If anyone were to fall gravely ill and be admitted to hospital, we would all hope that our family and friends would be in the ward alongside us to help nurse us back to health. But for those with Covid-19, the contagious nature of the virus means this simply just isn’t possible.
“I read the stories about Italian patients dying in intensive care units (ICU) and the families not being with them,” says Louise Rose, professor of critical care nursing at King’s College London. “It’s totally distressing. It’s just a very basic human need, wanting to be together by someone’s bedside at that time. That those suffering with Covid-19 would have no connection with their loved ones really moved me.”
We are arguably more connected than ever: there are 3.8 billion social media users around the world, Skype has 40 million daily active users and more than 65bn WhatsApp messages are sent each day. But as Rose watched the death toll rise – and with the pandemic set to spread across Europe and the US – surely, she reasoned, there must be some way of using technological advances to bring families with members in hospital together?
Rose was introduced to Dr Joel Meyer, a critical care consultant at Guy’s and St Thomas’ hospital and together they developed Life Lines, a communication app that allows virtual visits to loved ones’ bedsides through video calling, a vital scheme for palliative care during the pandemic.
Rose and Meyer’s collaboration started out when they asked friends and contacts for iPads and other tablets to use in contacting patients’ next of kin. Meyer says: “It was probably six weeks from me and Louise talking over the initial idea to us testing the app with staff acting as patients at St Thomas’, then two days later trialling it on the ICU.”
The speed of the rollout was a necessity for all of those at the frontline, who were dealing with harrowing scenes. Meyer says: “I couldn’t bear the idea a family might miss the chance to see their loved one before they died, so the fact we have enabled that, and made those final goodbyes happen means such a lot to me.”
The pair quickly mapped out the etiquette of using the secure app, Meyer explains, because there’s no avoiding that the circumstances of having to use the device can be uncomfortable at first. “To begin, we have to use the selfie camera to introduce ourselves and prepare the family for the fact their loved one is on a ventilator and that could be distressing,” he says. “Then we take the tablet to the patient’s bedside. When the relatives are ready, we flip the camera from selfie, so they can see the patient, and narrate the call. We help the patient and their family navigate it.”
As well as facilitating the video call between the patient and caller, doctors and nurses are able to update the family on the patient’s progress – delicate situations that would only have been carried out face-to-face prior to Covid-19. “The worst conversations are when we have to explain their loved one might not make it,” says Meyer. “It’s not perfect, but those talks are never perfect. And if we’re giving a family bad news, we will follow up with check-in calls and make sure they are OK – that they know we are there to talk.
“But that empathy can still be there over a video connection, emotional cues can be seen and body language detected and we can respond to that. In some ways it flattens out any hierarchy, so they are less nervous to ask doctors questions, as we’re all on the same level, the same interface: the doctor, nurse and family.”
Despite the UK’s high death rate, there are some stories of hope in the pandemic – and Life Lines has helped to facilitate some of these moments. Meyer says: “We’ve had a marriage proposal – a man who was just about able to speak, having just come off a ventilator, wanted to propose to his girlfriend, so we helped arrange that. And she said yes! Scenes like that, they really brighten all our days.
“It’s also quite common for patients to want to chat to their pets,” he says.
At the other end of line to the patients are their families. Diane, whose husband was hospitalised and spent 15 days on a ventilator due to Covid-19 earlier this year, says: “Seeing him on screen, even when he couldn’t respond, gave me hope. I just told him how much I loved him, how proud of him I was and how much our kids and grandkids were missing him. The first time he was able to talk was when he’d been off the ventilator for three days and his first words to me were: ‘I love you.’ I cried and cried.”
Life Lines – which has been developed through the secure online platform aTouchAway, created by Michel Paquet – has currently provided 1,046 tablets to ICUs countrywide, and 15,000 video calls have been made to those in need. The project has been supported by a number of academics, charities and companies, including BT, Google, King’s College, Aetonix and King’s Health Partners, but the young scheme is still fundraising to provide more tablets, software and 4G capabilities to equip more ICUs across the country.
It’s been “a rollercoaster journey” say Rose and Meyer. But the ultimate end goal for the project is to see critically ill patients through their hospitalisation, until they are discharged and able to return home to their families. Diane adds: “I asked my husband whether he’d heard my voice when he was so ill on the ventilator, fighting for his life, and he said he remembered hearing me and that it had given him strength.”
Donations to Life Lines can be made here: justgiving.com/campaign/life-lines
This advertiser content was paid for by the UK government. All in, all together is a government-backed initiative tasked with informing the UK about the Covid-19 pandemic.
