Dr Lucy Selman is a Senior Research Fellow and co-lead of the Palliative and End of Life Care Research Group at the University of Bristol. Here she describes the evidence reviews she’s been involved in to help inform bereavement support during the pandemic, and announces a new UK research study.
Like many non-clinical academics, when COVID-19 hit Europe, I felt helpless. My research projects on ‘pause’, I turned my attention to how I could raise awareness of key issues and help inform and support the palliative care response to the pandemic. One of the areas I chose to focus on was grief and bereavement during COVID-19.
Up to now, over 183,000 people have died from COVID-19 in the EU/EEA and the UK. Each of these deaths is associated with around five bereaved people, whose lives may have been deeply affected by this natural but at times devastating experience. Yet many of the challenges the bereaved have experienced this year have also affected non-COVID-19 deaths, since they relate to restrictions put in place to stop the spread of the disease: social distancing, hospital and care home visiting restrictions, and the need for Personal Protective Equipment.
I first worked with colleagues at the Cicely Saunders Institute on a narrative review of evidence related to bereavement support in hospital settings, which identifies and discusses risk factors for poor bereavement outcomes and makes recommendations for how to mitigate these. I was then asked by our local Applied Research Collaborative to conduct a rapid evidence review examining the possible impact of funeral restrictions during the COVID-19 pandemic. In this review with Dr Alexander Burrell, we synthesised evidence regarding the effect of funeral practices on bereaved relatives’ mental health and bereavement outcomes. While the quantitative studies were inconclusive, the qualitative studies gave important insight: the benefit of being involved in a funeral depended on people being able to shape the experience themselves and say goodbye in a way that was meaningful for them. The role of the funeral as a way of showing community support was also key.
Finally, I collaborated with a team at Cardiff University on a systematic review of system-level responses to mass bereavement events, recently published in Palliative Medicine. We identified common features of valued bereavement services after a natural or human-made disaster: a proactive outreach approach; centrally organised but locally delivered interventions; event-specific professional competencies; and an emphasis on psycho-educational content.
This new collaboration led to a successful funding application to the UK’s Economic and Social Research Council for a national bereavement study starting in August 2020 (Co-principal investigators: Dr Emily Harrop and Dr Lucy Selman). Over 18 months, we will examine the experiences and support needs of those bereaved since March 2020, and how UK bereavement services have adapted to the challenges of providing support during the pandemic. The first round of the longitudinal online survey is now open – anyone who has experienced the death of a loved one in the UK since 16 March 2020 is eligible to participate.
To provide a forum to discuss grief and bereavement, in October we will be holding Good Grief online, a Wellcome Trust-funded festival to help people talk, think and learn about grief. The festival is free to attend, and running over three days (30 October to 1 November 2020) – I hope to see you there!
Links and resources
- How coronavirus has transformed the grieving process by Lucy Selman
- Managing bereavement during the COVID-19 pandemic by Mai-Britt Guldin.
- Coronavirus, bereavement and grief by Cruse Bereavement Care.
Planning a meaningful funeral:
- For adults: Coronavirus: organising a meaningful funeral. Quaker Social Action website. Accessed 23 July 2020.
- For children: Coronavirus: How to say goodbye when a funeral isn’t possible. 26 March 2020. Winston’s Wish website. Accessed 23 July 2020.
- COVID-19 bereavement: memorialising. Sudden website. Accessed 23 July 2020.
Information and resources for staff and the bereaved:
Mourning collective loss:
- Evans, ter Kuile and Williams (2020). This Too Shall Pass: Mourning collective loss in the time of COVID-19
Follow Lucy @Lucy_Selman
Read more posts about Coronavirus and the Palliative Care Response on the EAPC blog and view more resources on the EAPC website.
JOIN PALLIATIVE CARE SPECIALISTS FROM ACROSS THE WORLD AT #EAPC2020 – 11th EAPC WORLD RESEARCH CONGRESS ONLINE 2020.
A live, interactive session will be devoted to Covid-19 and the Palliative Care Response at the 11th EAPC World Research Congress Online on Wednesday 7 October 2020 – 10am to 1.50pm CET. Find out more about the congress and view and download the interactive programme here.
The congress platform goes live on 21 September with masses of on-demand content available until 31 January 2021. Live, interactive online sessions take place on 7 to 9 October 2020. CME accreditation will be available. Learn and interact with leading researchers and chat with other registered delegates from the global palliative care community – all in the safety of your own home or office. Visit the congress website and register here.