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Dying and Bereavement during the coronavirus pandemic

Bereavement is a universal process and is a time of adjustment to any kind of loss, including death of a person. In the first few days, it is usual to feel disorientated and isolated from normality. There can be feelings of anger and frustration and deep sadness, the intensity of which will vary according to everyone’s individual circumstances.

The social distancing measures can be difficult in a loved ones final days

Some of the particular issues resulting from the coronavirus pandemic result from the social distancing measures that are in place. For example, during the final days of a person’s illness, if they are not at home, they may be unable to have visitors, so communication and support will need to happen in a different way. If they are at home, the same restrictions will apply. This could mean the usual network of supports may not be as readily available. People within teams may change because team members may themselves be ill or self-isolating . Your  usual arrangements for medication, prescriptions, and seeking health care advice may be different.

Bereavement during the coronavirus pandemic raises particular challenges.  The impact of the coronavirus pandemic means that some of the usual things that may help in the grieving process, such as sitting with a dying relative and holding a family gathering at a funeral, will not be able to happen because of the social isolation that the necessary spread of infection measures has brought.  This may result in the more complex and intense reactions of anger, frustration and guilt adding to the usual responses to grief. It can be difficult, especially if this may not be what your loved one would have wanted.

This may all feel very strange and very isolating. However, there are some things that may help you through this particularly challenging time.

What you can do

Everyone’s experience of grief is unique, yet everyone will be affected in the same way by the pandemic. The restrictions on visiting and social interaction are based on the best available public health advice of the time.

You can keep in communication with people, it will just be different to the usual face to face contact. This is important though, to help reduce the sense of isolation.

This may be a time for families to talk together about what they may or may not want to happen in this time of changed arrangements, and also in the event that others in the family might become unwell. Family discussions and setting realistic expectations may help in the future when looking back at this time.

In the time before death, try to keep contact with the person who is ill via phone, video messaging, or letter or card. If as a family or care giving group you use a video messaging, set up group chats to keep in contact with family members and your usual support networks to keep people updated.

Thinking through a simple funeral and then planning a future celebration of life when the isolation restrictions are lifted may be something you would like to think about.

Coronoavirus Pandemic -coping with grief and loss

Grieving is a normal process following the death of someone we love.  However, with the effects of the Coronavirus pandemic, coping with grief and loss we may need extra support in our grief, and we may need to adjust our normal coping strategies and the ways we mourn.

Many of the ways we usually grieve may not be possible for a while, for example, getting together to remember the person who has died, hugs or handshakes, getting out in nature, going to religious gatherings or families and communities getting together in large groups.

We all live with grief in our own way; however, there are some feelings and reactions that many people experience:-

  • Numbness and disbelief— “it hasn’t really happened”.
  • Feeling very weepy or being unable to cry at all.
  • Feelings of anger towards others or the situation.
  • Thinking that you have seen or heard the person, or searching for
  • Anger, anxiety, loneliness, depression or feelings of ‘I can’t cope’
  • Feelings of guilt. We might feel worried that their death was in some way our fault.
  • Difficulty sleeping or eating and in concentrating, and finding your memory is affected.
  • Feeling physically low and concerned about your health.
  • Regret about all the plans and dreams that you had before.
  • Challenges to your beliefs.
  • Low motivation for doing anything, even taking basic care of yourself can feel like a huge challenge.
  • Finding everyday situations and relationships difficult to cope with.

 

Grieving can take a long time and come in waves

Grieving is a gradual process that can take a long time; it is important that you give yourself time to grieve and take care of yourself during this time.  It can also feel like you are doing better, and then feel like you go back to square one again. This is normal. Grief can come in waves, you may feel okay one minute and then very low the next, or have good days and bad days.

Sometimes if you have had a challenging relationship with the person who has died it can be more, not less, difficult – you may be grieving the relationship you wish you’d had, as well as the person who has died.  You may also feel like your grief is suspended during the crisis – like you have gone into lockdown as well.  Best advice is to be where you are, and don’t think you should be feeling anything different to what you are feeling.

Griefis really just love. Its all the love you want to give, but cannot. All that unspent love gathers up in the corners of your eyes, the lump in your throat, and in that hollow part of your chest. Grief is just love with no place to go.”                                                             Jamie Anderson

Here are some suggestions for things that may help cope with grief and loss during the Coronavirus pandemic

  • Make a special place in your house or garden where you can remember the person who has died. Use a shelf or a small table which can be a focus for your love, and your grief.  You can put pictures of your loved one and anything else that was special to them there.  Lighting a candle can be a physical reminder of your love for them.
  • Reach out to friends and family, or some of the organisations listed below. It is so important to talk about it, even if it is on the phone, or through a window, or through the internet. Talking to someone in a similar position can also help, but your experience will always be unique to you.
  • If it is not possible to have a normal funeral or memorial service, see if you can gather online, or ask everybody who would have attended to light a candle or listen to a piece of music at the same time so you can find a way of connecting emotionally even if not physically. Recording the funeral, even if you plan a memorial later, can help anyone who couldn’t attend.
  • People will want to help but may not know what to say or do – tell them. ‘Please can I talk about what happened?’ or ‘Please can you send me something/shop for me/send me music’ or ‘Please can we talk about something normal or distract me’ Ask for what you need – there is no right or wrong.
  • Write a journal. Writing the feelings down can help to give them shape and movement. Drawing pictures of how you are feeling or singing can help give the feelings a channel rather than feeling so ‘stuck’. Grief needs to move.
  • Grief and trauma are felt in the body as much as the mind. Try to move your body in any ways that feel good. Stretching, yoga, exercise, dancing, even just a little bit can help the feelings feel less ‘stuck’.
  • You may feel that you didn’t get a chance to say goodbye properly or say all things you wanted to. Writing a letter to the person who has died can give an opportunity to express those feelings, even though you cannot send it.
  • Sometimes anger is easier to feel than grief. The death of a relative or friend can affect families very strongly, and misunderstandings are easy if you are communicating by telephone or text message.  Try to give each other the benefit of the doubt, and avoid arguments if possible.
  • Spend time with/in nature, even if it is just through the window, maybe looking at how it changes all the time. This time will pass too.
  • Meditation or mindfulness, or any other spiritual practice can help bring perspective and comfort and help the feelings be less overwhelming.
  • Keeping some kind of routine can be helpful. Try to eat regularly even if you don’t feel hungry. Try to keep a sleep rhythm.  Small achievable tasks can help, but try not to expect too much of yourself.
  • Plan for what you will do when we are able to be out and about again – both to remember the person and also any places you want to visit to remember them especially.
  • Don’t push yourself into major decisions if possible—there are no right times for doing anything, only at your pace.
  • Don’t rush to dispose of or distribute clothing and possessions—do this when you feel ready.
  • Try to let children share your grief and encourage them to express their feelings. Talking, reading, drawing and playing games can be helpful. Organisations below have loads of good resources and advice.
  • Plan for anniversaries, such as Christmas and birthdays, and the anniversary of your loved one’s death.
  • Recall happy memories—this may be painful, but can also be comforting. Looking at photographs and keeping personal mementos may help.
  • Be gentle with yourself. You may feel very alone or lonely.  We are all in this together and we as a community will do whatever we can to support you.

If you are struggling with traumatic memories or very difficult thoughts for a long time, it is important to seek professional help. Your GP or some of the organizations listed below will be able to help you.

This guidance has been developed by Charity Garnett RN, Bereavement Project Co-ordinator, Powys Teaching Health Board

Organisations that can help cope with grief and loss

Accessing helpful information and resources is more challenging at the moment as community hubs and offices are not open. There is  more of a need to rely on web based resources or information from family or health care professionals that you might come into contact with. HMGov has produced a leaflet called ‘ Information for the bereaved’ which sets out very simply what needs to be done when a person dies Bereavement-Leaflet-digital

If you have organisations or healthcare professionals who already support you please contact them. There are many organisations that offer support to people who have suffered a bereavement – many of them have changed how they support people due to Corona Virus. Some of them are listed below – please reach out if you are struggling.

Cruse Bereavement  www.cruse.org.uk

UK’s foremost bereavement charity Tel: 0808 808 1677

Bereavement Advice Centre www.bereavementadvice.org

A National organisation, that offers advice on all aspects of bereavement   Tel: 0800 634 9494

Good Grief Trust www.goodgrieftrust.org

An online search engine, that provides links to bereavement support across the country.

Samaritans – Supports people in extreme distress Tel: 116 123

Silverline – befriending service for older people – providing 24 hour support Tel: 0800 470 8090

Child Bereavement UK  www.childbereavement.org

Child Bereavement UK supports families when a baby or child of any age dies or is dying, and when a child is facing bereavement   Tel: 0800 028 8840.

Winstons Wishwww.winstonswish.org   –  Support for grieving children.

 

CITY HOSPICE BEREAVEMENT SERVICE

People grieve in different ways. For the families of patients who were cared for by City Hospice, a member of the City Hospice Team will make contact with you in the first few weeks. They will help you identify what will be the most helpful support for you at this time. Some people find that they are managing and so do not wish or need the support of further counselling. For those of you who do need support we are here for you.

The bereavement service at City Hospice at present can offer phone contact from one of the team. In view of the greatly increased need as a result of the pandemic, support will be offered from counsellors and senior members of the clinical team.

For information regarding City Hospice and how the Coronavirus is affecting us please click here