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COVID-19

On the Front Lines: Spokane hospice social worker focuses on patients, families despite coronavirus complications

Rick Fairbanks, case managing social worker for Hospice of Spokane is photographed Tuesday at Spokane’s Hospice House South, which has made some operational changes during COVID-19. (Kathy Plonka / The Spokesman-Review)

Rick Fairbanks, a social worker at Hospice of Spokane, aims to create “heartfelt moments” for patients and their families as they move toward the end of their lives.

Even with the coronavirus pandemic, “life and death continue to go on,” Fairbanks said.

While Fairbanks has yet to care for a patient diagnosed with COVID-19, health care in general and hospice specifically look different these days. Fairbanks said he hopes to continue providing patients and their families with resources, support and guidance during this difficult time.

Fairbanks and his wife moved to Spokane about 35 years ago. An outdoorsy couple, they were drawn to the recreational opportunities available in the Inland Northwest. Fairbanks also was drawn to Eastern Washington University and its master’s program focused on rural social work.

While Fairbanks finished graduate school, the couple had three daughters. Fairbanks then worked in a variety of settings doing social work before starting at Hospice of Spokane nearly five years ago.

“We’re really honored to be able to walk with people in the last weeks and months of their lives,” Fairbanks said. “They continue to open the door. It’s really nice to get to know folks. At the same time, it’s really heartbreaking work.”

At Hospice of Spokane, Fairbanks is part of a team that includes nurses, a chaplain, a bereavement counselor, a medical director, a pharmacist, volunteers and administrative support.

His role is to help connect the patient with resources such as Meals on Wheels, track down volunteers to give caretakers respite time, bring in therapy animals and set up advanced directives and other end-of-life tasks.

“We really connect people with each other,” Fairbanks said. “I guess that’s the ‘social’ in social work.”

Fairbanks also helps patients think about their legacies and reflect on their lives.

“I do a lot of life review, so, ‘What’s been important in your life?’ ” Fairbanks said. “Making sure that they hopefully find the value in what they’re leaving behind.”

Hospice is a “pretty tactile business,” Fairbanks said.

He visits each client about once a week and often gives hugs to both patients and family members. But since the coronavirus pandemic arrived and social distancing guidelines were implemented, he said, “all of that had to stop.”

While about two-thirds of Fairbanks’ clients are at home, the other third are in a care facility, such as a hospital, a nursing home, an assisted-living facility or a hospice house.

Hospice services can be added on to care provided at another care facility or at home, while patients in a hospice house receive all their care from hospice.

As a social worker, Fairbanks is constantly working to connect patients and their families with other services to keep them comfortable and calm as they near the end of lives.

“The services are still there, but they’re doing a lot of work-arounds,” Fairbanks said.

For example, Meals on Wheels is mainly offering frozen meals while the hospice volunteer program is suspended.

Accessing clients in nursing homes has been difficult because social workers like Fairbanks aren’t considered essential.

“They’re obviously not getting as much face-to-face support,” Fairbanks said.

Recently, a client was discharged because hospice workers couldn’t access the facility where the patient was treated.

When Fairbanks does get to visit residents in a nursing home, he often facilitates family connections via video chat.

“At least they can eyeball their loved one. They can see that they’re doing OK or maybe not doing so well, but at least they can see them,” Fairbanks said.

Fairbanks said he has advocated, with some success, for facilities to allow families to visit when their loved one’s death is imminent.

For Fairbanks, the goal is to create a peaceful environment for patients as they near death.

Despite the stress and anxiety that come with coronavirus, Fairbanks said it remains possible to create a space for patients to reflect on their lives and interact with loved ones.

Fairbanks encouraged family members, who may be struggling to grieve during this time, to spend time meditating, praying or just finding solid ground.

“The rituals that we normally have are being put on hold,” Fairbanks said.

While gatherings to celebrate one’s life can’t happen now, pulling out a memory book or sharing pictures with family members who aren’t nearby can be ways to grieve, Fairbanks said.