‘A silent epidemic of grief’: a survey of bereavement care provision in the UK and Ireland during the COVID-19 pandemic

Abstract

ObjectivesTo investigate the experiences and views of practitioners in the UK and Ireland concerning changes in bereavement care during the COVID-19 pandemic.DesignOnline survey using a snowball sampling approach.SettingPractitioners working in hospitals, hospices, care homes and community settings across the UK and Ireland.ParticipantsHealth and social care professionals involved in bereavement support.InterventionsBrief online survey distributed widely across health and social care organisations.Results805 respondents working in hospice, community, and hospital settings across the UK and Ireland completed the survey between 3 August and 4 September 2020. Changes to bereavement care practice were reported in: the use of telephone, video and other forms of remote support (90%); supporting people bereaved from non-COVID conditions (76%), from COVID-19 (65%) and people bereaved before the pandemic (61%); funeral arrangements (61%); identifying bereaved people who might need support (56%); managing complex forms of grief (48%) and access to specialist services (41%). Free-text responses demonstrated the complexities and scale of the impact on health and social care services, practitioners and their relationships with bereaved families, and on bereaved people.ConclusionsThe pandemic has created major challenges for the support of bereaved people: increased needs for bereavement care, transition to remote forms of support and the stresses experienced by practitioners, among others. The extent to which services are able to adapt, meet the escalating level of need and help to prevent a ‘tsunami of grief’ remains to be seen. The pandemic has highlighted the need for bereavement care to be considered an integral part of health and social care provision.

Changes in mortality patterns and place of death during the COVID-19 pandemic: A descriptive analysis of mortality data across four nations

“…The rise in hospital and community deaths indicates that need for palliative care services in these locations have increased. Studies have highlighted marked changes in palliative care services during the pandemic 3,28,38,39 . It will be important to address the barriers highlighted by these studies, including remote consultations, service adaptations and increased community resources.…”

Mental Health, Culture and Resilience—Approaching the COVID-19 Pandemic From a South African Perspective

“…The respondents of a UK-based study that was conducted on individuals who were bereaved during the pandemic highlighted the benefit of after-death rituals, including funeral attendance, as a meaningful way for the bereaved to pay their last respects ( 14 ). Visiting the sick, offering a prayer, and performing rituals for the sick and those who are dying are practices common to most societies, and abandoning these may result in complex bereavement issues, as described by some countries that experienced the pandemic before us ( 15 – 17 ). In the South African context, the practice of animistic and Christian rituals that have been passed down from generation to generation is believed to have a protective and emotionally uplifting role for the bereaved ( 18 ).…”

“…The WHO published guidelines on avoiding large faith group gatherings and encouraged conducting rituals and faith-related activities remotely or virtually ( 20 ), but the practical application of these guidelines remains to be established through research. In other countries such as the UK and Ireland, the non-contact ways of dealing with bereavement were assessed, and caution has been made to avoid the “tsunami of grief” by promoting support services for the bereaved ( 17 ). Events that are time-sensitive and cannot be postponed until the pandemic is under control, such as funerals, were performed under the new norms, but other cultural practices that are not time-sensitive may be postponed to a later time; for example, the winter schools for the rites of passage of initiation of boys to manhood were postponed to the summer season due to COVID-19 1 .…”

Assessment of Dysfunctional Grief due to Death from COVID-19 in Peru: Adaptation and Validation of a Spanish Version of the Pandemic Grief Scale

“…In this sense, dysfunctional bereavement due to death related to COVID-19 appears to increase the risk of mental and physical health problems, increasing symptoms of anxiety, depression, post-traumatic stress, separation distress loneliness, suicidal ideation, fatigue, increased substance use, increased risk of heart attacks, and other diseases (Bertuccio & Runion, 2020;Breen et al, 2021;Lenferink et al, 2020;Stroebe et al, 2007;Zisook et al, 2014). Also, these bereaved people may feel isolated and unable to access social support due to social distancing measures (Pearce et al, 2021). However, evidence on how the COVID-19 pandemic impacts the experience of dysfunctional grief and its prevalence is still limited, due, among other factors, to the absence of an instrument to measure its symptoms.…”