Bereavement will affect so many people in so many ways during
this time of coronavirus (COVID19 pandemic). The ‘lockdown’ is reshaping
everyone’s lives. Grieving at this time will also be incredibly challenging whether
the person has suffered with COVID, or of other causes. The following are some contributions
from twitter after I asked for ideas for bereavement support. (I am a public
health researcher and these are thoughts about what bereavement support is
required; I do not have counselling, clinical or psychological qualifications –
so these points should not be taken as ‘medical advice’).
Religion
Different religions have different practices around dying,
funerals and grieving. It is important that these traditions and religious
practices are acknowledged and respected, even if infection control measures must
be in place.
What happened in hospital or care home?
The bereaved may have many questions about what happened in
the last days of care. Hospitals and care homes have ‘no visiting’ policies, and
additionally transport is severely restricted, so many people are dying apart
from their spouse, family and care partners. People may feel that they have
gaps in their knowledge about how their loved one was cared for and why. Some
initiatives have encouraged clinical staff to record care processes in the last
days to help the grieving process.
Funeral arrangements
Due to infection control procedures, there are many constraints
on the usual care of the deceased and the funeral. People may feel upset that
they haven’t been able to be personally involved, or haven’t been able to arrange
the appropriate care. Funerals have been restricted to a small number which
means that people may feel that it hasn’t been a ‘proper’ funeral. Mourners who
are present in person may feel additional pressure and not have support of family
and friends. Innovations in technology have enabled family and friends at a distance
to join the funeral via teleconference eg Zoom or skype.
Usual routines
The usual social routines including going to work, social
engagements and church/mosque/temple are not occurring. These are normally
brief contacts which may help people to express and share their grief. The days
can run into each other which may lead people to become absorbed in their grief
and problems such as depression may go un-noticed.
Difficulty in accessing health and support services
The crisis of the pandemic and newspaper headlines about ‘protecting
the NHS’ have led many people to believe that they should try to avoid asking
for help. We know that this is happening because fewer people are attending GP
and hospitals compared to usual (previous years). This may mean that people
also feel inhibited from asking for help with their feelings and emotions
during bereavement.
Tele-support
While face-to-face bereavement counselling may not be an
option, phone counselling should continue to be accessible. As people are becoming
accustomed to videoconferencing (Zoom, skype) visual (non-verbal) communication
can add an important extra dimension. Some people may be accustomed to alternative
online communication styles, such as ‘instant messenger’ chat, facebook, or
even virtual reality worlds. Could these be used to support individuals or
groups, including peer support.
Special roles - who supports the supporters and volunteers?
People are taking on voluntary and other community roles at
the moment. There are community support groups and the NHS volunteers, as well
as more specialised volunteering (first aid, helplines, food banks). Any of
these may experience grief or trauma and may require support. This type of
support may be more like support for professionals including doctors and nurses
– and resources should be made available via voluntary organisations. However,
volunteers may not see themselves in this way, and therefore may not consider seeking
support, so they may need a ‘nudge’.
Communication or cognitive difficulties
There are many people who, in the rush to respond to COVID
pandemic, may be overlooked. I’m thinking of people with dementia or cognitive
impairment, visual or hearing impairment, autism and learning difficulties and
many more who may need additional support to help them understand and come to
terms with grief. From what I’ve heard listening to care partners of people
with dementia, daily mentions of the loss of their loved one is needed to
enable them to understand bereavement.
Child carers
Children may require more specialised support and there are
specialist organisations that can offer help. Children can also be carers, and may
require additional support as their role changes and they make new friendships.
Acknowledgements and further information
Thanks for comments and suggestions from people on twitter including; Kathryn Mannix, Wendelien McNicoll, John Wilson, Sara Mathews, Lucy Selman.
Heres some links that may be useful;
Surviving the Tsunami of Grief, Katrina Taee & Wendelien McNicoll https://t.co/haTozMScQD?amp=1
Cruse Bereavement Care 0808 8081677 https://www.cruse.org.uk/Bereavement Alliance https://nationalbereavementalliance.org.uk/
Counselling Directory https://t.co/hpLPTlzAu2?amp=1
Organising a meaningful funeral, Quaker Social Action https://t.co/TNGs9TneRF?amp=1
Let's talk about death and dying, Age UK https://www.ageuk.org.uk/information-advice/health-wellbeing/relationships-family/end-of-life-issues/talking-death-dying/
Sudden Supporting people after sudden death including COVID-19 https://www.suddendeath.org/covid-19-bereavement/advice-for-bereaved-people
