BMJ Guidance: palliative care for patients with severe covid-19

15th July 2020

Palliative care is commonly misunderstood as only being relevant for people who are dying. However, the relief of suffering, through provision of holistic and compassionate care, is an essential component of care for all patients with life threatening illness.

BMJ has published new guidance from the Cicely Saunders Institute on the palliative approach to the management of patients with severe covid-19 in hospital and community settings, focusing on the management of distressing symptoms, planning ahead, communicating with patients and their families, and grief and bereavement. 

The guidance highlights:

Many patients with severe covid-19 experience distressing symptoms, including breathlessness and agitation. Palliation of suffering is an important part of care irrespective of prognosis.

Patients with severe covid-19 may deteriorate rapidly. It is therefore useful to have a strategy in place for managing deterioration and potential death (for those not suitable for escalation to intensive care), which runs alongside the acute medical management plan.

Clear and timely communication with the patient (if they are able) and their carers is essential. Conveying hope that treatments will help needs to be sensitively balanced with explicit acknowledgement that patients are sick enough to die.

Ting R, Edmonds P, Higginson IJ, Sleeman KE. Palliative care for patients with severe covid-19. BMJ 2020;370: m2710 BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2710 

(Published 14 July 2020)