A dor que não pode calar: reflexões sobre o luto em tempos de Covid-19

Abstract

Resumo A Covid-19 provocou número elevado de perdas e mudanças nos processos de cuidado e despedida, fatores que podem dificultar a elaboração do luto. Objetivamos, assim, compreender as particularidades do luto no âmbito da Covid-19, ressaltando a importância da adaptação e da criação de estratégias voltadas ao cuidado da saúde mental nos processos de luto. O ensaio realiza um panorama teórico, indicando elementos presentes na pandemia com potencial para interferir no luto, e apresenta um levantamento de iniciativas adaptadas a tal contexto. A pandemia trouxe mudanças na forma de experienciar o morrer. Evidenciam-se iniciativas na tentativa de mitigar os efeitos emocionais, cognitivos e comportamentais. O momento convoca a repensar conceitos e (re)criar compreensões acerca da morte e do luto, ressaltando-se a importância da Rede de Saúde Mental, com o fortalecimento de ações de base sociocomunitária, reconhecimento de diferentes níveis de complexidade das demandas e acesso organizado à atenção especializada.

Family grief during the COVID-19 pandemic: a meta-synthesis of qualitative studies

“…Social isolationmostly adopted as a measure to contain the virus -negatively affects the grieving process since it impairs the exchange of social support and the monitoring of the deceased during the illness and after death 49,50,51,52,53,54 . Such impact, widely reported by the bereaved family members who participated in the reviewed studies, is in line with the indication that these experiences with loss, intensely affected in the context of a pandemic, affect the mental health of the population and lead to emotional, cognitive, and behavioral changes, possibly culminating in more intense and lasting grieving experiences 12,49,50,55,56 . The literature recognizes, above all, the restrictions and drastic changes that occurred in traditional funeral rituals (with a limit on the number of participants and reduced duration), which, according to the bereaved family members studied, generated suffering and hindered social support, which generated the impossibility of saying goodbye in two different moments, namely: in life, while the deceased relative was hospitalized, and in death, during the funeral rituals 12,49,50,56 .…”

“…Thus, the bereaved family members in the selected studies recognized that there were online alternatives to the restrictions to in-person meetings and the performance of traditional rituals, which contributed to dignifying the deaths and accepting the loss. The use of technologies favored online communication with relatives during hospitalization, dignifying the dying process 12,64,65,66 and allowing a closer relationship with health care teams, which may positively contribute to the grieving process 49 . Despite recognizing the importance of humanizing the support toward the bereaved family members and those who died due to COVID-19 12,66,67 , none of the selected articles explored the announcement of death, contrasting with the indications that this is a key moment for the family of the deceased 68,69,70 .…”

“…Such changes in grief, caused by the COVID-19 pandemic crisis, highlighted areas for future studies which also seem to be related to implications for mental health, with increased rates of depression and anxiety, as well as persistent grief. Scientific literature also indicates a psychological crisis, which can persist even after the pandemic 1,12,13 .…”

“…Coping with crisis demands interventions aimed at preventing critical situations, acting in the emergency and post-emergency recovery 12 . When the COVID-19 pandemic was established, actions could have been planned and adopted to deal with the moment of crisis and to reduce its consequences.…”

“…When the COVID-19 pandemic was established, actions could have been planned and adopted to deal with the moment of crisis and to reduce its consequences. In this sense, studies suggest the importance of public policies that consider comprehensive care, from socio-community-based actions to specialized care to accompany bereaved people 12 . Understanding the particularities of the grief experience during the COVID-19 pandemic is essential to develop and apply effective intervention strategies.…”