Message from CHAPCA’s Chair and Vice Chair

California Hospice and Palliative Care Spotlights the Importance of Palliative Care and Hospice Services for Patients’ Families During the COVID-19 Pandemic.


News reports made people aware of medical challenges and hospital resource shortages, from high volumes of patients to a lack of personal protective equipment (PPE), ventilators and ICU beds. The pandemic also revealed another aspect of healthcare in short supply: hospice and palliative care


End-of-life care is difficult no matter what the circumstances. As the number of people succumbing to the virus rapidly grew over a relatively short period of time, the work of specially trained hospice and palliative care team members has been amplified. With their knowledge and skills, hospice and palliative care teams were quickly thrust into a frontline workforce as the pandemic progressed.


Those identified by the U.S. Centers for Disease Control and Prevention (CDC) as people at a higher risk for severe illness and complications from COVID-19—older adults and those with serious underlying medical and comorbid conditions such as cardiac illness, cancer, congestive heart failure, and pulmonary disease—are those most often needing palliative care. While the Coronavirus hasn’t altered the clinical aspects of end-of-life care, hospice and palliative care team members have taken on additional responsibilities.


Hospice and Palliative care providers excel at navigating challenging conversations about patient goals and expectations, enabling them to play a significant role in supporting front-line responders as they care for Coronavirus patients by lending expertise and guidance in how to deal with patients and families in these difficult times.


Navigating a Compressed Time Frame


The pandemic has brought people face-to-face with mortality. While hospice and palliative care teams are accustomed to having difficult end-of-life conversations with family members and other loved ones, the often quick decline of many Coronavirus patients has forced the conversation loved ones are not prepared to have. There has been little or no time to have discussions about the patient’s wishes; no time to think through what a patient might have wanted. There’s also precious little time to ensure that loved ones understand the medical approaches that have been tried and why they are not working, or to prepare them emotionally for their loved one’s passing.


The situation has also been tempered in many instances by the need to have those exceedingly difficult discussions remotely. Having uncomfortable conversations that no one was prepared to have on a screen makes the situation even more challenging. Hospice and Palliative care providers are having to think creatively about how to use technology to allow for some degree of connection. That connection can make all the difference in helping patients and their families feel secure when having the most difficult of discussions.


Guiding Emotional Journeys


Although those who work in hospice and palliative care are no strangers to piloting the emotional path patients and families find themselves taking, that aspect also relies on technology. In this new environment, hospice and palliative care team members have also become communication intermediaries.


As trying as it might be, many people want the opportunity to sit at their loved one’s bedside and share cherished memories, hold their hand or just be with them. But since the Coronavirus has become a part of our reality, hospitals, Skilled Nursing Facilities and Assisted Living Facilities  have barred visitors, with very few exceptions, in an attempt to slow the spread of the virus. Communication from family and friends has transitioned from face-to-face to virtual bedside visits. Family members and friends must rely on technology—cell phones and iPads—to connect with the sick, who, in the most serious cases, may have a range of awareness but cannot reply. Often team members are witness to heartbreaking conversations as they hold a cell phone or tablet for patients who are too weak to do it on their own so they can say goodbye.


The impact of the pandemic has made the need for hospice and palliative care-trained healthcare professionals abundantly apparent. It will require education, not only for clinicians, but also for healthcare administrators and medical schools. We welcome your help in achieving this goal.





Suzie Johnson, CHAPCA Board Chair         

Jan Jones, CHAPCA Board Vice Chair             

Sheila Clark, President-CEO CHAPCA