A 5-point strategy for improved connection with relatives of critically ill patients with COVID-19

1. Stimulate family visits by restricting them to the closest relative who is asymptomatic and able to apply optimal personal protective measures.
2. Standardized written information for relatives. This letter is sent to the relatives but also discussed during the first remote call between the health-care professionals and the family.
3. Schedule routine telephone calls with the relatives to maintain continuity of communication. The calls could be made by a medical student, a non-ICU physician, another health-care professional, or a volunteer. In addition to these calls, family members are invited to call the physician and bedside nurse once a day to receive basic information. More detailed information is to be provided during a face-to-face meeting when the relative visits the patient. For conscious patients, smartphones and digital tablets can allow video calls or virtual ICU visits.
4. Stay in touch by encouraging the family to find ways to improve the link with the relative (web-based remote family conferences, diaries, drawings, text messages, and media groups).
5. Switch to a different approach in end-of-life situations to avoid depriving family members of the opportunity to say goodbye to a relative. For example, family conferences should be organized, remotely if needed, to meet family needs and prepare for the bereavement. The relative should be allowed to stay in the room as much as possible. However, the safety of the relative is a primary concern, and the health-care professionals must provide the relative with training in the use of personal protective equipment.

The Lancet