for the primary care practitioner (PCP), who was leading the goals-of-care conversation.

The PCP explained that a COVID infection could easily lead to crisis decision-making, placement in the ICU, and insertion of a ventilator for breathing support, which often has bad outcomes, particularly for older patients with comorbidities.
He then asked, “if you got sick, what would you want?’” Twaddle said. “They decided that if they got COVID, they would not want to be hospitalized.”

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Coming Together in Times of Crisis

COVID-19 Pandemic Has Underscored Need for Palliative Care

By Jennifer Moore Ballentine

When I wrote a blog on the role of palliative care in the unfolding pandemic on March 11, the U.S. had confirmed 1,281 cases of COVID-19 and 36 deaths from the virus; today, a little over 2 months later, we have confirmed more than 1.5 million cases and are on track to hit 100,000 deaths by June 1.

Through it all, palliative care has been front and center.

All aspects of living and dying and caregiving and grieving have been upended and turned inside out in just these few weeks. Within days of my writing the blog, our staff dispersed to remote work, learning to juggle the already huge demands of our work with homeschooling, caregiving, and the high anxiety attached to every sniffle and every trip to the grocery store.

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Hospice COVID-19 Unit Offers Patients, Families Needed Support

By Larry Beresford

Some Louisiana families whose loved ones are dying from COVID-19 have found solace in a specialized hospice unit that is caring for patients infected with the virus.

Heart of Hospice Inc. opened its inpatient COVID-19 unit on April 15 in Metairie, a suburb of New Orleans. The company, headquartered in Charleston, S.C., with locations in five states, is one of several hospices across the country opening or converting inpatient facilities to serve COVID-19 patients.

In hospitals and other acute-care settings, patients with the virus are isolated, with visitors banned to lower the risk of new infections. Those dying from COVID-19 are often alone or surrounded by strangers, a heartbreaking scenario for patients, families, and bedside clinicians.

Offering another option has been a priority for hospices that have the resources and abilities to make it happen. Specialized COVID-19 hospice units have been a godsend for patients nearing death and their families.

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