“Empty and Lost”: The Challenges of Being Bereaved During the COVID-19 Pandemic

ABSTRACT

Background/aims: The COVID-19 pandemic has resulted in millions of deaths worldwide, whilst also causing severe disruption to end-of-life, grieving and coping processes. We examine bereavement experiences during the pandemic and relate our findings to the constructs of lossoriented and restoration- oriented coping, described in Stroebe and Schut's Dual Process Model (DPM). Methods: Two independent UK-wide surveys were disseminated online, including via social media and community/charitable organizations. They captured adult experiences of bereavement (to all causes of death) from March 2020 to January 2021. Free-text data were analyzed thematically. Results: Free-text comments were provided by 881 participants. Six main themes were identified troubled and traumatic deaths;disrupted mourning, memorialization and death administration;mass bereavement, media/societal responses and the ongoing threat of the virus;grieving and coping (alone and with others);workplace and employment difficulties;and accessing support via health and social care. Examples of loss-oriented stressors included being unable to visit or say goodbye, the sudden and traumatic nature of many deaths, and restricted funeral and memorialization practices. Reactions included feelings of guilt and anger, and problems accepting the death and starting to grieve. Examples of restoration-oriented stressors and reactions comprised stressful deathrelated administration and severely curtailed social networks, support systems and social/recreational activities, which impacted peoples' ability to cope. Conclusions: These results demonstrate the exceptionally difficult sets of experiences associated with pandemic bereavement, defined by significant disruption to end of life, death and mourning practices, as well as usual coping mechanisms and formal or informal bereavement support. The DPM provides a useful framework for conceptualizing the additional challenges associated with pandemic bereavement and their impact on grieving and mental health.