A new study by authors from the University of Cambridge suggests that major changes in bereavement care – and indeed the meaning of bereavement – have taken place during the COVID-19 pandemic.
The first A major study of pandemic-related changes in bereavement care has found that the shift to remote working has helped some services reach them, but many practitioners feel they are unable to meet people’s needs /p>
The study was published in March January 2021, in the journal BMJ Open.
It is estimated that for every death, nine people experience a bereavement. The magnitude of the impact of the COVID-19 pandemic on the bereaved is now becoming clear.
The meaning of grief shifts as the number grows
Those whose loved ones have died from COVID-19 have had to cope with sudden and unexpected deaths, deaths in intensive care units and seeing loved ones at the end of their lives suffering from severe symptoms such as shortness of breath and agitation. Social distancing measures have resulted in end-of-life visits being restricted and some dying alone without an opportunity to express their condolences.
Course viewing and burial procedures have been severely restricted, with a major impact on the bereaved for all reasons, not just COVID-19. All of these factors mean that the risks of complicated and protracted grief reactions have increased during the pandemic.
In a study published today in BMJ Open, researchers from the Cambridge Department of Public Health and Primary Care report the results of an online Survey sent to health and social care workers in August 2020, asking them to describe their experiences and views on changes in bereavement care. 805 people responded, including those working in communities, care homes, hospitals and hospices in the UK and Ireland.
Bereavement services under pressure: a 600% increase
Services faced initial Challenges Adapting to changing national government policies. Some funeral services have been suspended because staff have been furloughed or hired, particularly specialized funeral services. Support for volunteers in hospitals and hospices was reduced and some services saw longer waiting lists.
“We had a 600% increase in deaths over a 3 week period. Dealing with the backlog of bereavement support has been challenging,” said one palliative care practitioner.
Bereavement support has fallen to a wider range of staff, including some with limited experience. Some people reported that before the pandemic, services were underserved and that the pandemic would exacerbate the situation and add new difficulties due to the complex grief responses.
Distance grief and what it says about the meaning of grief
The biggest change was the move to remote support methods like phone and video, reported by 90% of respondents. Adapting care to online or phone formats was a particular challenge due to limited access to the necessary equipment and staff training on how to use it.
Moving to remote support was a double-edged sword. On the one hand, this has expanded some of the options for bereavement support. Services supporting children and young people at times reported that these groups were more receptive to online support, and hospices and hospital teams reported that they were expanding access to their bereavement support. However, practitioners described remote work as “draining” and difficult to cope with, alongside their own emotional burdens during the pandemic.
Some practitioners feared being overwhelmed by demand: “We really only see those who there were bereaved in January/February, so there may be many more to come,” said a coordinator for the Community Listening Service.
Less emotional support to spread
The changes to the services were Reportedly interfering with the ability to offer emotional support: “It felt like we were at arm’s length with them while we were there to hold their hands and give them a hug when needed,” said a Palliative care professionals.
Many respondents expressed great concern about the long-term impact on bereaved families, emphasizing that the inability or limitations to care for the dying patient a, have a profound impact on bereavement.
“Many people who died were denied the opportunity to die in their preferred place of c are/preferred places of death and died in suboptimal environments to ensure their care in the received in recent days,” said one GP.
Anger and stigma: the stamp of Covid-19
While these survivors of COVID-19 and non-COVID diseases were similar Wisely affected by the restrictions, specific challenges related to COVID-19 have been reported. Some respondents described family anger at having COVID-19 on the death certificate.A specialist bereavement liaison nurse said the disease “appeared to carry a ‘stigma’ for some”. It has been hypothesized that this sense of stigma reinforces people’s feelings that they have failed to protect their family members from COVID-19.
Concerns about a large and “invisible cohort of people” have been raised expressed who may not have access to support or for whom support is being restricted, leading to greater unmet needs. “There may be a silent epidemic of grief that we haven’t addressed yet,” said one palliative care practitioner.
The meaning of grief will continue to change
Dr. Lead researcher Caroline Pearce said: “Bereavement care has undergone major changes in both the acute and community settings, affecting bereaved families, clinicians, support workers and the broader health and social care system. The increased need for bereavement support has challenged practitioners as they took on new responsibilities and skills and transitioned to remote and electronic working. The increased potential for prolonged and complicated bereavement responses among bereaved families during this time is of particular concern.”
Andy Langford, Clinical Director, CRUSE Bereavement Care, added, “Speaking out about bereavement remains an area of public uneasiness , and it is important that practitioners encourage bereaved people to consider grief as a “legitimate” reason to seek help from health and community services and from those they trust in their communities. It was encouraging that many respondents reported the development of new and expanded services, but it is imperative that these are made sustainable over the longer term. The need will not go away.”
Pearce, C et al. “A silent epidemic of grief”: a survey of the provision of bereavement support in the UK and Ireland during the COVID-19 pandemic. open BMJ; March 1, 2021; DOI: 10.1136/bmjopen-2020-046872