Plymouth resident Bob Sullivan and family members said goodbye to his father, Daniel, in a hospice home at the beginning of March.
Less than a week later, Gov. Charlie Baker declared a state of emergency in response to COVID-19, closing schools and nonessential businesses and leading care facilities and hospitals to restrict visitors.
“Things were starting to happen ... looking at it now I’m certainly glad he passed when he did,” Bob Sullivan said. “It really would have been an impossible situation for him.”
Daniel Sullivan, who was 84 and lived most of his life in Peabody, moved to a nursing facility in Plymouth last Thanksgiving to be near his son. His health had been declining and he was diagnosed with dementia.
Three days before he died, he went to the Dr. Ruth McLain Hospice Home in Braintree, which is run through West Bridgewater-based Old Colony Hospice & Palliative Care.
Before the COVID-19 pandemic, health care staff from local hospice providers would go into private homes, nursing homes and hospitals to work with patients.
With challenges accessing care facilities, providing care in a way that minimizes the spread of the virus and staying connected with patients and families, Brockton-area hospice providers have had to adapt to continue their work.
“It was trying to figure out how to continue hospice care, but now you’re adding a layer of unusual things and interventions that we have had to put forward to support the families,” said Toni Eaton, president and CEO of Old Colony Hospice.
The decision made by nursing homes or assisted living facilities to limit outside health workers and families was understandable, she said, but it left patients’ families “traumatized and devastated.”
Nicole Perrault, hospice liaison for the Brockton Visiting Nurse Association, said it’s not just care facilities and hospitals that have controlled who to bring in. Patients have been cautious, too.
In the months before Daniel Sullivan died, his son remembers hearing about COVID-19 and that it was a consideration about whether to keep him in a nursing home.
He would have struggled in a care facility with having to stay in his room and take meals there, Bob Sullivan said. His father was a social man who liked to golf, see friends and go out to eat.
Melissa Neumyer, a hospice and palliative care case manager for the Brockton Visiting Nurse Association, said the team she is part of had some patients who were expected to live longer, but they died sooner during the pandemic.
She thinks COVID-19 and the isolation and depression it has caused for those in care facilities contributed to their deaths.
People were dying alone, which is something Old Colony tries to prevent with hospice care, Eaton said.
During the pandemic, there was a patient who arrived at the Dr. Ruth hospice house. One of patient’s daughters drove hours to see her mother and say goodbye. If the woman were taken to another facility, she may have not been able to do that, Eaton said.
For the Brockton Visiting Nurse Association, Neumyer said referrals from nursing homes for hospice care has declined since the pandemic.
Perrault said the coronavirus affects people so fast and usually doesn’t give them the time to choose hospice.
“With COVID the last thing you’re trying to do is give up hope,” she said.
Neumyer said some patients changed their goals for care and decided to go into hospice at home because they didn’t want to go to the hospital and be potentially exposed to COVID-19.
Since the start of the pandemic, Old Colony has had at least half of its staff temporarily out of work for exposure to COVID-19, Eaton said.
“Like many, hospice staff members were scared about how COVID-19 could impact them and their families,” she said.
“They were afraid, too,” Eaton said. “They’re not just clinicians, they’re human, too.”
Both hospice providers have staff wear masks when going into private homes, care facilities or hospitals. They also make sure to know of any rules for visitors ahead of time.
There have been times when Neumyer has had to put on all of her personal protective equipment insider her car when visiting patients at home.
“There’s a lot of logistics you don’t have to think of until you’re in that situation,” she said.
Palliative care, which is about symptom management, has also had to change during the pandemic.
Eaton said much of that work has pivoted to videoconferencing.
The Brockton Visiting Nurse Association sets them up with a telemedicine system that will take the patient’s vital measurements like blood pressure, heart rate and weight at home, Neumyer said.
The organization transitions its palliative patients into hospice care if they need it. Neumyer said that’s a way to build on trust and relationships with a person and their family, especially when the time comes to have a conversation about end-of-life care.
She considers herself a hugger and said the ability to shake hands with patients helps her feel close with them. And when families are grieving, touch is a way to offer them support.
“Your first reaction is to put your arms around someone,” Neumyer said. “It’s sort of closure for us.”
The Brockton Visiting Nurse Association has a social worker who assists families with bereavement. They will reach out and check in after a loved one’s death.
Normally the organization has a memorial service every six months and all families who lost someone who was in hospice care are invited. Perrault said the Brockton Visiting Nurse Association is looking to see how it can host the event, which may need to be done over Zoom because of the pandemic.
Bob Sullivan looked back on the care Old Colony gave his father positively. In addition to putting his father at ease, he said staff gave him and his family attention and told them what to expect.
“It was a really dignified and humanitarian way for him to die,” Sullivan said.
Brockton Enterprise Article on September 26, 2020