“It was brutal. It still is”: A qualitative analysis of the challenges of bereavement during the COVID-19 pandemic reported in two national surveys

Abstract

The COVID-19 pandemic has been a devastating, mass bereavement event characterised by sudden unexpected deaths and high levels of disruption to end-of-life, grieving and coping processes, as well as social life more broadly. We analysed qualitative free-text data from two independent UK-wide online surveys to describe in depth the experiences of 881 people bereaved during the Covid-19 pandemic using. We analysed the data in two phases, conducting an inductive thematic analysis and then applying Stroebe and Schut Dual Process Model (DPM) (1999; 2010) as an analytic lens to further contextualise and interpret the data. The DPM identifies loss-oriented and restoration-oriented coping processes between which grieving people naturally oscillate. Loss-oriented coping involves coming to terms with the death and lost relationship, while restoration-oriented coping involves adapting to new ways of life. We identified six main themes: troubled deaths (guilt, anger and unanswered questions); mourning, memorialisation and death administration; mass bereavement, the media and the ongoing threat of the pandemic; grieving and coping (alone and with others); work and employment; and support from the health and social care system. Examples of loss-oriented stressors included being unable to visit or say goodbye, the sudden and traumatic nature of many deaths, and restricted funeral and memorialisation practices. Associated reactions were feelings of guilt and anger, and problems accepting the death and starting to grieve. Examples of restoration-oriented stressors and reactions were stressful death-related administration and severely curtailed social networks, support systems and social/recreational activities, which impacted peoples ability to cope. Study results demonstrate the exceptionally difficult sets of experiences associated with pandemic bereavement, and the utility of the DPM for conceptualizing these additional challenges and their impacts on grieving. Our analysis builds and expands on previous use of the DPM (Stroebe and Schut, 2021) in explicating the impact of the pandemic on bereavement. We make recommendations for statutory, private and third sector organisations for improving the experiences of people bereaved during and following this and future pandemics.

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

“…Similar problems have been reported in pandemic bereavement studies conducted in the Netherlands, UK and USA (Becque et al, 2021;Hanna et al, 2021;2021;. Problems communicating with healthcare providers (HPCs) related to difficulty getting information about their family member, being misinformed about their condition and hospital policies and not being involved in care or treatment decisions (Harrop et al, 2020;Torrens-Burton et al, 2021). More positive experiences included being treated with compassion and kindness, being able to visit, and relatives feeling that they were kept well-informed about their family member's condition and care (Harrop et al, 2020).…”

“…2 Improving family support immediately after a death, including routinely providing opportunities to discuss patient care and the circumstances of the death, and information about locally and nationally available bereavement support for adults, children and young people (Torrens-Burton et al, 2021).…”

“…When lockdown restrictions were in place, people struggled with not being able to visit friends, engage in social and recreational activities and experience respite from their situation. Fear of catching or spreading Covid-19 also affected people's ability to cope and go about their daily lives, particularly among those bereaved by the virus (Torrens-Burton et al, 2021). Consistent with these challenges, around a half of people reported high/fairly high needs for help with 'loneliness and isolation', 'feeling comforted and reassured', 'finding balance between grieving and other areas of life' and 'regaining sense of purpose and meaning in life' (Harrop et al, 2021a).…”

“…For families living together, lack of time and space during lockdowns, and periods of school closure, made it harder for them to process and find respite from their grief (Torrens-Burton et al, 2021).…”

“…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).…”