The following is a summary of “Palliative Care and Hospice in the Pandemic: A Review of State Planning and Lessons Not Yet Learned,” published in the April 2023 issue of Pain Management by Abbott, et al.

Crisis Standards of Care (CSC) guidelines have been established at the federal and state levels in the United States for disaster planning. However, recognizing palliative care (PC) and hospice needs during crises, including the COVID-19 pandemic, has been limited. For a study, researchers sought to quantify the number of state crisis planning documents that acknowledge potential PC and hospice crisis needs in a pandemic, evaluate the range of practical plans included in existing state Crisis Standards of Care plans, and summarize recommendations based on existing guidelines and literature.

A comprehensive internet search was conducted to identify state-based “crisis standards of care” documents. The search results were categorized based on the extent of PC and hospice planning: Absent, Mentioned only about critical care triage, described only in general principles, and described potential concrete plans to address PC and hospice needs.

Among the 50 states and Washington, DC, 45 states had electronically available crisis standards of care or emergency preparedness documents, with 35 being written or updated since 2020. Only 20 states mentioned concrete aspects of planning for potential PC or hospice service shortages. The guidelines primarily focused on alternate care sites, protective equipment, and specialist resources, while visitation policies were rarely mentioned.

Less than half of the state documents included concrete planning for PC and hospice needs, even three years after the start of the COVID-19 pandemic. Neglecting the crucial needs may result in avoidable suffering for patients in various care settings. Addressing these gaps is essential to better prepare for future disasters.

Source: jpsmjournal.com/article/S0885-3924(23)00451-7/fulltext