Ensuring quality of life while social distancing for those managing serious illness
Dr. April Krutka, Regence’s medical director for palliative care, shares professional insights and helpful resources
Hard to believe that just a few months ago, no one had ever heard of social distancing. While a difficult adjustment for many, staying home and keeping at least 6 feet away from others in public reduces the risk of getting COVID-19. Physical distancing is critically important for people who have a serious illness and a higher risk for severe infection. Simultaneously, these individuals often value time with loved ones and appreciate the assistance of others when they aren’t feeling well. So, how should they handle this unfamiliar practice of social distancing?
At Regence, we support people living with serious illness or significant injury with palliative care, defined as compassionate, patient-centered, family-oriented, specialized medical care. In light of COVID-related concerns, we asked our medical director of palliative care, Dr. April Krutka, to answer a few questions.
Why are COVID-19-related restrictions particularly unsettling for people in palliative care?
People living with a serious illness may go through times where medical treatments take over and personal priorities must be set aside. Losing sight of the things that spark joy can cause a person to feel out of control. Now, restrictions related to COVID-19 add another layer of complexity to living well while navigating the journey with serious illness. Social distancing can often limit some of the most important things in life, yet it is necessary to protect one’s own health and the people around you too.
How can people in this situation feel like they’re more in control?
During the COVID-19 outbreak, people who are seriously ill have an opportunity to think deeply about the things that bring them joy. I often ask my patients, what makes you smile? What gives you purpose every day? Now more than ever, it is helpful for each of us to define these answers for ourselves.
Staying in control really is about integrating moments of joy into our daily lives and focusing on what is most vital to our wellbeing. Sharing that insight with your doctor is also important; doing so will help your medical team create personalized care plans and medical goals for you.
What can people in the high-risk group do to stay emotionally and mentally healthy at this time?
It is critical to be extra diligent about your physical health by strictly practicing social distancing and following CDC and local health guidelines. Take care of your emotional health by continuing to socially interact with others but in an alternative way. Try video chats, emails, text – and snail mail! It’s a great time to become a pen pal by exchanging letters with family and friends.
The evolving COVID-19 situation has caused many people to better prepare. Beyond having enough food and supplies on hand, what else do you suggest?
Over the last 10 years, I have learned that everyone, regardless of age or health status, has “lines in the sand” regarding what they want to go through should they become ill. Everyone is different. Some people are willing to undergo aggressive medical treatments to restore health, and others prefer a comfort approach to care. Medical decisions should always be guided by the quality of life defined by each individual, as this allows doctors to know what that person is working toward. The first step is starting the conversation—my favorite part of being a palliative care doctor. Getting to know a person and personalizing a medical plan are so important. One resource to help people and families have the conversation is The Conversation Project, which offers tools, guidance and resources to start the conversation. Resources like conversation guides specific to COVID-19 are available online.
The second step is creating advance directives that clearly communicate personalized wishes regarding medical treatments. Visit CAPC for more information for patients, families and caregivers.
Our Care Management Team at Regence is committed to helping people with serious illness, and their caregivers, live as well as possible for as long as possible. Learn more about our commitment and resources for helping people and families live well with serious illness.