‘Saying goodbye’ during the COVID-19 pandemic: A document analysis of online newspapers with implications for end of life care

Abstract

Background: News media create a sense-making narrative, shaping, reflecting and enforcing cultural ideas and experiences. Reportage of COVID-related death and bereavement illuminates public perceptions of, and responses to, the COVID-19 pandemic. Aim: We aimed to explore British newspaper representations of ‘saying goodbye’ before and after a COVID-related death and consider clinical implications. Design: Document analysis of UK online newspaper articles published during 2 week-long periods in March–April 2020. Data sources: The seven most-read online newspapers were searched: The Guardian, The Daily Mail, The Telegraph, The Mirror, The Sun, The Times and The Metro. Fifty-five articles discussed bereavement after a human death from COVID-19, published during 18/03–24/03/2020 (the UK’s transition into lockdown) or 08/04–14/04/2020 (the UK peak of the pandemic’s first wave). Results: The act of ‘saying goodbye’ (before, during and after death) was central to media representations of COVID bereavement, represented as inherently important and profoundly disrupted. Bedside access was portrayed as restricted, variable and uncertain, with families begging or bargaining for contact. Video-link goodbyes were described with ambivalence. Patients were portrayed as ‘dying alone’ regardless of clinician presence. Funerals were portrayed as travesties and grieving alone as unnatural. Articles focused on what was forbidden and offered little practical guidance. Conclusion: Newspapers portrayed COVID-19 as disruptive to rituals of ‘saying goodbye’ before, during and after death. Adaptations were presented as insufficient attempts to ameliorate tragic situations. More nuanced and supportive reporting is recommended. Clinicians and other professionals supporting the bereaved can play an important role in offering alternative narratives.

Place, cause and expectedness of death and relationship to the deceased are associated with poorer experiences of end-of-life care and challenges in early bereavement: Risk factors from an online survey of people bereaved during the COVID-19 pandemic

“…were also particularly impacted by pandemic-related challenges, such as being unable to visit their loved one or say goodbye as they would have liked, limited contact with other relatives or friends, and social isolation and loneliness. This could reflect quarantining requirements after being close to an infected loved one, but also lockdown restrictions, fear and anxiety around social mixing and catching or spreading the virus, and the relationship challenges and sense of alienation associated with COVID-19 bereavement 12,23,24 .…”

Bereavement during the Covid-19 pandemic in the UK: What do we know so far?

“…The study publications summarised here report on interim (Harrop et al, 2020) and full results from the baseline survey (Harrop et al, 2021a;2021b;Selman et al, 2021a;Torrens-Burton et al, 2021). We also include in the summary a publication reporting results from the second round survey responses of 104 parent/guardian participants, who answered a question on the support experiences and needs of their children, aged 25 or under (Harrop et al, 2021b).…”

Commentary on “Remote Advance Care Planning in the Emergency Department During COVID-19 Disaster: Program Development and Initial Evaluation”

“…During the COVID-19 pandemic, when visitation policies were restricted, many end-of-life discussions took place via remote platforms. 4 Patients were often scared, alone, and dying of COVID-19 without their closest loved ones to hold their hands at the bedside. Many hospitals had transitioned to a virtual platform to deliver bad news and work through these decisions; however, the authors’ GOC program 3 used a bidirectional platform.…”

“…The program developed a system by which the bedside team could alert the remote palliative care providers to engage the family in end-of-life decisions. 4 These included DNR/DNI, MOLST, health care proxy discussions, and disposition. The Remote GOC Program 3 was created as a joint endeavor between the division of geriatrics and palliative medicine and emergency medicine.…”