By Laura del Carpio.
When COVID-19 hit and the world was suddenly turned upside down, I was in the middle of transcribing a series of interviews as part of my research. This work looks at the experiences of adolescents who have faced a bereavement (i.e. the death of someone significant) by suicide or other causes, and the impact that loss has on their lives. These interviews involved inspiring young people speaking about some of the most difficult times of their lives; hearing them discuss the circumstances that surrounded the deaths, the challenges they faced, and new insights and perspectives gained after the loss. While re-listening to these recorded conversations, I began to wonder how different the experience of grief and bereavement might be for individuals during these unprecedented times.
Grief during a pandemic
Coronavirus has impacted all of our lives significantly, and had a major impact on the way people approach death. At the time of writing, COVID-19 has taken the lives of over 130,000 people in the United Kingdom , and over 4.2 million individuals globally . In addition to this, deaths from non-COVID related causes such as suicide and other causes have continued to affect millions over this period. More and more individuals have experienced a close bereavement, or dealt with the prospect of mortality, perhaps for the first time.
It is worth noting that ‘grief’ is often used to refer to the natural responses following a loss to death, yet many of us have also experienced grief over different kinds of losses; the loss of our daily routines, regular contact with friends and family, plans for the future, and freedoms we perhaps once took for granted.
While the longer-term effects of the pandemic on our lives are yet unclear, it has presented several new challenges to dealing with death and dying [3, 4]. Unfortunately, many people were not given the opportunity to say goodbye to loved ones during the initial lockdowns. Some may have witnessed family and friends dying under difficult circumstances (e.g. sudden deaths, staff wearing full personal protective equipment, hospitals at capacity).
One of the biggest challenges for us all has been the need for physical distancing to reduce virus transmission. For those dealing with death, the limited social connections and increased feelings of isolation and loneliness may have disrupted their grief at a time when support from others is crucial, both emotionally as well as practically. Service provision has also been impacted, although many organisations have adapted by finding new ways of working with individuals remotely .
Restrictions on funeral gatherings and other death-related rituals meant that ordinary mourning processes were obstructed. The pandemic also affected certain communities disproportionately, exposing and exacerbating structural inequalities which may compound the experience of grief . Finally, dealing with death on top of anxieties about a public health crisis and secondary consequences of the pandemic may have resulted in the experience of bereavement being particularly challenging for some.
Although COVID-19 has transformed all of our lives, there have been some notable positives arising from the last year and a half. Communities have pulled together to support one another through difficult times, and these efforts have been encouraging and increased social cohesion within communities. Technological developments have offered possibilities to connect with others in ways we might not have considered previously; home working and schooling have allowed families to spend more time together, and services have learned to adapt by conducting assessments and delivering interventions remotely. Some individuals have gained new perspectives on life and mortality, and opened up important conversations about death and dying and end of life care. Others have found novel ways of creating meaningful connections with loved ones, and saying goodbye in different ways. Public mourning and the shared experience of loss may also have provided some comfort to those dealing with bereavement.
As we continue to see an uptake in vaccination rates, easing of restrictions, and reductions in COVID-19 cases and fatalities, we can also have hope that some of the additional challenges associated with loss and grief, especially during the first waves of the pandemic, are alleviated.
Looking after yourself and others
A final point I’d like to make is that there is no right or wrong way to grieve. Reactions to loss are personal and individual, and do not follow a set timeline. But there are some key points we might wish to keep in mind when dealing with loss (either through death or otherwise):
- Look after yourself. All of us will struggle at times, and it’s okay to not be okay. If you feel grief, give yourself permission to grieve. Grief may resurface, some days may be harder than others, and we are living through different times. It’s important to acknowledge loss and express grief, but it’s also valuable to allow yourself time to rest, do something fun, and engage in “restoration-oriented” activities .
- Reach out for support when needed. Connect with loved ones, whether in person or through other means. Many services and organisations (relating to bereavement, suicide, and others) have continued to offer support throughout these times, albeit in slightly adapted ways. A list of potentially useful resources is provided below.
- Reach out to others who might be struggling. For people dealing with the death of someone significant, having someone there to listen can be one of the most important and helpful things others can do. People might worry about saying the wrong thing, but often just acknowledging the death and simply being there is more important than finding the perfect words. Several resources exist with helpful suggestions on how to reach out to others who are dealing with a death (e.g. Finding the Words, Talking to a bereaved person, How can other people help?, Supporting a grieving friend or relative, and What to say to someone who has been bereaved)
- Remember loved ones in different ways. Our ability to collectively grieve and physically support each other may have been put on hold at the height of pandemic restrictions, but we can still honour loved ones in different ways through alternative memorials and celebrations of life. World Suicide Prevention Day is one opportunity to reflect and remember those who have died. Whether or not we have been individually affected by suicide, or other deaths, we all know someone who has, and we don’t always know what their struggle looks like. Let us use this opportunity to provide some hope and light to those who might be struggling in the darkness.
Finding support for bereavement
If you or someone you know would like more information or support on dealing with bereavement, a non-exhaustive list of UK-based resources are listed below.
- Your General Practitioner or NHS 111
- After a Suicide (booklet): www.samh.org.uk/documents/After_A_Suicide.pdf
- At a Loss: www.ataloss.org
- BAMEStream Bereavement Support Service: www.bamestream.org.uk
- Child Bereavement UK: www.childbereavementuk.org
- Childhood Bereavement Network: childhoodbereavementnetwork.org.uk
- Cruse Bereavement Care Scotland: www.crusescotland.org.uk
- Cruse Bereavement Care: www.cruse.org.uk
- Help is at Hand (booklet): supportaftersuicide.org.uk/wp-content/uploads/2020/04/HIAH_Booklet_2021_V5-1-2.pdf
- SANDS: www.sands.org.uk
- Sudden: sudden.org
- Support After Suicide Partnership: supportaftersuicide.org.uk
- Survivors of Bereavement by Suicide (SOBS): www.uk-sobs.org.uk
- The Compassionate Friends: www.tcf.org.uk
- The Good Grief Trust: www.thegoodgrieftrust.org
- The Loss Foundation: thelossfoundation.org
- Widowed and Young: www.widowedandyoung.org.uk
- Winston’s Wish: www.winstonswish.org.uk
- World Health Organization. (2021). WHO Coronavirus (COVID-19) Dashboard: The United Kingdom. https://covid19.who.int/region/euro/country/gb
- World Health Organization. (2021). WHO Coronavirus (COVID-19) Dashboard: Global Situation. https://covid19.who.int/
- Yardley, S., & Rolph, M. (2020). Death and dying during the pandemic. BMJ, 369, m1472 https://doi.org/10.1136/bmj.m1472
- Mayland, C. R., Hughes, R., Lane, S., McGlinchey, T., Donnellan, W., Bennett, K., Hanna, J., Rapa, E., Dalton, L., & Mason, S. R. (2021). Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic. Palliative Medicine, 1-12. https://doi.org/10.1177/02692163211019885
- Pearce, C., Honey J. R., Lovick, R, Zapiain Creamer, N., Henry, C., Langford, A., Stobert, M., & Barclay, S. (2021). ‘A silent epidemic of grief’: a survey of bereavement care provision in the UK and Ireland during the COVID-19 pandemic. BMJ Open, 11(3), e046872. doi: 10.1136/bmjopen-2020-046872
- Public Health England. (2020). Disparities in the risk and outcomes of COVID-19. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/908434/Disparities_in_the_risk_and_outcomes_of_COVID_August_2020_update.pdf
- Stroebe, M., & Schut, H. (2010). The dual process model of coping with bereavement: a decade on. Omega; 61, 273-289. https://doi.org/10.2190/OM.61.4.b