Bereavement in the Time of Coronavirus: Unprecedented Challenges Demand Novel Interventions

Carr, Deborah; Boerner, Kathrin; Moorman, Sara M.

doi:10.1080/08959420.2020.1764320

Cited by 146 publications

(171 citation statements)

References 23 publications

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“…It is also possible that the anticipated negative effects of the death of a family member on survivors may be even more severe given the unusually challenging and traumatizing circumstances surrounding family loss due to COVID-19 (50). First, deaths due to COVID-19 are sudden and unanticipated, which contrasts with the more protracted experience of losing a relative to a prolonged sickness that families in America typically experience.…”

Section: Discussionmentioning

confidence: 99%

Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States

Verdery

Smith‐Greenaway

Margolis

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

284

180

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The coronavirus disease 2019 (COVID-19) pandemic has led to a large increase in mortality in the United States and around the world, leaving many grieving the sudden loss of family members. We created an indicator—the COVID-19 bereavement multiplier—that estimates the average number of individuals who will experience the death of a close relative (defined as a grandparent, parent, sibling, spouse, or child) for each COVID-19 death. Using demographic microsimulation-based estimates of kinship networks in the United States, the clear age gradient in COVID-19 mortality seen across contexts, and several hypothetical infection prevalence scenarios, we estimate COVID-19 bereavement multipliers for White and Black individuals in the United States. Our analysis shows that for every COVID-19 death, approximately nine surviving Americans will lose a grandparent, parent, sibling, spouse, or child. These estimates imply, for example, that if 190,000 Americans die from COVID-19, as some models project, then ∼1.7 million will experience the death of a close relative. We demonstrate that our estimates of the bereavement multiplier are stable across epidemiological realities, including infection scenarios, total number of deaths, and the distribution of deaths, which means researchers can estimate the bereavement burden over the course of the epidemic in lockstep with rising death tolls. In addition, we provide estimates of bereavement multipliers by age group, types of kin loss, and race to illuminate prospective disparities. The bereavement multiplier is a useful indicator for tracking COVID-19’s multiplicative impact as it reverberates across American families and can be tailored to other causes of death.

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Section: Discussionmentioning

confidence: 99%

Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States

Verdery

Smith‐Greenaway

Margolis

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

284

180

View full text Add to dashboard Cite

show abstract

“…Bereavement from COVID-19 may be very challenging [149][150][151][152] . Traumatic death, a lack of preparation for the death, and low social support 153,154 have been described as risk factors for complicated grief, which in turn results in increased risk for suicidal behaviours, independently from other psychiatric disorders such as major depressive disorder and PTSD 155,156 .…”

Section: Interventions For Vulnerable Groupsmentioning

confidence: 99%

Adaptation of evidence‐based suicide prevention strategies during and after theCOVID‐19 pandemic

et al. 2020

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Suicide is preventable. Nevertheless, each year 800,000 people die of suicide in the world. While there is evidence indicating that suicide rates de‐crease during times of crises, they are expected to increase once the immediate crisis has passed. The COVID‐19 pandemic affects risk and pro‐tective factors for suicide at each level of the socio‐ecological model. Economic downturn, augmented barriers to accessing health care, increased access to suicidal means, inappropriate media reporting at the societal level; deprioritization of mental health and preventive activities at the community level; interpersonal conflicts, neglect and violence at the relationship level; unemployment, poverty, loneliness and hopelessness at the individual level: all these variables contribute to an increase of depression, anxiety, post‐traumatic stress disorder, harmful use of alcohol, substance abuse, and ultimately suicide risk. Suicide should be prevented by strengthening universal strategies directed to the entire population, including mitigation of unemployment, poverty and inequalities; prioritization of access to mental health care; responsible media reporting, with information about available support; prevention of increased alcohol intake; and restriction of access to lethal means of suicide. Selective interventions should continue to target known vulnerable groups who are socio‐economically disadvantaged, but also new ones such as first responders and health care staff, and the bereaved by COVID‐19 who have been deprived of the final contact with loved ones and funerals. Indicated preventive strategies targeting individuals who display suicidal behaviour should focus on available pharmacological and psychological treatments of mental disorders, ensuring proper follow‐up and chain of care by increased use of telemedicine and other digital means. The scientific community, health care professionals, politicians and decision‐makers will find in this paper a systematic description of the effects of the pandemic on suicide risk at the society, community, family and individual levels, and an overview of how evidence‐based suicide preventive interventions should be adapted. Research is needed to investigate which adaptations are effective and in which con‐texts.

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“…Social distancing practices, including the inability to gather in masses, stay at home orders, and facemask requirements, have also negatively hampered families' ability to personalize this experience (Jalali et al, 2020). The ongoing pandemic further complicates the grieving process as families have to do so in isolation, without faceto-face mourning rituals, financial uncertainties, and not being able to plan for the end-of-life care of their loved ones (Carr et al, 2020).…”

Section: Impact Of Losing a Loved One To Covid-19mentioning

confidence: 99%

Biopsychosocial and Spiritual Implications of Patients With COVID-19 Dying in Isolation

et al. 2020

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Critically ill patients with the Coronavirus disease 2019 (COVID-19) are dying in isolation without the comfort of their family or other social support in unprecedented numbers. Recently, healthcare teams at COVID-19 epicenters have been inundated with critically ill patients. Patients isolated for COVID-19 have had no contact with their family or loved ones and may have likely experienced death without closure. This situation highlights concerns about patients’ psychological and spiritual well-being with COVID-19 and their families, as they permanently part ways. While palliative care has advanced to adequately address these patients’ needs, the COVID-19 pandemic presents several barriers that force healthcare teams to deprioritize these essential aspects of patient care. The severe acute respiratory syndrome (SARS) outbreak in 2003 gave us a glimpse of these challenges as these patients were also isolated in hospitals. Here, we discuss the importance of the biopsychosocial spiritual model in end-of-life care and its implications on patients dying with COVID-19. Furthermore, we outline an integrative approach to address the unique and holistic needs of critically ill patients dying with COVID-19. These include intentional and increased coordination with trained palliative care staff, early and frequent goals of care including discussion of end-of-life plans, broader use of technology to improve connectedness, and shared decision making with patients’ families.

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Bereavement in the Time of Coronavirus: Unprecedented Challenges Demand Novel Interventions

Cited by 146 publications

References 23 publications

Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States

Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States

Adaptation of evidence‐based suicide prevention strategies during and after theCOVID‐19 pandemic

Biopsychosocial and Spiritual Implications of Patients With COVID-19 Dying in Isolation

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