Everything went topsy-turvey in 2020, including this blog. By the end of the year it expanded to cover whatever I needed in my personal and professional life. This is the third in a series of personal posts I am making later in the year about life early on in the pandemic (dated from when they first appeared in other location – this piece an interview for Readers Digest.)
How to Cope With Covid-19 Grief, According to Therapists
These three people lost their fathers to Covid-19; here are their stories of loss, and therapists’ advice on how to grieve during lockdown.
Barry Joseph, a Forest Hills, New York-based digital learning expert, recently buried his father in a Long Island cemetery plot next to his mother, who had passed away decades earlier.
Paul Joseph, a devoted father and grandfather, was just shy of his 88th birthday when he died in the hospital from Covid-19. “When I recall my mother’s funeral in 1990, in our pre-Covid era, I can still feel the love that came from the crowd surrounding us, and the support I drew from the Hebrew prayers they all chanted,” Joseph recalls. “This time, however, standing before his open grave, adjacent to my mother’s, their complete absence was deafening.”
Joseph set up his iPhone on a tripod so that his sister and other loved ones could participate in the funeral. But it wasn’t the same.
How could it be?
“With Covid-19, you can’t be near someone if they are in the hospital, you can’t touch them, and you can’t say goodbye,” says Evan Imber-Black, PhD, program director of the Marriage and Family Therapy Master’s Program at Mercy College in Dobbs Ferry, New York. “Right from the start there is a huge difference from the way we are used to saying goodbye to a loved one who departs, and there is not some magic way to replace that,” says Imber-Black, who is also the director of the Center for Families and Health at Ackerman Institute for the Family in New York City.
As the number of deaths from Covid-19 continues to climb, many more individuals will be faced with such loss. They may also find themselves saying goodbye to their loved ones virtually due to strict isolation protocols in hospitals. Social distancing has also dramatically changed end-of-life rituals, leaving many mourners without a map.
These individuals who shared their stories with The Healthy all lost older parents, but this disease does not discriminate and is not just striking the elderly—that’s just one of the many myths about coronavirus.
Complicated grief
The contagious nature of Covid-19 sets individuals up for complicated, ambiguous, and extreme grief, says Sherry Cormier, PhD, a psychologist who specializes in grief and grief mentoring and author of Sweet Sorrow: Finding Enduring Wholeness after Loss and Grief.
“Most of us are losing people to Covid-19 and we are not present when the person dies which makes it much more difficult to get closure,” says Cormier, who’s also professor emeritus in the department of counseling, rehabilitation counseling, and counseling psychology at West Virginia University in Morgantown. “When we are with someone who passes, it can be easier to accept because we are there to witness it.”This video file cannot be played.(Error Code: 203000)
Instead, says Cormier, “They’re wondering, ‘how did they die, when did they die, and what was it like?’”
These questions plague New York-based Instagram influencer Alison Brettschneider. She didn’t get to say goodbye to her father, noted lawyer Alan Hirshman, or hold his hand when he passed away from Covid-19, and she is having a hard time processing the loss as a result.
Brettschneider shares that she still doesn’t know what happened in the last few hours or minutes of her father’s life. There were so many ups and downs form his diagnosis to his hospitalization, but it seemed that he was on the mend and would be discharged from the hospital. “His personal doctor called me and said he sounded perfect,” she says. Her father wanted to know how soon he could leave.
This call was placed at 9:14 p.m. Hospital time of death was announced 9:51. “Pretty much all we know is he died from corona [Covid-19], but we still don’t know exactly what happened.”
“Under normal circumstances losing a parent is an indescribable heartbreak, but in what world—when your almost-90-year-old father who lives alone and is sick and not answering his phone—do you not go check on them?” she asks. “In what world do you find out your almost-90-year-old father was rushed to the hospital and not jump in the car and go? In what world do you not have any visitors in a hospital and in what world do you call a funeral home and there is a three-day wait for bodies to be picked up?”
Such difficult circumstances do increase the chances that a person will develop prolonged grief disorder, which can last at least 12 months, according to the American Psychological Association.
There are, however, some creative ways to adapt rituals and better cope with the loss even in these unsettling times, experts say.
Connect online
When Joseph took his father to purchase a walker at a local surgical supply store about a month before widespread shelter-in-place orders took effect in his area, he didn’t know it would be the last time he saw his father in person. When his dad developed Covid-19 and was admitted to the hospital, Joseph gave him an iPad that became their lifeline. “I could see him and talk to him every day and he became more responsive,” Joseph recalls. “Part of what Covid-19 was doing was creating barriers between people, and technology was lessening that impact and creating opportunities.”
Read together, share memories
As his father’s health declined, Joseph read him poems from Picnic, Lightning, a collection of poetry by American Poet Laureate Billy Collins, over the iPad. This book was extremely meaningful to his father who was on the board of the Walt Whitman Birthplace Association in Huntington, New York, where Collins spent time as a poet-in-residence. “I would read, reflect and connect the poems to his life,” he recalls. His father passed away peacefully to the sound of Joseph’s voice as he recited these poems.
Accept the care of others
Increasingly, health care workers are filling the void of absent family members by sitting with Covid-19 patients and holding their hands. Hillary Fox, a functional-medicine coach in Port Washington, New York, lost her 91-year-old father to Covid-19. She was comforted by the fact that a palliative care nurse practitioner was there with him. “She was our angel,” Fox says. “She would take an iPad in with him and let him know that we were there and speaking to the doctors on his behalf and she held his hand throughout.” This nurse practitioner also played her dad’s favorite music, from Frank Sinatra to Engelbert Humperdinck by his bedside. Fox is anxious to hear about her father’s final days: “I can’t wait to take her out to dinner,” Fox says.
Adapt the rituals
Whether you’re planning a wake, following the Jewish tradition of sitting Shiva, or taking part in another type of memorial service, rituals are really important because grief is so isolating, Cormier says. “We can’t do those things now and that is challenging because we need to feel connected to grieve well,” she says. Get creative and use technology to connect. Zoom funerals are becoming the new normal for many.
Joseph and his family re-imagined Shiva for his dad. “Rather than one short, massive Shiva call, we crowd-sourced the calendar over three days [and] anyone interested in paying a Shiva call could browse pre-determined times and, if a slot was available, put in their name,” he explains. In the end, more than 150 people paid their respects. While far from ideal, these virtual services can break down geographic walls and allow for more people to pay their respects and share memories of the deceased, Imber-Black adds.
Joseph is not a big Facebook or social media guy in normal times, but these aren’t normal times. “When my father passed away, I posted on a daily basis and felt supported on my schedule and in my terms,” he says. “It was a river I could dip into whenever I could get refreshed.”
Fox also held a virtual Shiva service for her father and asked friends and family to wear their Jets and Mets gear as those were his favorite sports teams. Normally relatives and friends bring food so that mourners don’t have to cook or worry about eating. Fox’s friends dropped off groceries and gift certificates for local restaurants to make this part easier.
Also, there’s a rise in online legacies, which can be healing, says Cormier. “Visitors can leave comments, and pictures share stories,” she says. This helped Brettschneider who shared stories and pictures of her father on Instagram and encouraged others to do the same. Here’s how to support someone who lost a loved one.
The ways in which Covid-19 has altered how people grieve is not ideal, says Imber-Black. “People are being as creative and inventive as they can be, but we don’t know yet and won’t know for quite a while how ultimately soothing this will be for people’s mental health down the road.”
Forgive yourself
If you can’t be there when a loved one passes away, you are much more likely to feel guilty, but it’s important to give yourself a pass due to the extenuating circumstances surrounding Covid-19, says Robin D. Friedman, a psychotherapist at Lotus Psychotherapy in White Plains, New York.
“Nobody deserves to be alone without their family at the end, and that is the one part that will always sit with us and will be difficult to resolve,” Fox shares. She has leaned on some of what she teaches her clients and is giving herself grace. Fortitude matters, adds Leslie Epstein Pearson, a licensed clinical social worker and family therapist in New York City. “People are getting through this grief because they come from a place of strength and health.”
Make donations
Raising money or awareness for a cause that is near and dear to the departed can help honor someone’s memory in a meaningful way. Fox asked individuals to donate to a non-profit called Community Chest of Port Washington because the town gave her father a great deal of joy. Joseph set up an online fundraising campaign to purchase iPads for hospitals, nursing homes, and rehab centers, so Covid-19 patients could connect with loved ones during periods of isolation.
Reach out
Mental health professionals are seeing patients via telemedicine and also offer virtual support groups for the bereaved, says Friedman. “Many therapists—most of whom are available now online—specialize in grief and bereavement work as well as traumatic loss,” she says. “Additionally, it can be helpful to join a support group for people experiencing grief that is facilitated by a trained professional to help individuals move through the multitude of feelings that can arise out of grief as well as help to build perspective as a result of the loss.” Prolonged grief can turn into depression if left unaddressed. (In case it could help: Here’s how to cope with depression during coronavirus quarantine.)
There are also things you can do if someone you know has lost a loved one during Covid-19, to help support them while social distancing.
If you know someone who has lost a loved one due to Covid-19, keep following up, says Cormier. “Pick up the phone and make that call or drop off flowers or a kind note by their doorstep,” she suggests. “As we move away from physical distancing, try to have some kind of personal contact to convey your concern and condolences.” It’s not just what you do or say in the immediate aftermath of a death that counts, she says. “In the short span after the death of loved one, we are often inundated with a lot of things including financial matters and the worst part of grief can hit six to 12 months later.”
