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A woman paints flowers on the windows of residents' rooms at Pinecrest Nursing Home in Bobcaygeon, Ont., where there has been an outbreak of COVID-19, on April 1, 2020.

Fred Thornhill/The Canadian Press

Mubarak Popat was a well-known grocer in Toronto’s Little India. He fell ill with COVID-19 last month after returning from his sister’s funeral in Britain. When his condition worsened, he ended up at a hospital in nearby Mississauga where his daughter Nooreen Mann is a respirologist and his son-in-law Rick Singh Mann an emergency-room doctor. Mr. Popat died on March 21 at the age of 77, becoming the first person in Toronto to succumb to the disease.

In normal times, Dr. Mann said, he and his wife would have kept close to Mr. Popat during his final days and hours. In these altered times, they got only fleeting visits and had to dress in full personal protective equipment, or PPE.

If Mr. Popat had been dying in different circumstances, “we would have been at his bedside, we would have been there overnight, we would have been spending those last moments with him instead of the five minutes a day that one of us would take going into the room, standing six feet away yelling through all our PPE, hoping he could hear us.”

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As Dr. Mann is quick to acknowledge, they are lucky ones. At least they got to visit. With hospitals, nursing homes and hospices limiting visitors, some relatives and friends are being forced to keep away altogether. Others are getting only brief solo visits. Group gatherings are out.

Most people hope they will get the chance to say a proper goodbye when someone they love lies dying. The pandemic threatens to rob them of that privilege. One of the most enduring human rituals – the deathbed vigil – is changing.

“It’s just a very lonely time for the families,” says Jennifer Robertson, 48, whose mother Margaret Begg is in a Sarnia, Ont., hospice after a fall. When she turned 93 last month, her family had to sing her Happy Birthday through the open window. Only her husband of 67 years gets to visit, accompanied by another daughter, who is a nurse. Husband and wife “sit there and hold hands.”

Ms. Robertson just hopes she will have the chance to say an up-close farewell when the time comes. “You want to be there. In her final hours, on her final day, I pray they will let us in, but I don't know if they will.”

Such fears are common these days. “People are feeling very helpless,” says Jennifer Mallmes, co-founder of the End of Life Doula Association of Canada, whose members help people negotiate the end of life much as birth doulas help with the start. “You are dropping your loved one at the hospital not knowing if you are ever going to see them again.”

Another member of the association, Sarah Farr, said some people are using video-chat services to keep in touch. Others simply have a caregiver or nurse hold the phone near to the person’s ear. “That’s very powerful at the end of life, just to hear a human voice,” she said. She urges people to prepare something, such as a letter or a poem to read or have read.

Joan Randall, 80, of Meaford, Ont., can’t visit her companion of more than 50 years, Rose Anne Dean. Ninety-four years old, she has advanced dementia and lives in a retirement home. “It’s just really hard because you just never know when something’s going to happen and you may not even have the choice to be there,” Ms. Randall said.

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To make contact easier, some institutions have put names or room numbers on the windows so relatives know which one to wave to from outside. Others with ground-floor rooms let visitors sit on the patio outside and talk to their loved one through an open window.

Still, it’s not the same as being in the room, sitting by the bed and holding your mother’s hand. “One of the things social distancing is teaching us is how important touch is,” said Clare Freeman, executive director of Dr. Bob Kemp hospice in Hamilton. Without it, “There is a kind of hollowness people are left with.”

Her hospice lets two visitors come into the room at a time, although they must enter separately. Visits are limited to one a day. Families can designate four approved visitors in total. But who makes the list? “We can see the pain in the families’ eyes of having to make that tough choice,” Ms. Freeman said.

Some are finding creative ways to reach out. One Bob Kemp resident was part of a vintage-car group. The other members couldn’t come to his room, so they lined up their fancy cars and waved to him.

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