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P-4 Family experiences relating to end of life care for patients with COVID-19 related respiratory failure

IntroductionIssues of resource allocation, visitation restrictions and infection control inevitably impacted the experience for relatives of patients who died due to COVID-19.MethodsWe conducted telephone consultations with the next-of-kin (NOK) of patients admitted to the respiratory HDU ward at Whipps Cross Hospital who did not survive their admission. This focused on a 19-week period between 17/09/2020-30/01/2021. Patients transferred to ITU were excluded.ResultsOut of 84 patients who did not survive their admission we were able to conduct a telephone interview with 53 NOK relatives. 34 (64%) relatives reported an overall positive experience relating to end-of-life care on the ward and 19 (36%) had a negative experience. 23 (43%) reported they were concerned about visiting due to the risk of acquiring infection and in fact 12 (23%) opted not to visit for this reason. 36 (68%) felt they were kept well informed by the medical team. 14 relatives (34% of those who visited) felt that PPE negatively impacted on their experience. 22 (53% of those who visited) felt the restriction on visitor numbers negatively impacted their experience and a similar number felt the ward environment negatively impacted on their experience. Out of the 24 relatives who had experienced a death before, 19 reported that visiting limitations were the main difference and this had had a negative impact. Relatives were invited to make general comments about what negatively impacted their experience and the most commonly recurring answer was the hospital-acquired nature of the infection (6 cases) and poor communication (5 cases). In the case of relatives with a positive experience, good nursing care was most commonly self-reported as having an impact (8 cases).DiscussionThis data highlights the challenging nature of end-of-life care in the COVID pandemic era and reveals some of the difficulties families faced under the circumstances.