Bereavement During COVID

The COVID pandemic and ensuing restrictions have had a lasting impact on those experiencing bereavement during this time. Significant challenges and distress have been experienced, but there have also been opportunities for grief to be expressed in new or different ways.

COVID highlighted the need for research evidence to inform development of resources to support bereavement. In particular there was a clear gap in provision of support to those who usually grieve with family and friends, rather than requiring professional support.

This resource has been developed by researchers at the University of Southampton in collaboration with people who have been bereaved and bereavement professionals. Based on a review of the evidence and a survey with bereaved people and professionals we identified key elements of family bereavement support.

Here we summarise some of the main findings of the survey.

Experiences of Death

Where the person was cared for had a significant impact on the bereaved. Visiting restrictions and how they were enforced in hospitals and care homes meant an inability to be present during the dying process, to bear witness, which alongside the sudden nature of many deaths resulted in incomplete endings.

Making decisions regarding who could visit if only one family member was allowed, alongside fear of infection or transmission of the virus, and the requirement for personal protective equipment to be worn, were also sources of distress. For some, visitor restrictions led to family conflict.

Health and bereavement services adapted their ways of working, utilising technology via video calls, text messaging and social media to facilitate contact and provide regular information and support. They often went the extra mile with acts of kindness which provided comfort.

The Impact on Funerals and Cultural Rituals

Following a death, the collection of death certificates, visits to registry offices and appointments with funeral directors had to be arranged online or by telephone. This prevented opportunities for bereaved families to meet professionals, ask questions and begin to make sense of the death.

Restrictions disrupted funerals, cultural rituals and usual ways of mourning. This lack of celebration usually afforded by religious and cultural traditions increased isolation and feelings of guilt at not being able to mark the life of the person who had died.

However, new ways of mourning including online funerals enabled greater access, and where recorded provided a lasting memorial. When funeral services were able to take place some found that restrictions on numbers of mourners meant the experience was more intimate and did not require them to conform to ‘normal’ societal expectations.

The Impact of Social Restrictions

Social restrictions exacerbated isolation for the bereaved and were a source of frustration when they were deemed unnecessary or there was conflicting guidance. The restrictions also resulted in delays in bureaucratic processes and reliance on technology with lack of face-to-face support. Social networks and usual routines which bring comfort were disrupted such as seeing, family and friends, attending church, going to the gym, or work. This increased loneliness and impacted mental health and wellbeing.

However, time away from ‘normal’ life enabled families to take grief slowly, providing space and justification for not having to socialise. Some formed support bubbles or disregarded restrictions for the greater good of caring for one another. For others online groups, inner faith, or starting fundraising activities were used to combat isolation. It was widely recognised that the changing restrictions and the associated uncertainty was universal.

The Impact of Media Reporting

In the media, misinformation, mixed messages and contradictions in public health and safety information were a source of frustration and anger. The prevalence of death reporting via mass statistics was difficult for some people minimising or overshadowing their own experience of grief and pain. However, the widespread social acknowledgement of grief allowed the experience of grief to be widely recognised which could help discussions between friends and family.

Recommendations

The survey responses demonstrate that despite significant distress there have been positive changes afforded by COVID and it is important that these are retained in the future.

  • Celebrate and remember the kindness and compassion that was shown within families and communities during the height of the pandemic.
  • Use the opportunities provided by widespread media coverage of death and bereavement to continue conversations within society and between families and friends.
  • Sustain and develop further new ways of working and communicating particularly the use of technology.
  • Continue to develop new funeral practices and ways of memorialising.

Funding

The initial work to develop this resource was supported by the National Institute for Health Research Applied Research Collaboration Wessex (NIHR ARC Wessex). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this website.

Ongoing iteration of the resource has been funded by a University Hospital Southampton research and development grant.

How to Cite this Resource

Campling N, Lund S, Brooks C, Allam A, Myall M (2022) Supporting families and friends in bereavement. University of Southampton. Available at: www.familiesinbereavement.org.uk