Category: Death and Dying

By Laura Ward

The COVID-19 pandemic has changed our lives in so many ways including the devastating impact on how we are able to mourn the death of our loved ones. When a death occurs, we have patterned ways of responding based on tradition, culture and religious beliefs. 

These responses are comforting for both the bereaved and for those providing support.  Soon after receiving word of a death, our support system mobilizes. People often begin showing up with food or flowers, jumping in to care for the children of the bereaved offering to run errands or help arrange a memorial event.   Cultural or religious beliefs provide ritualized ways to mourn which offer comfort in their significance and predictability.  These rituals mobilize community support for the mourners.   Muslim communities wash the body, wrap it in a piece of cloth and bury their dead quickly and in the presence of loved ones. This allows the soul to rest peacefully.  Christian and Jewish traditions call for close proximity with the dead in order for those left behind to confront their loss.  Events such as Repass, and Shiva allow survivors to find refuge in their communities.  In some cultures, those close to the bereaved will take turns sitting vigil with the family for days or even weeks after a death. 

During this health crisis, social distancing has made it so that people are unable to grieve their loved ones in traditional ways.  Without these rituals and the opportunity to be in the presence of the person who has died, see the casket and be around other people grieving the deceased, it can be harder for those grieving to make sense of the loss and eventually accept that their loved one has died.  Having traditions to follow and a set of rituals enables people to integrate the loss into their life.  Without this element of face-to-face support and left alone in quarantine, people experiencing losses may suffer more due to the isolation necessary for social distancing.  Social isolation has also been shown to prolong grief. 

In addition, we are in a stressful time, people are experiencing many losses beyond the death of a loved one ― including the loss of a job, savings, sense of identity and more. These additional stressors can get in the way of grieving normally, additionally those who would normally support the bereaved might be distracted by these stressors in their own lives and may be less emotionally available to provide support.  Also, people are overwhelmed with fears about contracting the virus or losing more loved ones to COVID-19. These all-consuming feelings may prevent people from acknowledging their grief, but it’s important to create space for it. Delaying grief is not healthy and can lead to long-term physical and psychological challenges. Instead of holding grief in, find new ways to go through the grieving process and say goodbye to your loved one within the limits of social distancing.

You don’t have to be alone.  It’s important to avoid withdrawing from friends in your grief even though we can’t support each other in person at this time.  The best thing we can do when we are grieving it to reach out as much as you can to family members through phone calls and video platforms.  Friends and family members can gather via chat conference to talk about their lost loved one, share memories or simply cry together and know they aren’t alone in their grief. Sending emails and letters to people in your network is another way to take part in a collective grieving process. I have often had clients speak about how meaningful it is to receive letters which include personal stories or experiences of their loved one that has died.  Some families or group of friends start group text chains to check-in or share memories or thoughts of the deceased.  The key is to talk to someone else about your feelings, rather than keep them bottled up. It’s important to find connection in whatever ways you can. Being intentional about the emotional bonds that are still present can provide some comfort, this is not the same as being able to have a hug or to sit together in close proximity but the virtual connections can be a way in which the emotional connections can be expressed where we are at now.  If you lack the motivation to follow through on connecting, try to book times for phone calls and video chats. Arrange these conversations as appointments you must keep. Agree on times with people in advance so you are more likely to follow through. Of course, choose to connect with people who provide healthy support, are responsive and flexible about your needs.  The amount of contact we need and want can vary on a daily basis and it’s helpful to connect with those who are understanding of this. 

Funerals and memorial services are valuable both on a practical to provide structure in that they give people tasks and a way of coming together to grieve.  They provide confirmation of the death though being able to view the body and grieve in community.  Physical touch through hugging our love ones is incredibly healing.  This coming together also empowers social support and connection, reassuring us that we are not alone in our loss.  Celebrating a loved one’s life in a public group setting with others is a very healing part of the grieving process, but social distancing and stay-at-home orders mean many families must delay memorial services for an unknown amount of time. The uncertainty of when they might be able to honor their loved one in this way is difficult and anxiety-provoking. Recognize that this is temporary and although there is a delay, these services can still take place and it is important that they do in order.  It can be helpful to think of these services as being delayed rather than cancelled. 

Depending on where you live and how you’ve been social distancing, you may be able to have a small service with immediate family, and there are ways to include others in the experience.  Many funeral homes are offering livestreaming of graveside services or larger, interactive virtual funerals.  Some allow immediate family the right to attend the burial process, while still following the CDC recommendation of no more than 10 people gathering in the same space. Mourners can still drive by in their vehicles in a parade, staying in their car while offering their respects.  Others have offered drive-thru windows with a video of the person on a monitor or in-person visitations with two people allowed in at a time and disinfecting between visitors.  One benefit of virtual funerals is that people who ordinarily might not be able to attend services, due to living far away, finances or even a discomfort with grieving in public, are now able to participate.  However, this process will not work for those who do not have or are uncomfortable with technology. It’s unclear when traditional funerals and grieving rituals will be an option in the future, but that doesn’t mean it’s impossible to process your grief and move forward in this uncertain time. Recognize your feelings of grief, loss and sadness as normal during this time. 

Identify and acknowledge any thoughts feelings that arise and let yourself move through them.  A wide range of feelings are normal during grief and it is often described as a roller coaster of emotions. Expressing whatever comes up can be helpful and writing out your feelings can be a therapeutic experience in times of grief. You can keep a private journal for your eyes only or even write a tribute to share with loved ones.  Some people find healing through writing a letter to the deceased.  Remember the times you spent together and share these memories with loved ones. Looking through photos can bring comfort, creating a photo slide show or music playlist can be another way of honoring and celebrating the relationship with your loved one.  Just like a written tribute, it can be shared now online or at a future memorial service.  Make a memory box, draw or scrapbook.  Engaging children and adolescents in these activities can also give them an avenue to process their grief. Consider other rituals that will allow you to express your grief now…light a candle, create some art in their memory, plant a tree or cook your loves one’s favorite meal. 

Generate a plan for coping.  Ask yourself how you usually take care of yourself during a difficult time and modify these to work in the current situation.  You can still do things like read, take a bath, go outside, eat healthy meals and nap.  You might find it useful to think about how your lost loved one would like you to respond in these circumstances. You can use this exercise to help generate coping strategies. Recognize that less activities in our lives make more time for thinking and feeling, this can be good and also overwhelming.  Distract yourself on occasion with activities you enjoy or try something new.  Moderate your news intake and be gentle with yourself around fear related to the pandemic. 

If more support is needed, reach out to the professionals.  Grief support is being offered online by many hospices and mental health professionals including Hospicare.  At Hospicare, we offer both individual and grief support in an online format.  There are social media groups for grief support as well as many online resources.  At hospicare.org/blog you can watch videos made by our interdisciplinary team with tips, resources and activities to cope with grief.  Connecting with online communities of grieving people help grievers feel less alone.  Talk to your doctor if you are experiencing physical symptoms of grief.  Grief is hard, it’s a different experience for everyone and there is no right way to grieve.  Practice self-compassion, allow yourself to have a good cry and take good care of your mind and body during this challenging time.