End-of-life support for people in care homes in the context of COVID-19: international report

Annette Bauer, Josie Dixon and Adelina Comas-Herrera (CPEC, LSE)

1st May, 2020

An international report on end-of-life support for people in care homes in the context of COVID-19 is now available here.

Key findings:

  • Up to half of COVID-19 deaths occur in care homes; all people dying of COVID-19 should have access to palliative care.
  • Palliative care has an important role to play in the response to COVID-19, in order to ensure that people dying as a result of COVID-19 – including care home residents – do so with dignity, with emotional support available and free of pain.
  • Countries have primarily focused measures in care homes on the prevention or control of the infection rather than on palliative care. Most care homes are unprepared for the pandemic and not all are well-positioned to provide palliative care to their residents in this context.
  • Whilst most countries have developed national or local guidance for health and social care staff on palliative care, in many countries this is not setting-specific or is contradictory and inconsistent; lack of personal protective equipment for staff and/or visitors and palliative care medication have been major barriers to ensuring a good quality of death for care home residents; financial measures to support palliative care providers have also varied between countries (leaving some providers potentially unable to support care homes in a timely way).
  • The COVID-19 crisis has exposed the weaknesses of many health and social care systems, including the under-staffing and under-funding of care homes and palliative care.
  • We have not found publicly available data for any of the COVID-19 outbreak countries on how many people received adequate palliative care at end of life. This kind of information will be essential in order to understand the performance of health and social care systems in terms of whether equitable care was provided for those reaching the end of life during the COVID-19 pandemic.

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