5feb5335dd64b.image.jpg

EAU CLAIRE — From the time his wife moved into a River Falls memory care unit, Bert Russell visited her every day.

The routine was important for both Russell and his wife, Pat, who has been living with Alzheimer’s disease for 19 years and is now in hospice care. But the comforting pattern was broken in March with the arrival of the COVID-19 pandemic and the resulting restrictions on visitors in long-term care facilities.

While Russell has been unable to see his wife in person since March 10 — even though he lives nearby — he is grateful he has had the opportunity to “see” Pat, 77, regularly via video chats arranged and facilitated by the staff at St. Croix Hospice.

“It’s been special,” Russell said of the video chats. “I couldn’t have tolerated this separation without this ability to communicate.”

Maintaining that connection between hospice patients and their loved ones, even when coronavirus safety protocols generally prevent them from being in the same room, is the reason many Wisconsin hospice providers have been coordinating video chats since early in the pandemic.

St. Croix Hospice, based in Oakdale, Minnesota, recently formalized its effort to help patients and families navigate the hospice journey together even when they’re apart by launching its InTouch Family Connection Program. The program’s tools include video chats, phone calls and in-person visits when possible that include personal protective equipment to keep everyone safe.

As regional COVID-19 cases surged in the fall at the same time colder temperatures made window visits less practical, St. Croix Hospice officials decided to launch the program to make it the standard for its offices in six Midwestern states. The hospice’s nurses, aides, social workers and chaplains facilitate the video chats and calls during their scheduled visits with patients.

“It’s devastating when hospice patients haven’t seen their family members for months,” said Sarah Roseth, St. Croix Hospice’s regional clinical director in west-central Wisconsin, including offices in Eau Claire and Hudson. “This allows staff to set aside a certain time to facilitate virtual visits. It certainly doesn’t replace in-person visits, but we’re going to do the best we can to facilitate that connection.”

It’s a trying time for anyone when a patient is going through an end-of-life journey, but pandemic-induced separation makes it even tougher, Roseth said, noting that staff at nursing homes and assisted-living facilities are often too busy to help with frequent video chats.

“We understand the restrictions because facilities are trying to keep everyone safe, but it’s really difficult for families to maintain that connection when they have to be apart,” she said. “We want to bring families and their loved ones together.”

When a patient appears close to death, the hospice sometimes has been able to provide the necessary PPE and work with facilities to allow one or two family members to visit in person, Roseth said, adding that St. Croix also tests its staff for COVID-19 twice a week as a precaution.

Erin Shadbolt, nurse administrator for Mayo Clinic Health System Hospice and a member of the Wisconsin Hospice & Palliative Care Association, said facility lockdowns, visitation limitations and the difficulty of making a connection behind full PPE have made it a particularly difficult year for hospice providers and patients.

In addition, she said, hospice staff have had to wear PPE to visits, screen for potential virus symptoms in patients and family members, educate patients in their homes about how to visit safely and provide frequent phone and video connections and in-person visits when allowed.

“The reality is that this is really challenging. ... There is real grief during this time for patients, loved ones and, ultimately, hospice staff,” Shadbolt said. “Hospice workers are deeply caring individuals and have struggled with their own grief to see people dying without their family at their side. We are hopeful that community vaccination and ongoing prevention methods — masking, hand hygiene and social distancing — will allow facilities to open back up to visitors and that we can return to a ‘new normal.’ “

Russell said his twice-weekly video chats enable him to stay up to speed on his wife’s condition and the care she is receiving.

“I fill her in on what’s going on with the kids and grandkids and great-grandkids,” said Bert, who then is able to keep the couple’s out-of-state children informed. “It’s been a huge help and comfort to actually see her and know how she’s being taken care of.”

That sentiment was echoed by Tarry Schuster, who grew up in Plum City but now lives near Fairbanks, Alaska, and has been unable to visit his mother, who is on hospice in Ellsworth, for nearly a year. Schuster last saw his mom, Dorothy Nooger, when he visited in February just before the pandemic struck Wisconsin.

Schuster was thrilled recently when St. Croix Hospice staff proposed setting up a video chat between mother and son from 2,500 miles apart.

“It was cool to see her,” said Schuster, noting that the virtual visit went smoothly despite nobody in his family being tech-savvy. “If I can do it, anybody can.”

Pauline Beman, a registered nurse case manager in the hospice’s Eau Claire office who facilitated the chat, indicated the joy was obviously mutual.

“My patient recognized her son and daughter-in-law on the video chat,” Beman said. “She had the biggest smile I’d ever seen.”

Roseth said she has been personally moved when conducting video chats between patients and their families.

“It’s emotional. It pulls at the heartstrings,” she said. “It’s an honor to be there for these families.”

While the InTouch program may have been created in response to the pandemic to help families get through a difficult time, it’s really just an extension of the philosophy that drives hospice care, Roseth said.

“We very much focus on the idea that no one dies alone,” Roseth said. “We know our patients are terminal, but we focus on keeping people connected and maintaining quality of life and joy right until their last breath.”