A changing narrative: The impact of COVID-19 on the roles of healthcare chaplaincy and advance care planning

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Rajagopal, Shilpa

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Advance care planning (ACP) is a set of processes designed to help individuals express and document their preferences for future care and treatment interventions in accordance with their unique personal values. Prior research has identified healthcare chaplains as well-suited, yet potentially underutilized, facilitators of ACP given their expertise in spiritual care and healing. While ACP plays an important role in mapping patients’ long-term care plans, the physical and emotional strains of the COVID-19 pandemic have disrupted traditional avenues of ACP. As a result, this study analyzed 236 frontline accounts from board-certified healthcare chaplains to identify the ways in which COVID-19 has affected ACP across different clinical settings. Content analysis revealed two major themes: 1) COVID-19 has limited the scope of ACP and completion of advance directives, leading to 2) the emergence of legal, organizational, and technological adaptations in response to these challenges to continue supporting end-of-life care decision-making. Given the severity and progression of COVID-19, such findings suggest that there is heightened urgency for ACP, especially among patients and families who are unprepared or unfamiliar with navigating such conversations. This is further reinforced by the fact that ACP should ideally occur prior to a patient becoming critically ill, necessitating that healthcare professionals approach ACP education from a more proactive stance. Additionally, there may be future opportunities to incorporate the changes in ACP facilitation to foster greater interprofessional collaboration and accessibility through virtual platforms.


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