This post has been updated.

Losing a loved one is a difficult experience that is even more complicated by the COVID-19 pandemic.  We know many of you have had family members, friends, and neighbors pass away recently and have been unable to attend funeral and visitation services.  We reached out to some people in the senior service community in hopes that the following guidance may be helpful.

Know that there are special allowances for end-of-life care.  The Center for Medicare and Medicaid Services has restricted visitation in nursing home settings, except in certain situations.  End-of-life visitation is compassionate care. In those situations, visitors will be limited to that specific room only:

For individuals that enter in compassionate situations (e.g., end-of-life care), facilities should require visitors to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. Decisions about visitation during an end of life situation should be made on a case by case basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms. Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.

Understand that this loss may be more difficult right now.  The advice that seemed most common among people interviewed was to acknowledge that this loss in this moment of time is going to be more complicated and more difficult.  The comfort that is felt by gathering with a circle of support is not as easily accessible. If you are the person who recently experienced the loss, this insight can help you to be more proactive about asking for what you need from others.  If you are a friend, this awareness allows you an opportunity to be supportive of those grieving in a different way.

Create a different kind of service.  Many funeral homes are finding that the graveside service is the “new normal.”  Family members are opting for a graveside service now and plan to have a larger celebration of life service when the risk of infection are reduced.  Some families have found it helpful to record or live stream the service they do hold for others to watch while at home. One family interviewed mentioned having a remote wake—the family gathered around computers on a Zoom meeting, shared stories and memories, sang together, and comforted one another.  For those who do opt for a more traditional funeral and/or visitation, the state recommends limiting the number of guests and using physical distancing and masks to help reduce risk.

Seek support.  When seeking support from others, do not forget resources like faith supports (clergy, chaplains, rabbis, Stephen Ministers), therapists (many of whom are offering teletherapy services right now), support groups, and bereavement support services. Rev. Chuck Starks said, “The phone is really critical as I have done quite a bit of praying with people over the phone.”

Jennifer Fox, LCSW with UT Hospice offered the following guidance,

For all who are grieving during this difficult and unprecedented time know that you are not alone. You can share with neighbors and help each other with the communal feeling of being seen in loss. Even though there has never been a more important time to keep physical distance from our loved ones, it’s more important than ever to stay socially connected. Try not to think of your experience right now in terms of “social distancing” and remember to reach out and stay connected.

 Utilize coping skills.  We all cope with loss differently and tools that are helpful to one person may not be to others.  Consider what coping skills have been helpful to you with other losses and to try those first.    Jennifer Fox offered,

Remember to be judgement free, as all people cope with loss differently. If someone wants to keep their distance and needs solitude, that’s okay. If you need engagement with others, that’s okay too. Use technology to help you connect. 

Don’t forget to talk often about the future. At some point we will return to our traditional grieving rituals. It’s great to plan those activities now such as, going to a favorite restaurant or visiting the grave site. Plan a larger service for once the restrictions are lifted. Look through photos and make a memory book and cherish the best of times.

Be present with your emotions and acknowledge them as they are real. If you are looking for additional insight check out this great article by Dr. Alan Wolfelt “Coronavirus and the Six Needs of Mourning.” UT Hospice bereavement coordinators are available to provide community grief support. Call 865-544-6222 and ask to speak with someone. 

Be mindful. If you find yourself turning to unhealthy tools for coping, now may be a good time to seek out help.  Be especially mindful of your escape habits (drinking, overeating, binge watching). Rev. Starks said, “My big concern is that people will simply use screen time to try and escape rather than face the issue.”  When you notice an urge to escape, try to instead acknowledge your feelings through use of journaling or talking with a trusted support.  If you or the people around you notice that there is increased dependency on substances for coping, seek assistance from a trained addiction expert.  Many physicians, substance abuse counselors, and individual therapists are offering telehealth medicine options that may be a good starting place.

Set a reminder. If you are the friend or relative of a person who has experienced a loss, mark your calendar with the date of death.  Set a reminder to check in with the person in a month after the loss, on special dates like wedding anniversaries and birthdays, on major holidays, and/or on the anniversary of the death.  Sometimes those little check-ins showing that you care mean the world to the person who is grieving.