Bereavement during COVID19 'lockdown'

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