Whānau experience of patients' deaths in Wellington Hospital during 2020 COVID-19 pandemic Levels 3 & 4.

AIM

A qualitative exploration of the experience of whānau whose relatives died in an acute hospital setting during Levels 3 ∓ 4 of the 2020 COVID-19 pandemic in Aotearoa New Zealand.

METHODS

Next of kin for 22 patients who had died in Wellington Hospital during Levels 3 & 4 of the 2020 COVID-19 pandemic (16/22 under General Medicine with an additional 6/22 who identified as Māori) from a total of 70 hospital deaths were interviewed by phone in August 2020. Whānau were asked to describe their experience of a relative dying. Following transcription, thematic content analysis was undertaken by the researchers.

RESULTS

Whānau provided poignant and heartbreaking accounts of their experiences. Researchers broadly categorised their feedback as positive or negative. The dominant factors that contributed to positive experiences for whānau were excellence in nursing and medical care. Māori whānau benefitted from hospital staff understanding the importance of tikanga Māori relating to dying and death practices, and incorporating these into the care of the patient. Factors that contributed to negative experiences for whānau included separation from loved ones at the time of death. The findings underscore the importance of whānau accompanying the dying patient, and non-abandonment. Other negative experiences were not having time to say goodbye, and insufficient communication with medical personnel. There were also misunderstandings and uncertainty about the changing hospital rules around isolation with great variability in interpretation by different staff.

CONCLUSIONS

Pandemic policies should prioritise the needs of whānau and hospitalised patients who are dying of any illness, including: daily telephone/Zoom updates by doctors and/or nurses with whānau; emailing photos to whānau of doctors/nurses/patient's room; having a bereavement whānau coordinator keeping in touch with relatives of patients who are dying; making follow-up telephone calls to whānau after the death; prioritisation of fast COVID-19 testing if there is a possibility that the patient will die; ensuring availability of Māori healthcare staff to support Māori patients and whānau; and observation of Māori tikanga around dying and death for Māori and their whānau.