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Otago Community Hospice nurse practitioner Louisa Ingham would normally spend 25% of her working month driving from client to client.
The brakes were slammed on that seven weeks ago when Covid-19 closed almost all activities, including provision of most hospice services.
‘‘It has certainly been challenging to provide our usual service under Level 3 and 4 restrictions,’’ Ms Ingham, who can care for patients as far away as Haast or Wakatipu as well as her usual Central Otago patch, said.
‘‘We are very mindful that as health professionals we are a potential vector, and we look after the most vulnerable population imaginable.
‘‘We assessed whether a patient needed a face-to-face appointment prior to going out, and we certainly visited those patients who needed to be seen in exceptional circumstances, but, like every health professional, we moved to a web-based, phone-based system where possible.’’
Level 2 would afford more chances to be out in the community, but lessons learned at higher alert levels would not be forgotten, Ms Ingham predicted.
‘‘I think it’s given us a kick up the bum to start using these things.
‘‘All of health will probably take a closer look at technology and how we can use it efficiently to meet people’s needs, where they are.’’
Living in inland Otago, Ms Ingham is used to hearing the area does not have a hospice.
It is one of many myths this week’s Hospice Awareness Week aims to dispel.
While it is true there is no building, she and several colleagues provide equivalent service to the facility in Dunedin.
‘‘The building is only a very small percentage of what we do know.
‘‘It is about supporting people to die in the place that they choose, and for most people, that is home now.’’
Ms Ingham’s care co-ordination team comprises not just nurses.
It includes a social worker, an occupational therapist, a counsellor, a spiritual support worker and, until recently, a psychotherapist.
Population growth and the ageing population has meant Ms Ingham’s workload has increased dramatically, and her team sees about 50 people annually — about a quarter of Otago Community Hospice’s yearly clients.
‘‘When I started with hospice eight years ago we had 15 patients. Now we sit at around 50.
‘‘It will be interesting to see if the coronavirus changes any of that.’’
Otago Community Hospice chief executive Ginny Green said that even as recently as three years ago, only a quarter of the organisation’s clients were rural.
‘‘Now it is more like 40 or 50%. Populations like to know that their services are intimately connected to their community and we have very visible teams out there, who will become more visible [in] Level 2.’’
Ms Ingham said living and working in a small community was a challenge for hospice workers, who routinely met clients or their families in the supermarket or cafe.
‘‘A lot of people ask why you would want to work with death or dying but it is so rewarding, getting to know families and work with them potentially over an extended period of time,’’ she said.
‘‘You develop a professional bond with families in their hardest times.
‘‘The hospice service is often like being a midwife, but at the opposite end of the spectrum.’’