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Coronavirus (COVID-19) and advanced cancer

For many people with advanced cancer and who are approaching the end of life, coronavirus has been making a difficult time even more challenging. The social distancing rules have been affecting how we spend time with our loved ones and friends. And the outbreak has been having an impact on healthcare services such as community nurses and hospice care.

Knowing more about what support is available can help you, and your loved ones, to feel more reassured.

Your end of life care and coronavirus (COVID-19)

You might feel worried and unsettled about what support is available to you.

Talk to your healthcare team about how you are feeling. They will be able to tell you what support and care they can give, and how they will do this.

What support is available during the coronavirus outbreak?

Your hospital team usually refer you to a community palliative care team for your care and support at home. This is a team of professionals such as palliative care or hospice nurses. They help with pain control, sickness and other symptoms of cancer. They also provide emotional support to you and your carers.

Other community teams such as district nurses or social workers may also be able to support you at home. You might also go to your local hospice for inpatient and outpatient support.

Your community team will support you during the coronavirus outbreak. But they might have to make changes to how they support you at times. Reasons for this include:

  • staff shortages due to illness or staff having to work elsewhere
  • to protect everyone from spreading the virus

Health care professionals will visit you at home. But sometimes, your community team might offer you telephone or video support instead of coming to your home. When they do visit you at home, they will follow strict infection control policies to protect both you and them. This will also reduce the risk of spreading the coronavirus. 

Your local hospice will be able to tell you what services they are offering. They might have changed the way they work. For example, some hospices have changed their visiting policies and have made changes to day care services.

What happens to my care if I get COVID-19?

Community health care teams will visit you if you have COVID-19. But you must tell them straight away if you get any symptoms. They will follow strict guidance on infection control to protect themselves and other patients. You might not see your usual nurse or carer each time. But they will speak to your regular team so they know about your care needs.

Your cancer might make you more at risk of becoming very unwell from COVID-19. You can talk to your health care team about this, and what will happen if you become very ill and need hospital treatment.

What happens to my care during lockdown?

You will still receive the care you need from your community health care team during lockdown. You might have followed the rules for shielding previously because you were extremely vulnerable. People in this group are more at risk of being seriously ill if they develop the COVID-19 infection.

You might have been asked to shield again. But the decision to protect yourself from coronavirus with shielding measures is your personal choice and depends on your circumstances. You might decide that because you have a limited time to live, you don’t want to follow shielding measures. Discuss this with your medical team, loved ones and friends.

Spending time with family and friends

Many people with advanced cancer want to spend more time with their loved ones and friends in the last weeks and months of their life. Rules on social distancing during the coronavirus pandemic have been making this more difficult for many. It's understandable that you might feel upset if you're separated from the people who you want to spend time with.

Can family and friends visit me in my home towards the end of my life?

A friend or family member providing essential care

If you have a friend or family member caring for you, but who doesn't live with you, they can visit you and go inside your home to provide essential care. For example, they can visit to help with washing and dressing, food or medicines.

It's important that they don't visit you if they, or someone they live with, have symptoms of the coronavirus. To reduce the risk of spreading the virus, they must wash their hands for at least 20 seconds when they come into your house and before they leave, wear a mask and follow social distance guidance where possible.

Other friends and family members

If other family or friends want to visit you, they have to follow the guidelines for the different nations in the UK.

In England, a family member or friend who is not providing essential care can see you at home. NHS England has guidance about visiting someone in the last days of life. It says that someone who is approaching the end of life should be asked about having a visitor. The number of visitors may be limited to one, but if social distancing can be kept, you might be able to have more visitors. It does not include the person giving essential care.

The healthcare team caring for you will tell your visitor about what to do to protect you, themselves and others from spreading coronavirus.

Talk to your healthcare team for details on what a visitor should do in Northern Ireland, Scotland and Wales.

Can family and friends visit me in a hospice, hospital or care home if I’m approaching the end of my life?

Hospices, hospitals and care homes have been changing their policies about visiting to lower the risk of spreading the virus. They will be able to tell you what their visiting policy is.

Most care settings have changed their rules on how many visitors can come and when they can visit. The length and numbers of visits may also vary.

In general, a visitor should:

  • drive to the hospice, hospital or care home if possible or ask another family member to drive them and not use public transport
  • wear a mask, wash their hands or use hand sanitising gel, and follow strict social distancing rules at all times
  • follow the shortest route in the building to get to your room and meet with someone from the nursing team before entering your room
  • bring as few personal belongings as possible
  • use the call bell to let the nurse know when they want to leave your room

If you have coronavirus

Your visitor should:

  • stay at least 2 metres away from others when they enter and leave the building and avoid touching any surfaces
  • not touch their eyes, nose and mouth with unwashed hands
  • cover any coughs or sneezes with a tissue, then throw the tissue in a bin
  • wash their hands with soap and water for at least 20 seconds when they arrive, when they leave, and then again as soon as they get home
  • wear personal protective equipment (PPE) provided by staff
  • remove their jacket or coat and roll up their sleeves before washing their hands and when putting on PPE
  • go the toilet and have a drink before putting on PPE to avoid having to remove it during the visit
  • follow stay at home guidance if they become unwell

Visitors don’t usually have to self isolate if they have worn PPE during their visit.

If you don’t have coronavirus

Your visitor may visit if they don’t have any symptoms of coronavirus. They should:

  • stay at least 2 metres away from others when they enter and leave the building and avoid touching any surfaces
  • not touch their eyes, nose and mouth with unwashed hands
  • cover any coughs or sneezes with a tissue, then throw the tissue in a bin
  • wash their hands with soap and water for at least 20 seconds when the arrive, when they leave, and then again as soon as they get home

If your visitor is in a household that is self isolating because they have been in contact with someone who has or might have coronavirus, they should not visit if they have symptoms. If they don’t have symptoms, they may visit, but should:

  • stay at least 2 metres away from others when they enter and leave the building and avoid touching any surfaces
  • wear PPE
  • stay at least 2 metres away from you and visit for no more than 15 minutes when only wearing a mask, apron and gloves
  • enter and leave as quickly as possible and through the shortest route

How can I keep in touch if people can’t visit me?

It's understandable that you might feel very upset if you can't spend time with the people you want to. If you feel well enough, you can still talk by phone or do video calls. Even if you don't feel well enough to talk, it might be nice to hear the voices of people you care about.

Your friends and family can still write to you or send gifts. If you have someone caring for you, they can help read letters to you and also help with phone calls. Your closest friends or family members can try and keep everyone else up to date about how you are if that's what you want.  

What happens if my family member or carer get COVID-19?

It's a good idea to have a plan in place in case someone you live with, or who cares for you, gets the virus. This might mean making a backup plan in case someone else needs to care for you. This would include names of alternative people who could help care for you if your main carer becomes unwell.

To protect yourself, there are some things you can do if someone close to you has the virus, including:

  • going to stay with other family members or friends
  • keeping away from each other as much as possible if you have to continue living together
  • getting advice from your GP or community team

Support for carers and loved ones

Looking after someone in the last weeks of life can be a huge emotional and physical challenge. So, it's important that you also look after yourself. 

Coronavirus has put a limit on many activities and services, so you might feel that you have less practical and emotional support available. And you might not be able to do things you normally do to look after yourself. So, you might have to find other ways of supporting yourself better. Below are some tips which might help.

Tips

  • Contact the community health care team and tell them how you are feeling. They might still be able to visit you at home, or they can offer both practical tips and emotional support over the telephone.
  • Try to make time to keep in touch with other family members and friends, for example, you can do this using the telephone, video calling or social media.
  • Your local authority might have a scheme to help with things like shopping and getting medicines. Look at their website or contact them directly to see what help they can offer you.
  • You can call the Cancer Research UK nurses on freephone 0808 800 4040, from 9 am to 5 pm, Monday to Friday if you want someone to talk to. 
  • You might be able to talk online to other people in a similar situation to you using online forums such as Cancer Chat.

The last few days

What happens in the last days of life is different for everyone. But it can help carers and relatives to know a little about what to expect. It can also be helpful to have guidance about what to do after someone dies.

We have a section of information about what happens at the end of life. This includes information about caring for the carer, what happens during the last few days of life, and what to do after someone has died.

After someone dies, you might go through a range of feelings. It can be a lonely time, and the current situation might make feelings even harder to cope with.

You might find it useful to contact an organisation that offers support and advice to people in this situation, such as Cruse Bereavement Care. They have information about bereavement during the coronavirus outbreak.

More information

Marie Curie is a charity that provides information and support, and nursing and hospice care to people at the end of their life. They have a section of information on their website about coronavirus and end of life care. This includes information about:

  • making decisions about your future care (advance care planning)
  • caring at home during coronavirus
  • what to do when someone dies

Marie Curie also has detailed information about attending funerals during the coronavirus pandemic. Because of the virus, the number of people who may attend has changed and varies in each UK country.

Everyone attending a funeral should follow strict social distancing rules and wear a face covering. There are also specific rules for people attending depending on their situation. For example, if you have coronavirus symptoms, you can't attend a funeral.