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The national registry of quality for end-of-life care, the so-called palliative registry, has been in existence for most of the year 2000. During the corona pandemic, the registry can provide an image of the last days of life of patients with covid-19.
Doctors and nurses estimate in a way what symptoms the deceased has had during the last week of life and if they have been alleviated.
– We are now starting to get figures on what it looks like when you die in covid-19 and we have data on up to 150 cases, says Peter Strang, chief physician and professor of palliative medicine at the Karolinska Institute and Stockholm Hospital.
– When it comes to the symptom of shortness of breath, it is more common in hospitals than in homes.
The figures are not yet accurate. and selection is limited, but according to Strang, more than 60 percent of hospital cases suffered from shortness of breath in the last week of life. Accommodation was approximately 30 percent.
Peter Strang wants to emphasize the vast majority of those infected with covid-19. But the new figures can provide comfort at a time when more and more people have to say goodbye to their families in special ways.
– The image of the general public is that there is a great need for housing, while the hospital is quiet. But the data that exists now does not speak in that direction.
Peter Strang is a physician and professor of palliative medicine at the Karolinska Institute and Stockholm Hospital.
Photo: Eva Tedesjö
Covid-19 is often said to have two phases: a first with fever, cough and fatigue, and a second, which may be more severe, where the so-called acute respiratory distress syndrome (ARDS) can develop.
– My assessment is that we have different people in accommodation compared to hospitals, says Peter Strang.
– You are very fragile in the accommodation, you do not face the disease with fever and fatigue. I think if you die, you die a little earlier there, so you can hardly have these worst symptoms.
When it comes to hours or days, it is important to have a quiet time.
Of 150 analyzed case It is about 100 from hospitals. There, the average age of covid-19 deaths was around 80 years, in 87 households.
After all, those who suffer from respiratory distress in nursing homes can, at this stage in life, where doctors have judged that the patient is dying regardless of treatment, get relief from morphine.
– When it comes to hours or days, having a quiet time is important, says Peter Strang.
On SVT’s Aktuellt Tuesday, virologist Lena Einhorn said older people “were suffocated to death” in Swedish homes. How do you look at it
– I think it is a very unfortunate statement because I do not think she has access to these figures.
– If you don’t, it’s a reasonable conclusion that it could be, when you don’t have access to oxygen during lung disease. But if you have the numbers, the interpretation is that these people are so fragile that they die in this first phase, before running out of breath.
On Wednesday, Lena Einhorn withdraws from the statement:
– You have supported me and I am not an expert in palliative care. It is certainly true that at high ages, people infected at the border are more easily inclined and therefore do not have the same painful situation as a younger person.
Christian Molnár is head of special housing operations in Familjeläkarna – the care provider responsible for health care in almost half of the nursing homes in the Stockholm region.
According to him, even a thing like security, not changing the environment at the end of life, plays an important role for the sick person:
– It is known that safety can sometimes be more effective than medication to treat both pain and anxiety.
