The role of home hospice care during and beyond COVID-19: The case of a home hospice organization in Lebanon

The need for hospice palliative care is increasing due to the increase in non-communicable diseases. The COVID-19 pandemic has further underscored the importance of hospice and palliative care approach and services for patients with advanced chronic conditions and patients with COPVID-19 and families.  Hospice care is a comprehensive holistic care that focuses on symptoms management and psychosocial and spiritual support to enable patients to maintain their dignity and quality of life. It aims to empower patients to live as fully as comfortably as possible.

According to the Global Atlas in Palliative Care, Lebanon is classified as a country that has isolated palliative care provision. In Lebanon, hospice palliative care has been advancing during the past 10 years. In 2011, the Ministry of Public Health (MoPH) established the National Committee for Pain Relief and Palliative Care, in 2013 it recognized palliative care as a medical specialty and in 2019, it issued a decree that reimburses hospital and home-based palliative care services for patients who are eligible for the MoPH’s health coverage scheme.

In 2010 a home hospice non-governmental/not for profit organization was established to provide home hospice care to terminally ill patients at a time where no home hospice palliative care services were available in Lebanon. The role of the home hospice model is to ensure the provision of high quality hospice care through the following core service elements mainly (1) providing timely and responsive care by the interdisciplinary team-nurses, doctors and psychologists, (2) assessing and controlling pain and other symptoms, (3) providing psychosocial and clinical psychological support, (4) improving the quality of life of patients and supporting them to stay and die at home.

With the COVID-19 pandemic, the model had to adapt its services to maintain the provision of hospice care to terminally ill non-COVID patients. This was achieved by setting a response policy to COVID-19 that covers (1) hospice services to patients and their families, (2) clinical team members and (3) office team members. The policy addresses aspects related to service provision including telehealth support and protection and infection control measures. Evaluation and reflections on the model’s response to COVID-19 revealed challenges and lessons learned and highlighted several success elements including timely, comprehensive and participatory response, continuous monitoring and evaluation, communication among team members, compassionate supportive environment, team commitment to the mission, reallocation of funds to secure availability of personal protective equipment and medications to patients and community support.

The role of home hospice services during the pandemic has been paramount in supporting patients and their families during a time where hospitals have been impacted and strained by COVID-19.

 

Author(s): Farah Demachkieh

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