Home | Practical Living | How are we to grieve now? Dealing with death in a pandemic

How are we to grieve now? Dealing with death in a pandemic

Benita Kolovos recently recalled the day her family had the funeral for their beloved Papou. Kolovos, a journalist, wrote of the toll that restrictions on funerals have taken on her and her family. Calling family members to tell them they couldn’t attend the service and sitting far apart from her loved ones in the church magnified her grief.

“I’ve never felt more alone,” she wrote.

Worst of all was the unexpected appearance of police officers, carrying guns, to do a head count with about fifteen minutes left in the funeral.

“They started speaking to church staff while the funeral director cut the service short, quickly calling for the coffin to be taken out.

“We were forced to feel in the wrong when we were doing everything right.

“Everyone rushed to their cars, terrified of a fine. Some couldn’t follow the hearse as we made our way to the cemetery.”

Benita’s experience will not be uncommon as we face living and grieving in new ways.

Most of us are familiar with the theory of the five stages of grief, also known as the Kübler-Ross model.

The stages of denial, anger, bargaining, depression and acceptance have long been used to help us understand and navigate our way through grief, but what about grief experienced in this current time of pandemic?

Losing a loved one is difficult anytime, but with added restrictions surrounding visitation in aged care and around funeral procedures coming into law in recent months people may struggle to find the closure they need.

“Even though there are some great things being done, I think there’s a lot of people [who are] going to be very frustrated,” says Dr Philip Bachelor, lecturer in cemetery practice at Deakin University and a specialist on grief and bereavement.

Bachelor has been working in the funeral industry for four decades and his course at Deakin University is the first of its kind in the world. He was motivated to improve funeral practice in Australia as, when he first started, the industry was at times “dreadfully insensitive”.

“We were uncaring, we were culturally offensive, we had no understanding of grief and bereavement. We basically had no idea who our clients were and what that were going through. And I decided that I wanted to find out who these people were and what they needed and what we could be doing better. It turned out to be the first such social research done in the industry anywhere,” he says.

The funeral experience is key for the grieving process, as grief is both personal and communal, Bachelor found.

“A funeral is a critical central focal point where if the whole family all gets together and you see your sister that you haven’t spoken to for a couple of months and you’re going to fall into each other’s arms, and they can cry and so on.

“That sharing is so important. But now we’ve got people, including large attendant families where they all feel, even the second and third cousins, they are absolutely critical family members and they must there. And mother has got 20 or 40 grandchildren. They all feel they’re got to be there and now they can’t.”

Bachelor points to Sigmund Freud’s work on grief, which said that grief is a task that we have to perform and we have to work through it; if not there will be consequences for our mental health.

“And if we can’t work through things in a smooth process and our grief is frustrated, we can end up with some serious psychological hang-ups,” Bachelor says.

“So, I am concerned in all of this, that a lot of people are not going to be able to say their goodbyes and honour their loved one in a way that they believe they should. And so I am concerned about the impact this is going to have on lots of people.

“People are familiar with Kübler-Ross, but her work has been seriously misapplied because she wasn’t dealing with mourners. She was actually dealing with people who are facing their own mortality within one particular hospice, but that’s been latched on to.

“And so many people talk about these specific stages of grief and of course we all grieve differently. All that is really common in our grief is that there is a beginning, a middle and an end.”

There is also potential for our grief to be compounded as panic and anxiety are heightened during the pandemic, especially for healthcare workers who face death regularly.

The aged care sector must look after its workforce

This may raise some questions for the aged care sector, as some experts believe that grief among staff is not properly understood.

Anita Westera is a former RN who has worked in the aged and community sector as well as on policy work with state and federal governments, including advising the former NSW minister for ageing.

She is now a research fellow at the University Of Wollongong’s Centre for Health Service Development, and she believes the grief caused by this pandemic has the aged care workforce under “extreme stress”.

She tells Aged Care Insite that in previous research she interviewed the major peak bodies and aged care providers who acknowledged that bereavement among staff is “under-recognised” and described it as the “the silent experience of staff”.

“There might be some one-off counselling and support, but there’s no real structured approach to looking after and supporting aged care staff in normal circumstances,” says Westera.

“At this time, we have staff experiencing heightened stress just because of the pandemic and also the fact that they are having to provide, on a day to day basis, so much more intensive personal, interpersonal, emotional support for residents because families and visitors aren’t coming through or volunteers who would normally provide that support aren’t there,” she says.

“They’re already under extreme stress, so their ability to cope in terms of death in times of COVID… the impact is likely to be far greater.”

Westera said that in normal circumstances there is often a “predictive element” to death in residential aged care. Approximately one-third of residential aged care residents die each year and staff are able to plan and often bring families into the process.

However, if homes experience a spate of deaths due to COVID-19 – such as in the aged care homes in Sydney – the speed at which they occur and the unknowns which surround the virus can be frightening for staff and families alike.

“I think it highlights that there is a need for systems or the sector to actually take it more seriously than it currently does,” Westera says.

“And I probably would liken it to an intensive care unit in a major hospital. Albeit it’s an acute situation, but… there might be lessons to be learned from the health system that could be applied in the aged care system.

“But in the short term it is about firstly acknowledging that staff are experiencing this.”

Westera has worked closely with the aged care royal commission over the last year and has found that overall staffing numbers and training are inadequate and therefore staff are already working in tough conditions, now made worse by this crisis.

“Staff are extremely stressed as it is. In our report, which we did for the royal commission, we found over 50 per cent of people living in aged care facilities have staffing levels that are what we call unacceptable.

“From a government perspective it is about increasing the staff but increasing the capacity of staff or increasing skilled staff.

“A lot of our aged care personal care workers in particular are working across multiple sites. They’re not well paid, they’re not well skilled and they’re certainly not well supported. My sense is that if we had better clinical skills in the staff in terms of registered nurses and so forth, you might eventually also see improved support for those personal care workers as well.”

Adjusting to strange times

Funeral homes, churches and officiants have adjusted the best they can to the changes. Online funerals have become commonplace.

“Some fantastic things have developed, firstly funerals are now pretty much all being videoed and a lot of them are being live streamed: you can even have live captioning now on the services and that can be done in different languages,” says Bachelor.

“So you can have some of the family sitting at home watching this in English and some of them watching it in Italian or whatever the language may be.”

But he does believe the government messaging around funeral practice could be clearer.

“Just a couple of days ago, we had a local police station phone us to say that a lady has come in and asked can she come and visit the cemetery. They [the police] were asking us if she could come and visit the cemetery.

“That demonstrates to me that nobody quite knows what’s going on and what is acceptable, not even the police. I think it really is a very awkward situation, I suppose, for all of us in everything, but in funerals, which are a most sensitive thing. I understand we’ve got to try and keep people apart, but I think in some situations we should just be asking people to do their best, but allow people to grieve.”

And for dealing with the new grief paradigm, Bachelor suggests that what we need to do now is to simply talk with one another.

“The best thing I can suggest for people to do is talk and share,” he says.

“And so, my suggestion is, you’ve got emotions for a very, very good reason, whether you’re male or female, don’t be afraid to use them.

“And where you need release, take that release, no one will ever think you are less a person for it.

“But I would say, be yourself.”

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One comment

  1. Thank you for your article about “How are we to grieve now?” It was beautifully written, sensitive and caring.

    I hope that the research mentioned soon will be put into action – everywhere!