End-of-life dignity in palliative care, pandemic COVID-19 and telemedicine

Abstract

Dying with dignity is a right, defined as a process with the following characteristics. Dying with minimal suffering from symptoms and limited invasive treatment. The study aimed at understanding how the pandemic changed the way of dying in end-of-life care and what we can then add to what was done previously. A search was carried out in the PUBMED/Medline database to find articles that answered the research question. We carried out this research between December 2019 and June 2021. Articles with original data written in English, Portuguese and Spanish were used as keywords: 'end of life'; 'palliative care'; 'COVID-19'; 'dignity' and telemedicine'. Twenty-two studies met the inclusion criteria. There was significant heterogeneity in the origin of these studies conducted in 12 different countries. Five themes were found from the articles: Palliative care during the COVID-19 pandemic; end of life during the COVID-19 pandemic; the evolution of telemedicine during the COVID-19 pandemic; use of telemedicine in palliative care; and the use of telemedicine and dignity at the end of life. The results were relatively positive in terms of some parameters; however, some suggestions for improvement stood out. Telemedicine has enormous potential to improve care at the end of life in terms of quality of life, autonomy and adherence to pharmacological and non-pharmacological treatment. However, more intervention studies are needed to create protocols for monitoring these patients at home.

Keywords

• covid-19
• dignity
• end of life
• palliative care
• telemedicine