Illustration of two hands touching each other.

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  • While a possible third confinement is emerging, associations and citizens are worried that the doors of palliative care services, hospitals and nursing homes are already being closed.

  • Visits from families and friends in times of the Covid-19 epidemic do indeed raise certain questions in terms of patient and caregiver safety.

  • But the texts are clear: visits from relatives remain authorized, with restrictions.

“It's been a month since I saw her, when she probably only has a few weeks left to live.

It's precious wasted time, ”deplores Claire.

Her mother, suffering from cancer for two years, has been hospitalized in follow-up care since December in a clinic in the Ile-de-France.

Too weak and too malnourished to go home.

In early January, a cluster of Covid-19 broke out and the clinic closed to protect caregivers and patients from further contamination.

Without the possibility for families to support their suffering loved ones and sometimes at the end of their life.

" It's inhumane !

"

"The head of department protects his colleagues before taking care of the well-being and psychological suffering of his patients and their families," Claire laments.

We probably do not have all the ins and outs, but no one explains anything to us.

It's inhumane !

Each week, she insists on knowing when the visits can resume.

“We are told that they are waiting for government decisions.

But we already know that if there is a re-containment, we will not be able to enter the clinic.

Once, the manager replied: "you will never make me feel guilty" ... "

However, we thought the debate was closed.

Last March, the appearance of the Covid-19 caused the total closure of nursing homes and hospitals.

But since then, the instructions have evolved: if the visits are obviously limited and supervised, they are maintained.

In nursing homes, and therefore in palliative care.

“We encourage loved ones to stay at the bedside of our patients,” confirms Xavier, alias the Star Man, palliative care nurse in Metz and star illustrator on Instagram.

We remain strangers to our patients, even if we forge close ties.

It is therefore obvious that no one should die alone.

"

"Ask yourself what is right for each patient"

However, Claire is not the only one to echo this farewell made impossible.

Monday, in a joint press release, the French Society of Support and Palliative Care (SFAP) and the National Center for Palliative Care and End of Life (CNSPFV) warned about "a tightening of the rules concerning visits to hospitalized patients or in nursing homes: relatives cannot visit their parents at the end of their life or in very poor conditions ”.

“There are few places where there is no visit at all at the end of life, nuance Claire Fourcade, president of the SFAP.

But we are alerted by families who tell us that it is complicated.

»With great disparities depending on the area.

And tragedies which push some families to withdraw, against medical advice, their mother or father from the hospital structure.

Or even caregivers, struck, who take the risk of organizing clandestine visits.

This is why Claire Fourcade, a palliative care physician in Narbonne, insists: “the texts of the Ministry of Health specify that for patients at the end of their life, visits must be organized for families.

After that, it's up to each establishment to set its rules and that's normal.

We suffered during the first wave of the uniformity of instructions.

It's complicated, but I invite the teams to question themselves about what is right for each patient.

And the question must remain permanent.

We cannot say to ourselves that a protocol established two months ago remains current.

»Prohibiting children from kissing their dying father or grandchildren from disguising themselves in front of their hearing-impaired grandmother can thus be decreed in theory, but remains particularly cruel in real life.

“Allowing significant mixing is putting ourselves in danger.

"

Xavier tries to find a clever balance between security and humanity.

"In our department, we try to offer maximum flexibility to families, but the health situation forces us to take strict measures," explains the nurse, who has just released a new comic book,

Je serai là

*.

We are entitled to one companion per room with the obligation to wear a mask.

It is not always obvious… I think back in particular to a patient who had four brothers and sisters and eight children.

We assess on a case-by-case basis in situations of imminent end of life, we allow more relatives per room, but we ask families not to clutter the corridors.

"

View this post on Instagram

A post shared by ☆☆☆ The star man ☆☆☆ (@ l.homme.etoile)

On the other hand, there is no restriction on the length of visits in his hospital.

“They are allowed at any time of the day or night, and a loved one can stay overnight at a patient's bedside.

"But Xavier recalls:" the situation is not simple, many hospitals have been affected by waves of contaminations of caregivers.

This results in bed closures and inability to care for other patients.

Allowing significant mixing is putting ourselves in danger.

"

Claire is also a caregiver.

This balance is also trying to find it.

And for her, there is no doubt that removing visits is not an appropriate response.

"There are ways to ensure security: a single person can make an appointment in advance, with a temperature measurement or a negative PCR ..." Flexibilities that seem urgent to put in place.

Even in the event of re-containment.

"Confinement or not, for patients at the end of their life, that should not change the rules," says Claire Fourcade.

The question arose for the visits last spring because we lacked equipment.

"

Which is no longer the case.

“These visits from relatives are essential for patients and for families, because that's also how mourning is possible,” she continues.

And finally for the teams.

To feel like we're doing our job right.

It is important for the future.

We will live with the way we have accompanied each other.

I often say that palliative care is the peace of the survivors.

"

* I'll be there, The starry man, Calmann-Lévy Graphic, January 20, 2021, € 16.50

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  • End of life

  • Hospital

  • Coronavirus

  • Health

  • Covid 19