Supporting Families of Covid-19 Victims During the Ongoing Pandemic

Offering Help to Bereaved Families
Noriko Setou1), Yukihiro Sakaguchi2), Noriko Murakami3)
1) Fukushima Medical University, School of Medicine, Department of Disaster Psychiatry2) Kwansei Gakuin University，School of Human Welfare Studies3) Kobe Red Cross Hospital, Division of Psychosomatic Medicine＊English translator and proofreader

Mikiko Yamaguchi and Heather Hill

1) Additional challenges of coping with bereavement caused by COVID-19 infection
Family members of people who have died from COVID-19 seem to have more difficulty in copingwith grief and loss. The reasons are as follows:
・ The disease progresses very fast, becoming severe over a very short period. This gives
family members little time to say goodbye and leaves them in shock.
・ They may not be able to accept the death of their loved ones because they could not spend
time with them when they were dying nor be present at their death.
・ They are unable to hold important ceremonies such as memorial vigils and funerals in thenormal way.
・ They may easily feel guilty at failing to protect their loved one from infection or they may
think it was their fault that the person was infected.
・ They can easily get very angry towards people and facilities that may have caused theinfection, or public organizations who were slow in taking public health measures.
・ While infections are still present in the community, there is limited contact with other people.
Those who are infected and their family members may also experience discrimination,leaving bereaved families isolated and with no support from others at their most difficult
time.
・ Where they have lived in the same house as the deceased, they are generally required toremain in quarantine in the house where they have abundant memories of the deceased.
That may amplify difficult feelings for the family members, especially given that there are
extremely limited opportunities to engage in outside activities that could help take theirmind off their current situation.
・ They are exposed to media information including the daily toll of COVID-19 deaths, which
only serves to deepen their trauma.
・ This strong traumatic reaction continues for a long time and may disrupt the process ofgrieving.

２）Ways to help bereaved families
The following are suggestions, based on overseas experience, for ways to support bereaved
families of victims of COVID-19:【When the person is near death】
・ If the family members can share their thoughts and feelings with the person even when
the person’s level of consciousness is low, it can mean a lot to them even after their loved
one dies.
For example, family members can express their appreciation and love to the person in aphone conversation (or voice recording), or send letters and notes by fax and ask for them
to be placed by the patient’s pillow.
【When the person dies】
・ If there are family members who cannot be present at the time of death, take photographsof the deceased and the room where possible. These may help family members accept thereality of their loved one’s death.
・ If the time allows, it may be possible to put letters, notes and drawings from adults orchildren in the family in (or on top of) the casket.
・ Talk to children openly and honestly about the death of the person, in ways appropriate totheir age.
・ Being present at the person’s deathbed and attending their cremation play a major role inthe bereaved families’ grieving process. Depending on circumstances, you may be ablearrange with the funeral home to have the hearse drive in front of the deceased person’shouse so that family members can say their final farewells through the windows (the hearse
windows and doors remaining closed).
・ When the deceased is cremated or there is a funeral/farewell ceremony attended by only afew people, inform the people who in ordinary circumstances would have participated about
the date and time of these events. By doing so, these people can mourn by looking at thephotograph of the person and/or lighting candles. Videoing these farewell ceremonies works
well not only so the bereaved family can watch them but also so they can share them,
online for example, with close friends and acquaintances of the deceased.
・ It is a great consolation for those who have lost a loved one to share such videos, memorialphotographs and messages to the deceased with others online and to talk about the person
they have lost.
【After the loss of a family member】
・It is important to keep in contact with the bereaved family so that they don’t become isolated.

・

Even if you cannot see them in person, send your condolences by email, letter or text.

・Try to contact bereaved family members from time to time, even by just sending shortmessages or sending messages at regular intervals. They may not respond to you, but inmany cases, these messages will help them.

・If you are very close to them, you can share memories and photographs of the person overthe phone and upload to social media as a way to support each other.

・Help with ordinary daily activities that the bereaved family needs such as providing meals
and doing the grocery shopping. This can be a big help to them. While you cannot visit inperson, you can leave food and groceries at the entrance of their house.

・During the pandemic, the media inevitably pick up the news on deaths. That will often
amplify the painful feelings, so you may want to advise bereaved family members to limit
their exposure to media.

３）Resources that may help
・

When you reach out to people who have lost their loved ones through COVID-19, it isimportant that you have knowledge not only about supporting people who have experienced
trauma, but also about loss and bereavement, what bereaved families need and what is
likely to be most useful to them. Further information is on our Japan Disaster Grief Support(JDGS) website:・

http://jdgs.jp/

JDGS Website for supporting people who have lost their loved ones in disasters

http://al.jdgs.jp/

JDGS Website for ambiguous loss

In other countries, support for bereaved families, normally provided through direct contact,is now being offered via telephone calls and emails. However, a shortage of qualified
counseling staff severely limits the amount of support that can be offered. Therefore, it isrecommended that bereaved families use websites such as the above as resources to copewith the loss of their family members.

・At this time, it is important not to forget those bereaved families who have lost their loved
ones through causes other than COVID-19. These people also may not be able to say aproper farewell to their loved ones because they cannot get together and have a funeralwake and memorial ceremonies, and it may be difficult for them to receive support fromother people. Also, they may become hesitant to ask for support.

・When a relative dies from a cause other than COVID-19, tell children what the name of theillness was. Give children clear information, for instance that the person died from an illness
called cancer and that it is not infectious to others. This is one of the things that children
may be worried about.

【Reference】


Cruse Bereavement Care https://www.cruse.org.uk/Australian Centre for Grief and Bereavement
https://www.grief.org.au/Default.aspx?hkey=e57b003b-1eac-495b-b267-74456fc2d08d

The Irish Hospice Foundation

https://hospicefoundation.ie/

LEEDS Bereavement Forum

http://lbforum.org.uk/【Note】
・ The information we have provided here should serve merely as a guide. When offering
bereavement support, please respect the situation at the time, consider safety for every person
who is involved and the thoughts and hopes of the bereaved family, and handle the situation
in a careful and sensitive manner.
［First Edition: May 19, 2020］