Palliative Care in Two Pandemics

By Jennifer Moore Ballentine

I had hoped, by this mid-summer moment, that the COVID-19 crisis would be mostly in the rear view – or at least in the rear view and maybe up ahead around a few bends. Instead, we are still right in the middle of it. And palliative care continues to be right in the middle of it.

Skills essential to good palliative care have proved essential in caring for COVID-19 patients: navigating difficult decisions and conversations, managing severe and distressing symptoms, bearing witness and keeping company when family and loved ones are kept away, and – sadly – doing our best to ensure comfort at death.

As I recently noted during a panel discussion for the Coalition to Transform Advanced Care, COVID care is palliative care, and palliative care has never been more relevant and urgently needed.

Preparing the Workforce

Likewise, palliative care education has never been more relevant and urgently needed. From the end of March to the end of June, we made 19 of our self-paced courses available to frontline clinicians at no charge. By the end of April, we’d had nearly 3,000 registrations, and by the end of June, more than 5,000.

You won’t be surprised at the “best sellers” (350+ registrations each):

Our free telemedicine open forums, featuring Drs. Fratkin and Mistler of ResolutionCare, were also well received, with more than 1,000 registrations over 6 sessions. Videos of these sessions are now available you weren’t able to join us.

Clearly, clinicians are hungry for learning how to support, comfort, and communicate with patients in severe distress, and how to care for themselves in severe distress and overwhelm.

Addressing Racism and Healthcare Disparities

This painful pandemic has exposed another one that has been here all along, eroding trust, building barriers, and degrading care: the pandemic of racism and its many distressing symptoms.

Longtime disparities in nutrition, safety, education, health, and access to quality care, including palliative care, have disproportionately affected racial and ethnic minorities, with higher COVID-19 death rates among African American, Native American, and LatinX communities.

We’ve also seen and felt the convulsions of injustice, disproportionate incarceration, and violent death emanating from racism and bias. It is time for us as a nation, as organizations, as individuals to reckon with the legacy of oppression, intended or not, conscious or implicit, out loud or insidiously silent.

Here at the Institute, we’re undertaking a close inventory of our courses to ensure they address issues of disparity, bias and discrimination. We know many of them do, whether embedded within a larger context as in our cohort courses, or as the focus of the learning.

We are committed to ensuring our content on these topics is current and compelling, that we deploy education to address these issues as effectively as we do advance care planning or symptom management, that we are as much a part of the eradication of this pandemic as we are of the other.

My hope is that, as we confront these dual pandemics, palliative care will emerge stronger, more essential, more appreciated, and more accessible to anyone, anywhere who needs it. As the field grows, we are right there to help train and support current and new generations of clinicians.

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