Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient

Morris, Sue; Moment, Amanda; Thomas, Jane deLima

doi:10.1016/j.jpainsymman.2020.05.002

Cited by 110 publications

(142 citation statements)

References 20 publications

(10 reference statements)

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“…Family members/loved ones of deceased patients with COVID-19 might be at increased risk of complicated grief and post-traumatic stress disorder [ 38 , 40 ]. Several risk factors may be present, such as: a rapid disease trajectory that might have hampered the preparation for death; less social support caused by social isolation; multiple losses due to COVID-19 in one family; feelings of guilt or (self-)blame; and the inability to undertake traditional grieving rituals [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Support to families before and after the death of a patient can positively influence bereavement outcomes. [38] Results: Most gave a strong (66.2%) or conditional (23.5%) recommendation for bereavement support being offered to family members/loved ones of deceased patients with COVID-19 by healthcare professionals trained in palliative care or bereavement support. ( Figure 1M) Comments provided included that bereavement risk as well as need for support will vary and some people will cope with their usual social or community support.…”

Section: Family Members/loved Ones Of Deceased Patients With Covid-19mentioning

confidence: 99%

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COVID-19: guidance on palliative care from a European Respiratory Society international task force

et al. 2020

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BackgroundMany people are dying from COVID-19, but consensus guidance on palliative care in COVID-19 is lacking. This new life-threatening disease has put healthcare systems under pressure, with increased need of palliative care provided to many patients by clinicians with limited prior experience in this field. Therefore, we aimed to make consensus recommendations for palliative care for patients with COVID-19 using the Convergence of Opinion on Recommendations and Evidence (CORE) process.MethodsWe invited 90 international experts to complete an online survey including stating their agreement, or not, with 14 potential recommendations. At least 70% agreement on directionality was needed to provide consensus recommendations. If consensus was not achieved on the first round, a second round was conducted.Results68 experts (75.6%) responded in the first round. Most participants were experts in palliative care, respiratory medicine or critical care medicine. In the first round, consensus was achieved on 13 recommendations based upon indirect evidence and clinical experience. In the second round, 58/68 (85.3%) of the first round experts responded, resulting in consensus also for the 14th recommendation.ConclusionsThis multi-national task force provides consensus recommendations for palliative care for patients with COVID-19 concerning: advance care planning; (pharmacological) palliative treatment of breathlessness; clinician-patient communication; remote clinician-family communication; palliative care involvement in patients with serious COVID-19; spiritual care; psychosocial care; and bereavement care. Future studies are needed to generate empirical evidence for these recommendations.

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Section: Resultsmentioning

confidence: 99%

Section: Family Members/loved Ones Of Deceased Patients With Covid-19mentioning

confidence: 99%

COVID-19: guidance on palliative care from a European Respiratory Society international task force

et al. 2020

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“…In times of COVID-19, interventions must also be tailored to the fact that patients have lost relatives during the coronacrisis, and sometimes, also, as a result of COVID-19. This brings additional challenges over and above those resulting from the fact that treatment is offered remotely (Eisma et al, 2020;Kokou-Kpolou et al, 2020;Morris et al, 2020). Factors complicating the grieving process when relatives die during COVID-19 include isolation of the dying relative in the last stage of life, limited opportunities to say goodbye, restrictions placed on funerals, and lack of (physical) support following the death.…”

Section: Tailoring Treatment To the Patient's Circumstancesmentioning

confidence: 99%

Remotely Delivered Cognitive Behavior Therapy for Disturbed Grief During the COVID-19 Crisis: Challenges and Opportunities

Boelen

Eisma²,

Smid

et al. 2020

Journal of Loss and Trauma

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Cognitive behavior therapy (CBT) interventions are effective in alleviating disturbed grief. CBT is typically delivered faceto-face. Government policy during the coronavirus (COVID-19) pandemic (quarantine and social distancing) may impede access to face-to-face therapy. Psychotherapy is now widely delivered remotely. In this article, various points of attention related to the application of CBT for disturbed grief using telephone or videoconferencing (or video calling) services are discussed. Additionally, we explore possible ways in which individual risk factors and stressors connected with COVID-19 can be addressed in treatment. Remote treatment brings challenges but also opportunities to help people in shifting from unhealthy to healthy grieving.

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“…Specifically, experiencing a sudden loss, in intensive care, combined with exposure to multiple secondary stressors (e.g., infection, social isolation, job loss) has been argued to elicit severe grief reactions in those experiencing bereavement due to COVID-19 (e.g., Eisma et al, 2020;Kokou-Kpolou et al, 2020;Morris et al, 2020). Moreover, government policy to reduce the spread of COVID-19 (e.g., social distancing, quarantine) may yield additional stress, as it may affect death rituals and social support, thereby hampering the grief process (Eisma et al, 2020).…”

mentioning

confidence: 99%

Acute grief after deaths due to COVID-19, natural causes and unnatural causes: An empirical comparison

Eisma

Tamminga²,

Smid

et al. 2021

Journal of Affective Disorders

194

169

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Background: There are now over 800,000 registered deaths due to the COVID-19 pandemic worldwide. Researchers have suggested that COVID-19 death characteristics (e.g., intensive care admission, unexpected death) and circumstances (e.g., secondary stressors, social isolation) will precipitate a worldwide increase of prolonged grief disorder (PGD) and persistent complex bereavement disorder (PCBD). Yet, no study has investigated this. Since acute grief is a strong predictor of future pathological grief, we compared grief levels among people recently bereaved due to COVID-19, natural, and unnatural causes. Methods: People bereaved through COVID-19 (n = 49), natural causes (n = 1182), and unnatural causes (n = 210), completed self-report measures of demographic and loss-related characteristics and PGD and PCBD symptoms. Results: COVID-19 bereavement yielded higher symptom levels of PGD (d = 0.42) and PCBD (d = 0.35) than natural bereavement (but not unnatural bereavement). Effects held when limiting analyses to recent losses and those who participated during the pandemic. Expectedness of the death explained this effect. Limitations: Limitations include using a convenience sample and self-report measures. Conclusions: Higher grief levels occur among people bereaved due to COVID-19 compared to people bereaved due to natural loss. We predict that pandemic-related increases in pathological grief will become a worldwide public health concern.

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Caring for Bereaved Family Members During the COVID-19 Pandemic: Before and After the Death of a Patient

Cited by 110 publications

References 20 publications

COVID-19: guidance on palliative care from a European Respiratory Society international task force

COVID-19: guidance on palliative care from a European Respiratory Society international task force

Remotely Delivered Cognitive Behavior Therapy for Disturbed Grief During the COVID-19 Crisis: Challenges and Opportunities

Acute grief after deaths due to COVID-19, natural causes and unnatural causes: An empirical comparison

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