Communication Strategies Learned From COVID-19

Have the COVID-19 visitation restrictions increased your anxiety and burdened your ability to communicate with your loved one? Are your frustrated trying to get updated and accurate information during their hospitalization or while they are living in a care community? This article reviews a recent study exploring this topic as well as provides sound strategies for caregivers to consider.

Hospital Settings

The purpose of this study was to explore family members’ experiences and support needs during the COVID-19 pandemic (Chen et al., 2021). The study was predicated upon the fact that there was little research available as to how best to support the needs of this caregiver population (Chen et al., 2021). Although these recommendations are specific to hospital healthcare providers, they can also be applied to assisted living, personal, and memory care community settings. For family caregivers, this information provides insight as to identified communication gaps to better you to ask questions and maintain reasonable expectations during an emotionally difficult time for you and your loved one. 

It’s important to note, the staff who manages and cares for your loved ones generally do not make the visitation policies they are charged with enforcing. This presents a difficult dynamic for both families and staff. The staff does not want these restrictions, nor do they want to deprive you of spending time with your loved ones. They will likely lose their job if they do not enforce the policies in place. Please keep this point in mind when communication with senior care professionals.

During the COVID-19 pandemic, Chen et al. (2021) documented the following caregiver concerns for caregivers of hospitalized patients suffering from the virus:

1. Family members had difficulty reaching ICU healthcare providers to obtain an update on their loved one’s condition.
2. Caregivers were confused and became suspicious by the verbal excuses given by staff for why they could not see their loved ones. 
3. Caregivers turned to social media and television for information which then increased confusion and suspicion.
4. Family members could not keep team members straight over the phone.
5. Visitations restrictions exacerbated pre-existing communication concerns due to shift changes and large staff turnover.
6. Video chat calls with intubated patients were deeply disturbing to family members.
7. Caregivers were bereaved after the patient’s death from COVID-19 because they did not have the opportunity to grieve properly or participate in end of life care.

In response to these trends, Chen et al. (2021) made the following recommendations for communication strategies to support isolated family caregivers:

1. Conduct an initial assessment of communication preferences with family members, such as determining who is the proxy or surrogate decision maker for the patient.
2. Ask for family preference or no preference for seeing patient ventilated through video call and prepare family for what they will see when the patient is on ventilation.
3. Keep family members informed at least once a day and at an agreed time.
4. Use plain language and give correct information to help family members understand the situation and gain feelings of control.
5. Hold ongoing discussions with family members about emerging clinical scenarios to foster shared decision-making.
6. Expect that family members will often ask the same questions continually because they need to receive information repeatedly and in different ways.
7. Reassure family that their loved one is being treated as a whole person rather than solely as a critically ill patient.
8. Hold family meetings via telephone or videoconference as early as possible, ideally within 5-7 days of ICU admission.
9. Initiate palliative care upon admission to the ICU, assess family readiness and emotional state. 

Senior Care Community Settings

How do these recommendations apply if your loved one is currently living or relocating to an assisted living, personal or memory care community?

1. Identify who is charged with family communication. Make sure the staff has the correct contact information. Try to appoint one or two family members as main points of contact rather than have several family members calling and asking for updates. 
2. Should you be calling the nurse’s station for medical questions and the social work department for social support questions?
3. Will there be more frequent care conferences? Generally, these conference calls are held every three months with the interdisciplinary team.
4. If my loved one cannot use a cell phone, how else can I stay in contact with them?
5. What are your Covid-19 visitation policies? Do you offer outdoor visits? Who schedules the visits?

Advocating for your loved one shouldn’t cause you stress and anxiety. I hope these strategies above equips you with the knowledge to have open and honest communication with your loved one, and your loved ones care team. If you are looking for more education, insight, or resources on caregiver support, please reach out to me below. I would be honored to work with you and your families.

References

Chen, C., Wittenberg, E., & Sullivan, S. (2021). The Experiences of Family Members of Ventilated COVID-19 Patients in the Intensive Care Unit: A Qualitative Study. American Journal of Hospice and Palliative Medicine, 38(7), 869-876. https://doi.org/10.1177/10499091211006914

Author: Aimee J. Gustitis, BSN, RN, JD with MyCatholicDoctor

Editor: Samantha Wright, Director of Education and Online Resources with MyCatholicDoctor

Make an appointment or send Aimee a message:

Aimee J. Gustitis, BSN, RN, JD