Lifting COVID-19 Visitation Restrictions in a Palliative Care Unit: A Two- Year Experience

Background Visitation restrictions during the COVID-19 pandemic have been linked to psychological distress and compromised quality of palliative care. However, few long-term studies have evaluated the consequences of lifting these restrictions. This study aimed to investigate the outcomes after lifting visitation restrictions in a palliative care unit (PCU). Methods We retrospectively analyzed consecutive advanced cancer patients admitted to a 20-bed PCU and their visitors from July 18, 2023 to March 31, 2025. Visitation policies imposed no restrictions on visitor numbers, relationships, or duration. Visitors undertook mandatory in-person health screening by nursing staff, masking, and hand hygiene in accordance with institutional infection control guidelines. Descriptive statistics and trend analyses by patient–visitor relationship were performed. Results A total of 385 patients (median age, 76 years; 55.8% male) were admitted. No COVID-19 infections occurred within the PCU. Two visitors reported COVID-19 infections after visitation, but no secondary transmission to patients was observed. In total, 14,164 visits were documented, with 13,800 valid registrations identifying 2,959 individual visitors. The median visit duration was 65 minutes (interquartile range, 30–139 minutes). Longer visit duration was significantly associated with closer relationships: spouses (98 minutes), parents and children (72 minutes), siblings, grandparents and grandchildren (54 minutes), other relatives (43 minutes), and friends and associates (31 minutes) ( p  < 0.001). Conclusions Lifting visitation restrictions under multilayered infection control measures was successfully sustained for nearly 2 years and did not result in any COVID-19 outbreaks in the PCU. These findings highlight the importance of safeguarding patients’ rights to be with their loved ones at the end of life while ensuring infection prevention.