Grief During a Pandemic
The death of a loved one is one of life's most difficult experiences, and when a loved one dies during the COVID-19 pandemic, regardless of the cause of death, beginning the grief journey can be more complex. Along this journey, you will encounter some difficult and sad moments, as well as some pleasant moments, as you reflect on the good times and experiences you and your loved one shared. Those feelings are a normal part of the grieving process. Remembering A Life is here to help - to guide you through this challenging time and inspire you to embrace your grief as an important part of the grieving process.
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Foreword
By Alan D. Wolfelt, PhD
Someone you love has died. The death of a loved one is always difficult, but it is likely that the COVID-19 pandemic has made the circumstances of the death, as well as your family’s grief, especially challenging.
As you know, hospital visitations, travel, and gatherings have been severely restricted. You may have been prevented from visiting the person who was dying, traveling to be near the person or other loved ones, and even holding a funeral (or the service you wanted). And others may have been unable to visit you and offer their support in person.
No matter the cause of the death, these exceptional circumstances are no doubt making things even more distressing for you and your family. I am sorry you have been so deeply affected by this time of hardship.
The information in this booklet will help you better understand your unique grief and the care for you’ll need for yourself and your family (including children) in the months to come. In the short-term, it will also help you work with your funeral director to put together a funeral or memorial service plan to best meet your family’s needs to grieve, mourn, and support one another.
Remember, there is no rulebook for what we are experiencing during this pandemic. You are doing the best you can, given the situation. So is everyone else. Be kind to yourself, and though the stress of traumatic grief can certainly make it difficult, try to be patient with others.
Perhaps the one “rule” is to be open and honest as you share your thoughts and feelings with friends and family. Expressing your inner grief is called mourning, and over time and with the support of others, mourning – bit by bit, day by day – is how you begin to integrate this tragic loss into your life.
And please hold onto hope. Even as you are grieving, the people and activities that help you feel hopeful about the future are a lifeline right now. Look to them for comfort and connection.
About the Author
Alan D. Wolfelt, PhD, is an author and educator on companioning others and healing in grief. He is on the faculty of the University of Colorado Medical School’s Department of Family Medicine and serves as director of the Center for Loss and Life Transition, in Fort Collins, Colorado.
Grieving in a Pandemic
The Nature of Grief
Grief is our emotional response to loss. Many emotions, including anger, guilt, sadness, depression, loneliness, hopelessness, and numbness may be present after the death of a loved one. While grief is a universal experience and all of us will experience grief many times over the course of our lives, every grief experience is also unique. We do not grieve in the same way over different losses, and individual survivors grieve the death of one person differently.
At this particularly difficult time, it is important that you give yourself permission to feel the emotions you are feeling, which may change from day to day or even from one moment to the next. There is no “wrong” or “right” way to grieve because your emotions reflect both your special relationship to your loved one and the circumstances of their death.
Traumatic Loss
Losing a loved one in the midst of this pandemic is a traumatic experience. If we lose someone suddenly, or if we were not able to be with them while they were dying, our grief responses are complicated by the traumatic nature of the loss. Survivors may feel overwhelmed with thoughts of their loved one’s death. They may experience intense distress in yearning or searching for the deceased due to their sudden separation. The bereaved may also experience emotional distress along with their other grief emotions, including feelings of emptiness, disbelief, and distrust in other people.
If you are experiencing any of these feelings, know that they are normal responses to the abnormal circumstances of your loss and that, with time and support, they will lessen. Talking about these feelings with close family and friends may help you recognize, sort out, and understand your emotional responses to loss and to trauma.
Traumatic Loss Triggers
A loved one’s death during this pandemic can lead to both grief and trauma, which may cause survivors to experience triggers of their loss that can temporarily disrupt them as they begin their mourning process.
A trigger can be anything that provokes distressing memories of the loss – from an image on the news or the sound of a phone ringing, to the sight of a loved one’s clothing or the scent of their perfume. When we are confronted with a traumatic loss trigger, we might feel immediate, high levels of fear and anxiety, like being suddenly on guard, or physical reactions, such as our heart pounding, our palms sweating, or our mouth going dry.
As a survivor, you might be experiencing some of these responses or other kinds of responses to triggers that cause distress. Responses to trauma vary, and everyone’s reaction is different. Even painful reminders of your loss experience are all ways in which the mind and the body are trying to process your loss and integrate it into your life. While your instinct might be to try to avoid potential triggers, you should try not to isolate in your grief. Most people who experience traumatic loss triggers will find that they gradually lessen over a period of days to months.
Ambiguous Losses
Grief following a loved one’s death can be complicated during this public health crisis because we are all experiencing non-death losses at the same time. Some may be concrete and easy to identify, such as financial or employment insecurity and lack of social interaction. Other losses might be harder to recognize, like no longer having the comfort of our normal routines or freedom of movement in public spaces.
We may also be experiencing the losses of our “assumptive world” – the set of core beliefs that stabilize, ground, and orient us and make us feel secure in our daily lives. Pandemic, like other forms of traumatic and mass casualty events, can threaten our belief that the world is, or ever will be, a safe and secure place.
Grieving a death while dealing with non-death losses can feel overwhelming for several reasons:
- Many of the non-death losses you are experiencing may have directly impacted the degree to which you could be with your loved one prior to their death, which might prompt feelings of anger and regret
- The death may make the effects of your non-death losses feel stronger, particularly losses of interaction and movement
- You might feel that your grief isn’t being recognized and supported as it would have been if your loved one had died at another time because everyone is currently experiencing non-death losses
While you grieve your loved one, try to recognize and validate the other losses you are experiencing as a way of making sense of how these losses impact one another for you personally.
Risk of Disenfranchised Grief
In addition to other complications to grieving the loss of a loved one during this pandemic, survivors are at risk of experiencing disenfranchised grief. Anyone suffering a loss whose grief is not openly acknowledged, socially validated, or publicly observed can experience disenfranchised grief, including survivors in a pandemic. When the number of people who die of a single virus is extremely high, one may feel that their loved one’s death is not receiving attention or is only being treated as a statistic.
Your grief responses may include feelings of helplessness and powerlessness if you believe that your individual loss is not being acknowledged, validated, or treated with care. Here are steps to take to reduce these effects:
- Practice emotional self-care by identifying your losses and validating your feelings about them
- Ask for support from the friends and family who will respect and listen to your individual grief experiences without giving you unsolicited advice
- Plan memorials and tributes to your loved one, both now and in the future, that will help you feel recognized and acknowledged in your grief
Children and Grief
Acknowledging children’s grief after the loss of a loved one is always important. Each child grieves uniquely, just as adults do, and children deserve open and honest communication about the death of someone they cared about so they can make sense of the loss and begin their own mourning process. The coronavirus pandemic has already created an unstable world for all of us, including children, who have experienced losses of social interaction with friends and classmates and the challenges of distance learning and media exposure. In supporting children in their grief, we should:
- Communicate honestly and repeatedly about the loss and their loved one. In talking to children about a death, we can’t expect them to be able to process the loss in one conversation. Involving children in honest conversations about the loss and how their loved one died, as well as sharing memories of the deceased, will help them to recognize that the death has occurred, that death is permanent, and that they have a right to their feelings about it. Sharing our feelings with children and asking about their feelings teaches children that we all have our own individual emotions and that we can feel, and mourn, differently but together.
- Use clear and appropriate language. The language we use in communicating with children should be accurate and developmentally appropriate. There are no means of death that children cannot understand if given clear and simple language. Avoid phrases that cloud a child’s understanding of what death is, such as “went to sleep,” “passed,” and “went away.” If your loved one died of complications of COVID-19, explain to children what the terms “coronavirus” and “pandemic” mean, especially since they have heard these words so frequently and menacingly throughout this health crisis.
- Recognize that children will guide you in supporting them. Children often need time to process the information they receive about a loss before wanting more information. Assure them that you are always there to answer any questions they have and will answer them honestly. When children know they can come to you to ask questions, express their emotions, or simply receive a hug, they will do so. Often, younger children may engage in magical thinking and believe that something they did or didn’t do caused a loved one to die. Older children may feel shame or regret for interactions they had in the past with the deceased. Reassure children of all ages that what happened was not their fault and remind them of the love felt by the deceased for them and from them.
- Include children in memorialization. If physical distancing guidelines prevent children from being part of a viewing or funeral service, or if you are planning a memorial service to take place when the pandemic has ended, create other opportunities to memorialize your loved one that include children. Children often work through their grief by using play and creativity. Doing art and crafting projects together that memorialize the deceased, creating collages or scrapbooks of pictures or drawings of them with the deceased, and giving them “feeling journals” to write in as they work through their emotions can all help children come to terms with their loss.
If You Were Separated From Your Loved One at the Time of Their Death
If you were unable to be with your loved one while they were sick or could not be with them when they died, you may feel robbed or cheated of time with them in their end-of-life moments. You may feel angry that the coronavirus pandemic required protocols that kept you from being at their side, and you may feel disoriented in beginning to mourn while wrestling with these circumstances. All of these feelings are justified, and nothing about your experience was deserved.
There are no words possible to erase the pain you may be feeling at not being with your loved one during their death, but it can be helpful to remember that a life is far more than its endpoint. The life of your loved one was made up of millions of moments, including moments of laughter, happiness, and joy, many of which you shared with them. Remembering these shared moments might help you remind yourself that you carry your whole relationship with your loved one with you as you move forward with your grief.
While dying is essentially a process that each of us does on our own, it is natural to want to be with someone meaningful to us when they are dying. Being present in their final days and hours allows us to prepare for the loss we will experience and also to provide comfort to them. Right now, you may feel upset on behalf of your loved one because they had to die without the benefit of family and friends at their side. That feeling is understandable. Know, though, that they did not die alone. Their death was witnessed and felt by compassionate nurses, doctors, and other healthcare professionals who sought to surround them with care and comfort. And, importantly, they died while wrapped in the love they felt for you and from you throughout their life.
Planning Funeral and Memorial Services
Funeral and memorial services are central to our grieving experiences. When we experience a death, the funeral ritual is often the first and most important way in which we give and receive support, affirm our relationship with the deceased, honor the life that has ended, and begin to transition to a changed life for ourselves. Funerals serve many important psychological, social, and spiritual purposes, and we are used to having choices in planning funerals to fulfill those purposes.
Because of physical distancing guidelines and other safety protocols, you may feel frustrated or upset about planning a funeral or memorial right now. Those feelings are reasonable, and it is important that you are able to plan rituals that still allow for the purposes of a funeral that are most valuable to you and that will honor the life of your loved one. Even with restrictions due to the pandemic, you still have choices and options to plan a service – or services – that will help you and your family as you begin your mourning processes.
Talk with your funeral director while you consider your wishes. Funeral directors are our partners in navigating the loss of a loved one in this pandemic and are similarly navigating ways to best serve you when you experience a loss. They are a key resource to help you create tributes and plan meaningful ways to honor your loved one. Funeral directors recognize that restrictions on services pose challenges and frustration for grieving families and working hard to adapt to this public health crisis while continuing to help families understand the options available to them to honor their loved one in ways that are safe.
You are also encouraged to discuss the specific precautions the firm is taking to comply with CDC and state guidelines to limit exposure to the coronavirus, including restrictions on the number of attendees at private services, physical distancing within the funeral home and use of masks, disinfectant, and hand sanitizer.
When you meet with your funeral director, talk through strategies for planning services and ask about their ability to provide webcasting or recording services if those are of interest to you. You can also ask them for suggestions for youth involvement in the funeral.
There are a number of ways to honor your loved one meaningfully during and after this pandemic. Just as our grieving is unique, so too are our memorialization decisions. There is not a one-size-fits-all approach to planning the funeral of a loved one in ordinary times, and there shouldn’t be a one-size-fits-all approach to it during this time, either. Give yourself permission to explore options with your funeral director and make the decision that is best for you and your family. Some plans to consider:
- Having a private viewing limited to close family and friends
- Having a private service for close family and friends
- Having a private viewing and/or service with a public memorial in the future
It might feel overwhelming to select who can attend a private viewing or service, especially in a large family. You might be worried that holding a memorial service in the future will feel “too late” and that your loved one’s death will not receive the attention and acknowledgment deserved. Instead of trying to plan the “best” service for your loved one, it might be helpful to focus on planning a viewing or service that is the “best for right now” while choosing ways to honor the life of your loved one in the future, either formally or informally.
Determine which elements of an immediate viewing or service are important to you and the degree to which you are comfortable in incorporating technology. Technological adaptation practices that may be able to assist you in preserving your wishes for a service while allowing others to participate remotely include:
- Livestreaming a private service so friends and family can participate virtually in real time
- Recording a private service and sharing the recording selectively with others
- Collecting written remarks from family and friends via email and reading them at a private service
- Using memorialization pages on social media or funeral home websites so friends and family can share tributes to and memories of the deceased
Holding a memorial service in the future allows extended family and the larger community to support you and your family in your ongoing grief while celebrating the life of your loved one. The funeral ritual usually marks the beginning of the mourning process, but we know that mourning continues long after the funeral ends. Having a formal or informal memorial service in the future may benefit you and others by offering a time and place for giving and receiving support over your loss. It is never too late to honor our dead, and it is never too late to share our grief. Planning a larger and more detailed service in the future may also assist you in beginning to work through your grief by giving yourself the time to plan the service you most want.
If Your Loved One Died as a Result of Complications of COVID-19
CDC and state guidance note that funeral service professionals, using proper personal protective equipment, may safely and compassionately handle, embalm, cremate and bury the bodies of those who have died of the novel coronavirus.
Viewing the deceased is one of the most important options for survivors to have following a death. At the time of this printing, CDC guidelines state that viewing the body of a loved one who has died of COVID-19 is allowed.
Additionally, the CDC states that “there is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19.” Out of precaution, you should consider not touching the body, especially if you have underlying health conditions, or only touching the body if you are wearing gloves.
Supporting Your Health While Grieving
Taking steps that value your physical and emotional health is crucial while working through the early days and weeks of your loss during this pandemic. Some strategies include:
- Safety – follow the recommendations of experts to slow the spread of the coronavirus and minimize your chance of contracting it
- Routine – particularly in this stressful time, establishing and maintaining a routine can help you take some control over your daily life
- Nourishment – try to eat healthy, nutrient-rich foods and drink plenty of water
- Limiting alcohol – abusing alcohol or other substances can endanger your health while also hindering your grieving process
- Exercise – engaging in physical movement, even a short walk that adheres to social distancing regulations, can be helpful to your well-being
- Sleep – maintaining stable sleep patterns right after a traumatic loss isn’t always possible, but you should try to rest your mind and body even if you are experiencing sleep disturbances
- Mental health checks – “check in” with yourself and your feelings at least twice a day and more frequently whenever you are feeling particularly overwhelmed by grief
- Mood changes – traumatic loss can lead to rapid and upsetting mood changes. If you are experiencing mood changes, practice deep breathing and remove yourself from the environment (virtual or physical) in which you are experiencing them if possible
- News media – Make a pact with your family – or with yourself – that you will obtain news at certain, limited points of the day instead of watching repeated and stressful information all day long
- Seek support – whether through a phone call to a trusted friend, a tele-meeting with a grief counselor, or a video chat with a distanced family member to reminisce about your loved one, it is important that you obtain the support you deserve
Conclusions and Beginnings
Losing a loved one is hard under normal circumstances and experiencing the loss of your loved one during this pandemic is extraordinarily difficult. As you begin your grief journey, I encourage you to reflect on memories with your loved one and the particular gifts they brought to your life. We do not get over grief, we get through it. It is important that we honor our dead and share our grief into the future. This pandemic will end, but our love for those we have lost will not. After a death, we move forward into a world that has changed personally and permanently, but we do not leave our loved ones behind. We carry them with us, with the knowledge that our bonds cannot be broken, even by death.
About the Author
Sara Murphy, PhD, CT, is a death educator and certified thanatologist (Association for Death Education and Counseling). Dr. Murphy teaches at the University of Rhode Island and conducts workshops and seminars on death, dying, and bereavement nationwide for professional organizations, schools, and community groups.
About This Guide and the Funeral Service Foundation
The Funeral Service Foundation funded this guide and created it in collaboration with the National Funeral Directors Association and RememberingALife.com. A special thank you author Sara Murphy, PhD, CT and foreword author Alan Wolfelt, PhD for their commitment to serving those who are grieving the death of a loved one during the COVID-19 pandemic.
The content in this guide is intended to complement, but not substitute, the care and opinions from your funeral service professionals, health care providers and grief and bereavement experts. Please seek professional advice if you have any concerns.
Since 1945, the Funeral Service Foundation has served as the profession’s philanthropic voice. The charitable arm of the National Funeral Directors Association since 1997, the Foundation awards scholarships, offers tools and resources and makes grants to organizations that advance its mission to support funeral service in building meaningful relationships with families and communities.
Copyright © 2020 Funeral Service Foundation. Permission is granted for educational and nonprofit use of the publication and content, with acknowledgement. All other rights reserved. Published by the Funeral Service Foundation, 13625 Bishop’s Drive, Brookfield, WI 53005.