• Chunichi Shimbun

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While many hospitals are restricting visits by patients’ families amid the spread of COVID-19 infections, one facility in Nagoya has been making efforts to let patients with palliative care needs meet their family members as often as possible.

On an afternoon in early February at Minami Seikyo Hospital’s ward for patients undergoing palliative treatment, which is treatment for those without the prospect of recovery, Mihoko Hoshihara, a 62-year-old nurse, was speaking to a 99-year-old woman lying on a bed.

“This was made by a volunteer,” Hoshihara said, holding a traditional hina doll made of origami paper with colorful patterns. She was handing dolls to each of the 20 patients at the ward.

“That is pretty,” the woman said with a smile, reaching out for the doll.

All the patients on the ward stay in private rooms. A message board set up by volunteers on the wall of the ward’s corridor is filled with messages of gratitude from patients and their families, along with portraits of doctors and nurses.

However, the door — the only entrance to the ward — no longer opens automatically like it did before the pandemic.

Patients’ families had been allowed to enter the ward freely at any time, and had been able to stay overnight to be present during their loved ones’ final moments.

But the rules had to be changed after a patient hospitalized in a different ward in the hospital was confirmed to have been infected with COVID-19 in February last year and many at the hospital suggested restricting visits to prevent the spread of the virus.

Since most patients needing palliative care are older and have terminal illnesses, they could develop severe symptoms if they get infected. Visits to the ward were restricted to 15 minutes a day, except for those attending for someone’s final hours.

Then, after Aichi Prefecture declared its own state of emergency in August, all visits to the hospital — including those to the palliative care unit — were banned for about two weeks.

Although many staff members at the hospital said the ban should be maintained even after the state of emergency was lifted, Hiroyuki Nagae, 61, who heads the hospital, resumed visits by patients’ families along with the end of the state of emergency.

“At times of emergency, decisions tend to be made from the viewpoint of those who provide medical care, but that should not be the case,” Nagae stressed. “You can’t feel the patients for real if you only see their faces online, such as over video calls.”

That said, visits could not be resumed completely and those to the palliative care ward were still restricted to 15 minutes and a maximum of three people per visit. The hospital had to prohibit visitors from staying overnight in principle.

Volunteers offering cups of coffee to patients and their visitors at the palliative care unit — a popular service among the patients — also had to be halted temporarily.

As visits were restricted, nurses at the unit became busier responding to calls via smartphones and mobile phones from family members day and night, since some of the patients were too sick to take the calls themselves. Nonetheless, the nurses took the calls because they attached importance to the last moments spent together by patients and their families.

Last fall, the hospital allowed a woman to stay overnight as an exception, to spend time with her mother who was hospitalized at the palliative care unit. The woman was having a hard time accepting her mother’s worsening condition, and appeared to be in such a state of shock that she didn’t react to the doctor’s explanations.

Hospital staff asked the woman to talk about various things with her mother. Although no one knows what they talked about, the woman seemed calm the next morning and thereafter. Nearly a month later, when her mother passed away, she was able to be at her bedside.

Staff members at the unit have to cope with a variety of requests from different patients and families that cannot always be dealt with within the rules.

When a large group of family members asked if they could all meet with a patient together, the hospital decided to take the patient to an elevator hall outside the ward for the meeting, instead of letting them enter the ward.

The family deeply appreciated the decision and thanked the hospital after the patient’s death, saying that having been able to meet the patient had become a precious memory for them.

Even after the second state of emergency was lifted, the hospital maintained restrictions on visits while gradually relaxing the rules.

“Hospital staff and volunteers have continued thinking about what to do to make the palliative care unit a place where the last moments of life can be spent with peace of mind,” Hoshihara stressed. “We are still struggling now.”

This section features topics and issues from the Chubu region covered by the Chunichi Shimbun. The original article was published March 16.

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