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

The Covid-19 pandemic has been a devastating mass bereavement event, with measures to control the virus leading to unprecedented changes to end-of-life and mourning practices. In this review we consider the research evidence on the experiences of people bereaved during the pandemic. We summarise key findings reported in the first five publications from our UK-based Bereavement during COVID-19 study, drawing comparisons with available evidence from other studies of bereavement during the pandemic. We summarise these findings across three main topics: experiences at the end of life and in early bereavement; coping and informal support during the pandemic; and access to bereavement and mental health services. The synthesis demonstrates the exceptional challenges of pandemic bereavement, including high levels of disruption to end-of-life care, dying and mourning practices as well as to people’s social networks and usual coping mechanisms. We identified considerable needs for emotional, therapeutic and informal support among bereaved people, compounded by significant difficulties in receiving and accessing such support. We provide evidence-based recommendations for improving people’s experiences of bereavement and access to support at all levels.

Do we need to decolonise bereavement studies?

At this re-launch of the journal Bereavement, we explore the question, ‘Do we need to decolonise bereavement studies?’ We do not offer definitive answers, but rather seek to open up conversations. We briefly explore some of the main debates and explanations of what ‘decolonising’ means. In its broader understandings, this entails questions about the nature of the knowledge that underpins claims to ‘expertise’, since knowledge inevitably reflects the socio-historic position and biography of those who produce it. This raises uncomfortable issues about the ‘universality’ of that knowledge, and how to understand what is shared between human beings, including how to understand experiences of pain and suffering. In addressing the nature of, ‘bereavement studies’, we first consider complexities of language and translation, before observing the heavy domination of the ‘psy’ disciplines in affluent minority worlds, oriented towards individualised, medicalised and interventionist perspectives. We indicate work that seeks to challenge these limitations, including the decolonising of psychiatry itself. We argue the need for such decolonising work to go beyond cross-cultural work originating in affluent minority worlds, beyond interdisciplinarity, and beyond crucial work on equality, diversity and inclusivity. Bereavement, as a field of study and a set of practices, needs to take account of the legacies of complex colonial histories of exploitation and harm that continue to shape the world in general, and in particular, the aftermath of death in the continuing lives of the living. We conclude with some implications for ‘bereavement’ practice, from a UK perspective.

Beliefs and strategies for coping with stillbirth: A qualitative study in Nigeria

Stillbirth, the loss of a baby during pregnancy or childbirth, is one of the most devastating losses a parent can experience. The experience of stillbirth is associated with trauma and intense grief, but mothers’ belief systems can be protective against the impacts of grief. Women in Nigeria endure a high burden of stillbirth and the aim in this study was to describe the beliefs and strategies for coping with stillbirth. Twenty mothers bereaved by stillbirth in Nigeria were interviewed; seven of them also participated in a focus group. The findings of the study revealed that the experience of stillbirth was influenced by beliefs which originated from superstitions, religion, and social expectations. These beliefs played significant roles in how mothers coped with the loss, by providing them with a framework for sense-making and benefit-finding.

The uniqueness of twin loss and grief

Loss of a twin unexpectedly in adulthood can leave the remaining twin feeling lost, devastated, and empty. The surviving twin can question the normalcy of these feelings and their response to the grief experience as compared to other losses. A literature review on adult twin loss followed by a review on sibling loss produced a sparse amount of information relevant to my questions. Both reviews centered around losses in childhood with little evidence of support for losses during adulthood. Guidance to assist with coping after this type of loss did not reveal specific coping strategies for the twinless twin. The coping strategies identified may be valuable for any person in their grieving process. The unique loss may benefit from future research on the most effective coping strategies. Grief therapists need further resources specific to singleton grief. Further research and clinical work would improve grief experiences during adult twin loss.

Overcoming adversity: Insights into an acute hospital service of supported viewing for families bereaved during the Covid-19 pandemic

The number of people bereaved due to the Covid-19 pandemic is a major health and social care concern. At a time of unprecedented demand on acute and critical care services, restricted family presence to reduce transmission of the disease had a profound impact on the way bereavement support could be provided in the hospital setting. In response, relatively rapid adaptions to practices were required. This paper provides inspiration and guidance on an acute hospital initiative designed to address the emotional needs of the immediately bereaved. The core features of a supported viewing service are presented through the lens of key employees who played a central role in its development and delivery, and with reference to the prevailing literature. Formal evaluation of the service through qualitative inquiry is recommended, complementary to anecdotal evidence of appreciative uptake of the service during the pandemic.

Bereavement behind bars: Grief support groups with and without therapy dogs for incarcerated females

Grief is a universal experience; however not everyone experiences grief and loss in the same way. People who are incarcerated are often informed of losses via phone, are unable to attend funeral services or participate in supportive rituals, and can have difficulty expressing feelings in a place where showing emotion can be dangerous. Being unable to obtain support and process grief and loss may contribute to impaired functioning. In this study of bereavement support for women in prison, incarcerated women with recent or unresolved losses (n=32) were randomly assigned to grief support groups with therapy dogs (animal-assisted, AA) or without therapy dogs (non-AA). Pre- and post-test measures of bereavement symptoms and prolonged grief disorder (PGD) were obtained. This study shows that AA groups had more significant decreases in symptoms, lower rates of post-group diagnostic criteria for PGD and higher rates of perceived support/benefit from the groups.

How was your lockdown?

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