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More than 480,000 people around the world have died from Covid-19 (as at 25 June), leaving behind millions of bereaved relatives, friends and loved ones. 

Grief is part of the human experience, but the unique circumstances of the global pandemic mean there is a risk that relatives could find it especially difficult. This could lead to prolonged bereavement, post-traumatic stress, and damage to physical and mental health. 

There are a number of factors that research evidence shows increase the risk of poor bereavement outcomes. These include having a relative die in hospital in intensive care, seeing a relative experience severe breathlessness, and not being able to sit by a relative’s side, all of which are more likely in the pandemic. In addition, there is the risk of disruption to relatives' normal social support networks, for example, due to social distancing measures. 

In response, a team of specialist palliative and end of life care researchers at ARC South London, based at King’s College London’s Cicely Saunders Institute, has made a series of recommendations for mitigating the negative effects on bereaved relatives and health care professionals. 

Dr Jonathan Koffman, reader in palliative care at the Cicely Saunders Institute, and one of the authors, says:

Life’s most grievous losses disconnect us from our sense of who we are and can set in train a process of not only re-learning ourselves, but also the world. The loss of loved ones during the global Covid-19 pandemic, particularly when this has happened in hospital, has made this process even more challenging

Dr Jonathan Koffman

The researchers aimed to provide practical and compassionate advice and guidance for health professionals to support family members in the time leading up to possible death and after. Importantly, the researchers also highlight the multiple stresses this challenging work imposes on frontline health and social care professionals. 

Drawing on the best available evidence, the researchers recommend:

  • early advance care planning discussions and parallel planning with patients and families 
  • proactive, sensitive, and regular telephone communication with family members
  • provision of accurate information about a patient’s condition 
  • enabling family members to say goodbye in person where possible and supporting virtual communication if not
  • providing excellent symptom management and emotional and spiritual support
  • sign-posting relatives to bereavement services and support
  • collecting mementoes or keepsakes for relatives 
  • writing a personalised condolence letter after a patient’s death. 

For frontline staff caring for dying patients and supporting their relatives and loved ones, this is emotionally challenging and potentially distressing work. To mitigate the effects on staff, the researchers recommend consistent organisational leadership, as well as access to both informal and professional support for health professionals on the frontline.

Read the recommendations and access the resources in full here. 

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