“A few hours before my mum died, I video-phoned and heard her calling out the names of her nearest and dearest. I soothed her and talked to her as she fell asleep. I don’t think she ever woke up again.”
BBC producer Andrew Webb wasn’t able to visit his mother in hospital in the last days before her death.
Instead, he used technology to spend time with her virtually.
Similar stories are playing out around the world, as coronavirus restrictions prevent families from visiting desperately ill patients in their final days and hours.
Here, Andrew shares what happened to his mother, Kathleen Webb, and how he managed to stay connected with her until the end, despite being physically distant.
There is also a full guide on how to use similar technology at the end of the article.
My mum had a heart attack on the day that we were meant to be celebrating our parents’ 50th wedding anniversary.
But we’d already cancelled the family meal we were supposed to have.
My brother Laurence and I had discussed the threat of coronavirus, and nearly two weeks before the UK government introduced social restrictions we decided to protect our mum and dad by stopping the celebration.
Had it happened, we’d have all met up near their home in the south-west of England in the middle of March – the weekend before the UK celebrated Mother’s Day.
Back in November 2019, my mum had life-saving emergency surgery after her bowel ruptured. The problem re-emerged days before their anniversary celebrations had been due to take place. My dad took her into hospital.
Over the following weeks, she was unable to keep food down, grew weaker, and eventually died after her upper bowel ruptured.
Doctors believed surgery would have killed her, and if it hadn’t, would have left her with a very poor quality of life. There was little they could do.
Although UK restrictions weren’t yet in place, coronavirus was already taking hold and our family faced a very difficult dilemma: How could we visit a frail and ailing relative in hospital when we could pose a risk to them, and to other patients and staff?
And then there was the risk to us. My brother’s family have underlying health conditions, so he decided he couldn’t compromise their safety by visiting a hospital.
My dad, Bernie – aged 75 – visited my mum’s hospital wearing decorating masks and gloves that I had posted to him.
I began to prepare him for the reality that not only was it a potential risk to everyone when he went there, but that laws were likely to be passed preventing hospital visits.
We had been using WhatsApp on smartphones to talk to my mum, with my dad answering from her bedside, then holding the mobile phone up for her to see us.
This let several of us have video conference calls between the hospital ward and family in both London and Hong Kong.
But once the coronavirus lockdown began, my dad had to stop visiting in person.
My mum’s poor health meant she wasn’t capable of answering a phone unaided, so we had to call the hospital and ask the nurses to answer the phone that my dad had left with her.
Then suddenly, my mum was moved into isolation with suspected coronavirus. The brave nurses were putting on gloves, masks and gowns to enter her room.
I arranged video calls to coincide with the nurses going in – they were always happy to help, knowing that because of the lockdown, the phone was my mum’s only lifeline to the outside world.
But then the phone stopped working.
It was broken – and since we had to get a different phone to my mum anyway, we decided to experiment with a number of apps.
My brother and dad discovered that Skype has an auto-answer function.
We also installed an app called AirDroid that enabled us to view the new phone’s screen remotely and operate it.
My brother sterilised the phone at his veterinary surgery and drove to the hospital.
He gave the phone to a nurse, by laying it in front of the hospital and waiting for her to arrive and pick it up as he stood more than 2m away.
My mum lived a few more days, getting weaker and weaker.
The nurses propped the phone up, so we could call in over Skype and see her when it answered automatically.
I ordered a phone tripod online, but it only arrived in time for her funeral.
Over Skype video, my mum said goodbye to me, my brother and her grandchildren, including my six-year-old daughter who lives in the US state of Virginia.
Without modern phone apps, this would have been impossible.
So, in a twist of fate, coronavirus had forced us to find a way of communicating that enabled her closest family to join in remotely, and brought more of us together at the crucial moment.
My dad said his own goodbye to his wife of 50 years on a phone call, although he was only 30km (19 miles) away.
The nursing staff were fantastic, checking on my mum repeatedly. But on two occasions I called and heard my mum calling for pain relief, alone in her coronavirus isolation room.
I phoned the nursing station, and my mum was given painkillers a few moments earlier than might have happened without the phone by her bedside.
A few hours before she died, I connected to the phone at 02:00 and heard her calling out the names of her nearest and dearest.
I soothed her for 15 minutes, and talked to her until she fell asleep. I don’t think she ever woke up.
My dad and my brother’s family attended a 10-minute cremation service a couple of weeks later.
Under UK laws, up to 10 people can go to a funeral, but we decided it was safer if only a few people went. And so apart from two neighbours, no other mourners – including myself – were in attendance.
We were still concerned about the risk of infection, so my brother’s family wore masks.
There was no video facility at the crematorium, so my brother and nephew used Zoom on their own phones to share the service with my friends and me. I recorded it for people who weren’t able to join us in watching on the day.
The Church diocese wouldn’t allow my mum’s vicar to carry out the service because he is over 70, and thought to be more vulnerable to Covid-19.
A younger vicar, whom we hadn’t met before, took the service.
We now have a record of the service that, if it weren’t for coronavirus, we would never have had.
As soon as the funeral was over I edited the video and used photographs to create a memorial to my mum.
I deliberately recorded different shots throughout the funeral so that I captured everyone who attended online, as well as both feeds from the crematorium.
This was the first time I truly grieved the loss of my mum.
I’d been worried that for three weeks, I hadn’t really been upset, and feared I might break down later.
However, editing family photos and listening to the music I used, composed and performed by my niece, Jude Pegler Webb, for her college course, was a very tearful experience.
It was technology that helped me begin the grieving process.
My overwhelming memory of this period is the generosity, strength and kindness of others.
I just hope a little of what I’ve learned about how to use technology in such difficult circumstances can help people in a similar situation.
How we did it: Virtual hospital visits
1. We downloaded Skype, because it allows multiple people to make video calls together across the main operating systems. We used Android phones, Apple iPhones, Macbook Pro computers, and Windows 10 computers.
It is only possible to use Apple’s FaceTime video-call app if you are all using Apple products, which we were not. However, Google’s equivalent – Hangouts – works on Apple and Android devices.
2. On the Google Android phone that was going to be delivered to my mum, we went into settings on the Skype app and activated the option to automatically answer the device when called:
a. Select “Chats”, at the bottom left of the screen, then select your profile picture at the top centre (this will be an icon of a head and shoulders if you’ve not uploaded a profile picture).
b. Select “Settings”, at the bottom of the screen.
c. Select “Calling”, which opens up the “Calling Settings” menu:
d. Select “Answer incoming calls automatically”. Also select “Start my video automatically” to enable the phone in hospital to show you at home what its front camera is pointed at.
e. Another option appears near the bottom of the screen: “Only allow Skype calls from contacts to ring on this device”. If you select this, you could easily find that someone wants to join the call, but they are blocked. Therefore, we left this option off.
Although this meant strangers could have connected, they’d have to have known or guessed my mum’s Skype ID. I’d set it up just a few days prior and only gave it to my family – so an unwanted call was extremely unlikely.
If the patient previously used the Skype account often, such as for work, it would be much safer to create and log into a new account on the phone they will have. This would ensure that only the family and close friends can call the Skype account.
Other apps, such as Zoom and Microsoft Teams, have auto-answer functions, as do Apple devices by changing Accessibility settings.
We turned off automatic updates on the phone – the last thing we wanted was for the phone to reboot and require account passwords to be re-entered.
Instructions to turn off auto-updates on Android devices
Instructions to turn off auto-updates on Apple mobile devices
Backup chat apps
We installed several other video call apps in case Skype failed.
Video call apps include WhatsApp, Google Hangouts, Zoom, Microsoft Teams, Facebook’s Messenger and Line for Android, Apple and Microsoft Windows devices.
However, the automatic answer facility available with video conferencing offered by Skype was the reason we chose it – plus it was simple for my dad to use in isolation at home. Some other very detailed and professional systems require you to log into a website to adjust this function.
Facebook has just announced it will support up to 50 people chatting in its new Messenger Rooms. This could prove to be a rival to Zoom for recreational purposes, at a time that socialising is happening over chat apps, rather than in person.
Modern Apple devices running iOS 12.1.4 or iPadOS also support conference calls with FaceTime. You have to tap the screen then flick up the menu from below the initial menu, so it’s not as obvious how to do this as it is in Skype. And, remember that FaceTime is only available for Apple devices.
Controlling the phone: AirDroid
We installed the AirDroid app on an Android phone and computers, to view what the phone’s screen was showing and operate it remotely.
AirDroid has versions for Android, Windows, Apple iOS, and Apple Mac OS X. However, it can only control Android devices and is a file-sharing system for Apple devices.
ApowerMirror is an alternative app to control an Android device from a Windows PC or a Mac, and there are others with some similar features.
We chose AirDroid to give us an option to answer calls or change settings.
It’s clearly a security risk if installed without someone’s knowledge. But it appeared ideal for controlling a phone in these circumstances, as a backup, should Skype require a password to be re-entered, for instance.
There have also been reports of security loopholes. AirDroid has said that it is secure.
One problem emerged when the phone powered down after being unplugged from a charger, and we couldn’t reconnect to AirDroid – although it should have been possible and worked in our tests.
If it had worked in hospital, we could have known whether the phone was plugged into a charger after it had been switched back on.
For Apple devices, the pre-installed Find My iPhone app gives you battery information.
Tripod and charging cable
I ordered tripods with extendable legs that could stand on the floor and reach head height, or be collapsed to stand on a bedside table.
I also mail-ordered several 3m charging cables, addressed to the ward. Short cables proved difficult in these circumstances and were the main reason the phone powered down, after which AirDroid failed.
Both orders arrived after my mum’s death, so I asked the hospital to keep the cables, and the tripods were used at the funeral.
Additional research by Michael P Mahoney.