GCM Role is Working With Family In COVID-19

Care managers cannot be in the hospital with a  patient dying of COVID-19. They can support their bereft children, who cannot see their parents during the hospitalization, in those last moments of goodbye’s or after the death in this deadly pandemic.

In normal times care managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care. But is COVID -19 they can offer guidance to the family through the sometimes weeks of hospitalization, intubation, their loved one is on a ventilator and ultimately often- death separated from loved ones.

Navigation Through a COVID-19 Death

 The normal final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, in coronavirus, the blind alleys may be blocked by a rushed hospitalization, banned from seeing their loved one in the hospital and not understanding the disease that is killing their loved one. Care managers can find an opening through this maze.  Family dynamics and fear of dying can all explode a fraught crisis of care in dying of coronavirus. When vital end of life decisions need to be made, the stress of the responsibility and the seriousness of the situation can break in a mammoth wave of distress fear and anxiety over the “ whole family system”. The geriatric care manager specializes in this whole family system even at the end of life.

Facilitate Family talks over hospitalized COVID-19 Elder

Care Managers can facilitate terrified discussions, and clear the way for family members to come together to work as a functional unit around an unknown killer disease that preys on their loved one. Understanding the differing viewpoints is critical.  Knowing what a parent wants and does not want during the last days and hours of life help define and simplify the role of the family.  It helps the family bear the burden of having the responsibility of making decisions that their parent wants. Turning this around can also help families have some solace that they carried out their parent’s wishes after their parent’s death. 

Care managers can help family members handle the stress of an elder’s hospitalization and death by:

• Encouraging routines, exercise and social connectedness with friends and family
• Advocate for them with the hospital staff to get updates in this chaotic time in hospitals,
• Help them maintain contact with hospital personal to get updated medical status
• Create opportunities to communicate safely with the hospitalized family member via text, telephone, email, or video chat
• Support and mediate if necessary proactive discussions and advanced directive preparation in a rush if not done
• Build a circle of care can help to reduce some of the potential conflicts,
• Support them in having essential conversations, prior needing  intubation, on last wishes if health status deteriorates  
• Provide opportunities to say goodbye
• guide them in setting up rituals that can celebrate the end of life and give solace to a family during a time when there are yet no rituals for a COVID-19 death.
• Work with the hospital to set up Zoom with the family to say goodbye to a loved one. 
• Geriatric care managers do much more with clients and families but especially now with Covid-19 elder’s and their families facing a  separated, fractious end of life

• See more about Cathy and her book Care Manager’s Working With The Aging Family