New challenges for end-of-life care in Sarasota, Manatee

As an employee with Tidewell Hospice, Pauline Mailey admits she and her fellow nurses are the “touchy feely” type.

The personalized care is one reason they got into hospice care. But with the coronavirus outbreak, everything has changed. Now they wear masks and goggles and touch patients minimally, such as for assisting with baths, personal hygiene or medical care.

Tidewell provides hospice services in Manatee, Sarasota, Charlotte and DeSoto counties. Its 500 nurses provide care to an average of 1,200 patients through in-home care or at one of eight hospice houses, including one in Lakewood Ranch.

“We want to build that relationship and that trust,” said Mailey, the chief nursing officer for Tidewell Hospice. “It’s so much more difficult to do with a mask on your face or eye goggles. You’ve taken that intimate relationship-building experience it should be, and it becomes more sterile. That’s not comforting.”

Mailey said the precaution is needed to protect both Tidewell’s staff and its patients, but for the time being it has changed the dynamic of end-of-life care compared with two months ago.

Instead of getting a visit in person by every member of Tidewell’s team — social workers, chaplains, nurses, therapy providers and even massage therapists — most nonmedical professionals are meeting with patients and their families through telephone calls or a videoconferencing tool.

“It’s increasing their isolation,” Mailey said. “It’s isolating enough to be told you have six months to live. We try to be the support. We try to bring together the unit of care to embrace the patient and families. Now we can’t even have extended family or friends in person.”

Some of Tidewell’s volunteers have helped with making phone calls but are not able to visit with patients or families. They are practicing social distancing, Mailey said.

Tidewell President and CEO Jonathan Fleece said he continues to hear positive stories about Tidewell’s care and is proud of the way its team has adapted. He said measures like videoconferencing have allowed Tidewell to stay “as connected as we can” while protecting employees and clients.

“It is finding that balance,” Fleece said.

Fleece said there will be a budgetary impact to Tidewell because of the pandemic.

Unexpected expenses have included mass purchases of personal protection equipment, more telehealth technology and increased staffing. It also provided free day care to its medical professionals through the Lakewood Ranch and Venice YMCAs.

Fleece said Tidewell has received funding from the coronavirus relief bill, but the nonprofit is still working to understand how and for what it can be used. He expects Tidewell will need to dip into its reserves to cover pandemic-related costs, which he anticipates will be in the millions.

Fleece also said he is grateful the community has donated homemade masks and gowns for Tidewell staff and that local foundations have continued to support Tidewell and its programming.