Saying goodbye: How the COVID-19 pandemic has changed Manitoba’s end-of-life care

WINNIPEG — More than 500 Manitobans have died from COVID-19. It’s a grim statistic that is taking a toll on the province’s health-care system and the staff dealing with a wave of deaths they haven’t experienced before.

Dan Picca said his mother Shirley is among the hundreds of Manitobans who have died related to COVID-19 in recent weeks. The 70-year-old woman died on December 4 after weeks of battling the virus on a ventilator.

Shirley had been a cashier at the Food Fare on Maryland Street in Winnipeg for more than a decade and had become a staple in the community.

“I had no idea that the community knew her and made her feel like part of the community,” Picca said. “I’m getting comments from people I haven’t seen since high school like 25 years ago, saying ‘That was your mom. I had no idea. She was part of our family. I used to go to Food Fare just to see her’.”

Shirley Picca

Shirley Picca (pictured) died on December 4 after weeks of battling COVID-19 on a ventilator. (Submitted: Dan Picca)

Dr. Bojan Paunovic, the site director for the Health Sciences Centre’s critical care, said the demographic of people who are spending time in HSC critical care units has changed. In the spring when COVID-19 first hit Manitoba, the doctor said they were seeing older patients, but that has changed in the second wave with a younger population.

Some of these patients who are the most critical require intubation and are placed on a ventilator. As of Wednesday, the province said 32 people on a ventilator were COVID-positive.

‘SIGNIFICANT’ NUMBER OF PATIENTS ON VENTILATORS UNABLE TO RECOVER

Picca’s mother was among the patients in Manitoba who required emergency intubation overnight after she was admitted to Grace Hospital.

“That was the last time we talked to her,” he said.

It was only after his mother was put on the ventilator that Picca said he was told she had tested positive for COVID-19. He still doesn’t know where she picked up the virus.

IN PICTURES: Red Zone: On the frontline of Manitoba’s COVID-19 pandemic 

Paunovic said it is common for patients to be on a ventilator for two weeks or longer.

While patients can be weaned off the ventilators and eventually moved out of critical care – Paunovic there is a “significant” number of patients whose lungs are severely damaged from the virus to the point that they will never be able to be weaned off the ventilator.

HSC intensive care

The medical intensive care unit at the Health Sciences Centre in Winnipeg on Tuesday, Dec. 8, 2020. (MIKAELA MACKENZIE / WINNIPEG FREE PRESS)

He said at this point the patient is moved to palliative care, and staff starts the virtual conversations with the family about the end-of-life care.

Picca said it was early December when doctors at the Grace Hospital told him over FaceTime that there was little more they could do. His mother had been on a ventilator for three weeks and her condition had not improved.

Because his mother was no longer infectious, Picca was allowed to say goodbye to his mother in person – a moment he knows not many Manitobans are given during the pandemic.

“I was really surprised were able to go see her before she passed away, because I didn’t think family members were allowed to go,” he said. “It’s not the ideal situation – I don’t want to say goodbye to my mother, but you don’t want her to pass away alone either.”

HEALTH-CARE STAFF TASKED WITH HELPING FAMILIES GRIEVE

Paunovic said health-care staff have to find creative ways to connect families with their loved ones virtually to facilitate these end-of-life plans.

The death of loved ones has also taken a toll on health-care staff, many of whom rarely had to deal with the death of a patient before the pandemic struck.

covid unit

A COVID-19 unit (which used to be an orthopaedic surgery unit) at the Health Sciences Centre in Winnipeg on Tuesday, Dec. 8, 2020. (MIKAELA MACKENZIE / WINNIPEG FREE PRESS)

At the Health Sciences Centre, the GD-2 unit initially served as an orthopedic surgical unity, but it was restructured to be a COVID-19 ward and was later turned into a ‘COVID-19 Red Zone,’ where front-line workers care for some of the sickest and most infectious patients.

“Staff have had to make tremendous adjustments,” said Anna Marie Papiz, the manager of the unit.

She said prior to the pandemic, the staff on the unit very rarely were faced with death or critical code situations.

“Now that’s become commonplace here,” she said. “It’s been a huge learning curve for everybody all over trying to provide the best care possible for these patients.”

hospital workers

Anna Marie Papiz, manager of patient care, and Aaron Turner, nurse, chat outside of a COVID-19 unit at the Health Sciences Centre in Winnipeg on Tuesday, Dec. 8, 2020. (MIKAELA MACKENZIE / WINNIPEG FREE PRESS)

Aaron Turner, a charge nurse on the unit, said he has had to facilitate a family’s final goodbye with a loved one virtually.

“Seeing that is very emotional,” Turner said. “It’s not something we’ve had to do before. I think it becomes a part of business, I suppose. But you can never get used to that.”

He said the nurses and staff on the unit do everything in their power to allow the family to grieve and help them through the process.

Picca said the staff caring for his mother was incredible to him and his family. They included him in daily FaceTime calls and explained the situation to him in layman’s terms so he knew what was happening.

“You felt like the nurses and doctors were treating her like one of their own family members,” he said.

 

This is part two of a three-part series ‘Red Zone: On the frontline of Manitoba’s COVID-19 pandemic’ from CTV News giving Manitobans a deeper look at the impacts of the COVID-19 pandemic on our health-care system.

The final installment of this series will be released on Dec. 19, featuring the future of the COVID-19 pandemic in Manitoba and the lasting impacts it may leave behind.

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