Coronavirus in Scotland: what does grief look like in an age of lockdown?

The pandemic and subsequent lockdown has created a new reality, one in which people who have lost loved ones are denied the usual connection, comfort and closure that can sustain them as they grieve, with some unable to say physical goodbyes at home or in hospital due to isolation, and limited numbers at funerals.

Janet Watson, a counsellor for Cruse Bereavement Care Scotland, describes grief as "no one size fits all but with clear stages people go through".

She adds: "Initially denial, then anger, followed by a period of coming to terms which can lead to depression, and often bargaining – if I had done this they might still be here, if I live like this, it won't hurt so much.

"When you lose someone you love, we lose the person but not the love – we need to relocate the person in our life."

But grieving during these uncertain times, with restrictions on proximity that could potentially last longer than lockdown, presents a concern.

"People are really struggling not being able to grieve in the same way," she said. "Funerals can now have as few as three people, you can't touch, be close or hug. People can't go and see dying relatives which can cause more guilt that might already have been there. [When you lose someone], you are dealing with the loss of normal life and in these circumstances can cause a much longer grieving process."

Cruse volunteers are providing support to people online and by phone during lockdown, with call lengths jumping from an average of around 15 minutes to over an hour.

Fiona Arnott-Barron, chief operating officer of Cruse, has concerns over grief being "paused" during this time. Difficult circumstances surrounding a death can cause a bereaved person to develop complicated grief, also known as prolonged grief disorder, which can persist for years and can interfere with normal functioning.

Ms Arnott-Barron said: "That's what worries me, all the unresolved feelings causing a tsunami of grief. We are ready for that inevitable surge."

Ms Watson agreed: "At the end of this, I see there being a huge flood of demand on services such as ours ... I think it will be about finding ways to retrospectively honour [people's] own grief and the loss of their loved one – finding ceremonial ways to do that."

Funerals are often an important stage in the grieving process, where memories are shared and bonds of love celebrated. But with families forced to social distance during services – and others not even able to attend – the usual comfort gained from these occasions in missing.

For humanist celebrant Susan Douglas-Scott, of Celebrate People, this is one of the hardest aspects of life under the threat of Covid-19.

She said: "One of the parts of grieving is giving people a good send-off. A big part of it is really celebrating the person's life. We share the stories at the service and you just see people lighting up with the joy of those memories.

"Now people have lost that. Normally people are holding hands or hugging, or laughing together so none of that is happening in the same way which is creating a massive gap for people."

Gillian Sherwood, director of clinical services at The Prince & Princess of Wales Hospice (PPWH) in Glasgow, recognises the difficulties that people with life-limiting illnesses face during the pandemic preparing and managing their affairs and saying goodbye to their loved ones, while others are grappling with new fears over contracting the virus.

She said: "People are scared, which is putting more pressure on patients and families and is further isolating them. We are doing our utmost to provide reassurance and care by helping people to discuss and achieve what matters to them, within what is our new normal.

"Many of us will be processing what this means on a personal and social level and how we will re-integrate or cope with the long-term effects of the changes. If we then take into account the death of someone we love in this state of national anxiety and uncertainty, without the reassuring structure of existing social connections and cultural rituals, what will your grief look like?"

Case study: Jenny Douglas

On the morning of the funeral of Jenny Douglas's mother in April she received the call that her father, living in a care home, had died just hours before.

It was a devastating blow for the carer who had moved in with her mother in Aberdeen in February to help look after her in the advanced stages of cancer.

Coming to terms with the death of her parents within seven days of each other during lockdown has been difficult for Ms Douglas who has been unable to be close to or touch family and friends in her grief.

"The funeral was very hard because we could only have seven people in for the service. Everybody else had to stand outside but it's not like you can come out and shake people's hands and get a cuddle and that was really horrible, not being able to get a bit of comfort from somebody else."

Hazel Douglas died on her 79th birthday, just weeks after her diagnosis. Ms Douglas feels lucky to have already been with her mother when the country went into lockdown, and could say her goodbyes in person but other members of the family couldn't do the same.

Ms Douglas' father George was unable to see his wife of nearly 50 years before her death, as living with vascular dementia and pneumonia in a care home meant he couldn't leave.

She said: "I think he'd given up before then but telling him about my mum, I think he just decided, I've had enough, I'm going with her."

Ms Douglas was allowed to see her father in person to tell him the news, but before then had only been able to communicate with him via video call, which caused him confusion.

The day of his death, Ms Douglas saw her father, 81, again as his condition had worsened but stabilised. She told him how much she loved him, and he did the same.

The day of the funeral and her father's death are a blur, with Ms Douglas phoning family and friends to tell them the news before attending her mother's service at the funeral directors.

She said: "It was the strangest feeling and all I could think of was they were both gone in such a short time."

George Douglas was buried one week later with a handful of family and friends in attendance.

Not being able to embrace her wife, who travelled to Aberdeen from Glasgow for both funerals, has been "soul destroying" for Ms Douglas.

"I feel as though I've still not grieved properly," she said. "I've not been able to get a hug and it doesn't feel real. I feel overall [lockdown and isolation] is going to hold a lot of stuff back and it'll take me longer to get to grips with it all."

Tips on living with grief

In the aftermath of death, it is important to remember that grief is normal and although painful, will get better as time passes.

Seek help from any close family members or friends – either practical or emotional. Grief can be lonely, so try to maintain connection with people.

Sleep when you can, even if only for a few hours at a time. It is well known that grief frequently disturbs normal sleeping patterns, and can bring unusual or disturbing dreams, and the lack of sleep can be exhausting. If this persists, speak with your doctor.

Avoid tasks that require concentration, when our concentration is not as sharp as usual, thoughts of what has happened can flood our minds, making tasks such as driving dangerous.

If you can’t face eating, just try small snacks little and often and remember to drink not to become dehydrated. Alcohol is best avoided.

Talk about how you are feeling. Grief can be overwhelming, it is common to question the meaning of our own lives following a death, and thoughts of suicide are not unusual either.

Don't expect too much of yourself. Grief is a major event and affects us in many ways.

For support call Cruse Bereavement Scotland on 0845 600 22 27