Table 1.

Palliative care needs for cancer patients during COVID-19 pandemic

Patients needs
Physical care
Symptomatic management of symptoms of COVID-19 infection, e.g.,  Dyspnoea, cough, fever, pain
Management of palliative care emergencies
Psychological impact
Isolation and social distancing results in loss of self-esteem, autonomy, feeling of connectedness with family and the health-care system
Fear of the unknown due to uncertainty and disease progression
Fear of contracting the infection
Fear of not getting appropriate medical help
Social impact
Restriction on social gathering, travel results in lack of access to social support groups
Infected families are socially stigmatized
Loss of jobs/incomes
Limited availability of daily commodities
Spiritual impact
Cancellation of religious meets
Traditional death rituals are truncated
Ethical and legal aspects
Triaging for in hospital palliative care and ventilators
Protection of patients, family members, health care workers and society from infection
EOLC issues
Inadequate discussion regarding EOLC
Lack of an advanced directive
Distance from family members causes difficulty in decision-making
Difficulty in ensuring dignity of death due to strict infection prevention protocol
Structure and process of care: The barriers are
Limited resources and its appropriate allocation
Preparedness of the palliative care team for the outbreak
Lack of national policy integrating palliative care with the health care system and outbreak management
Caregivers needs
Inadequate knowledge about the disease leads to fear of uncertainty
Uncertainty of access to medical help
Lack of social and spiritual support
Belief in several Myths regarding pandemics
Fear of contracting the infection
Health care worker’s needs
Stress, exhaustion and insomnia due to long working hours
Fear of getting infection
Fear of death
Separation from family causes depression
Lack of resources including personal protective equipment
Inadequate manpower trained in palliative care

EOLC: End of life care