Ventilator or Hospice? COVID-19 Strains Care System

“We are seeing more and more situations where we’re being asked to step in,” says Terese Acampora, the chief operating officer of MJHS Hospice and Palliative Care in New York City.

Many hospice programs received an influx of patients before the virus began to bear down on the U.S., as hospitals discharged patients to free beds. COVID-19 has only added to that load.

“We’re seeing a massive need for community-based care,” says Edo Banach, president and CEO of the National Hospice and Palliative Care Organization in Alexandria, VA.

At the same time, hospice organizations are finding themselves short-staffed during the pandemic.

Acampora says 40% of her field staff, who would be making visits to patients, can’t come to work right now. She says some are having child care issues, while others are sick, including some who have been infected with the new coronavirus.

If hospitals have struggled with a shortage of personal protective equipment, or PPE, for staff, hospice programs have been even further down on the list.

Banach says it’s a common problem nationally, too.

“They’ve had to go on the secondary market and get protective equipment from China or Home Depot or nail salons just to have enough gowns and masks to protect their employees.”

“It’s been forgotten that there are millions of people getting care in the home, and their caregivers need protective equipment, too.

The day Acampora spoke to a reporter by phone, she had two nurses to visit more than 100 patients.

“Every day, I have to look to see which staff do I have available to go in and see people,” she said. “It’s been a challenge.”

MJHS accepted its first COVID-19 patient in early March, she said, and would continue to take as many patients as it could.

Not everyone qualifies for hospice care. Under federal rules, patients qualify for hospice only if they have a terminal diagnosis and 6 months to live. And while hospice providers can provide medication and treatment to make a person comfortable, they don’t try to cure the disease. MJHS doesn’t consider COVID-19 — by itself — to be a terminal diagnosis. Its patients with COVID infections also have another condition, like cancer, that qualifies them for hospice care.