Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Narratives of loss: the impact of COVID-19 lockdown on experiences of loss, grief, and bereavement

Rhiannon Dew https://orcid.org/0000-0001-8279-8711 1 * , Lis Heath 1 , Richard Egan 2
+ Author Affiliations
- Author Affiliations

1 Otago Medical School, University of Otago, Dunedin, New Zealand.

2 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

* Correspondence to: rhiannon.kate.dew@gmail.com

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 14(4) 345-351 https://doi.org/10.1071/HC22090
Published: 17 October 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Introduction: Restrictions imposed to eliminate the spread of the coronavirus disease 2019 (COVID-19) virus had significant implications on peoples’ experiences of caring for family/whānau at the end of life, and on their own bereavement process.

Aim: This qualitative research explored the impact of COVID-19 lockdown restrictions on experiences of loss, grief and bereavement in Aotearoa New Zealand.

Methods: This qualitative narrative research used semi-structured interviews with 10 participants who experienced the loss of a loved one during Levels 3 or 4 lockdown in Aotearoa New Zealand (23 March–13 May 2020). Interviews were coded using NVivo software and inductive thematic analysis was used to evaluate the data.

Results: Results were grouped into three themes: death experience; mourning in isolation; and availability of support. These themes provide insight into the challenges and difficulties participants faced when they experienced the death of a loved one during a COVID-19 lockdown, and the impact of these restrictions on their experiences of grief and bereavement.

Discussion: The findings from this research suggest there is an increased risk of prolonged grief among those bereaved during lockdown. Primary care professionals need to be aware of this increased risk in order to identify need and provide access to bereavement support.

Keywords: bereavement, COVID-19, grief, prolonged grief disorder.


References

[1]  Mayland CR, Harding AJE, Preston N, et al. Supporting adults bereaved through COVID-19: a rapid review of the impact of previous pandemics on grief and bereavement. J Pain Symptom Manage 2020; 60 e33–9.
Supporting adults bereaved through COVID-19: a rapid review of the impact of previous pandemics on grief and bereavement.Crossref | GoogleScholarGoogle Scholar |

[2]  Frangou C. The pandemic has disrupted death and mourning in ways we don’t yet understand. Canada: St. Joseph Communications; 2020. Available at https://www.macleans.ca/society/covid-19-pandemic-disrupted-death-mourning-grief/ [Updated 15 July 2020; Accessed 2 August 2020].

[3]  StatsNZ. COVID-19 data portal. Wellington, New Zealand: New Zealand Government; 2021. Available at https://www.stats.govt.nz/experimental/covid-19-data-portal?tab=Health&category=Weekly%20deaths [Accessed 6 April 2021].

[4]  Verdery AM, Smith-Greenaway E, Margolis R, et al. Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. Proc Natl Acad Sci 2020; 117 17695–701.
Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States.Crossref | GoogleScholarGoogle Scholar |

[5]  Government NZ. New Zealand Covid-19 Alert Levels. 2020. Available at https://covid19.govt.nz/assets/resources/tables/COVID-19-alert-levels-detailed.pdf [Accessed 26 January 2021].

[6]  Ministry of Health. COVID 19 National Hospital Response Framework – The Process. Wellington: Ministry of Health; 2020. Available at https://www.adhb.health.nz/assets/Documents/OIA/2021/09-21/OIA-964-3.-National-Hospital-Response-Framework-V2-210420.pdf [Accessed 17 November 2021].

[7]  Wallace CL, Wladkowski SP, Gibson A, et al. Grief during the COVID-19 pandemic: considerations for palliative care providers. J Pain Symptom Manage 2020; 60 e70–6.
Grief during the COVID-19 pandemic: considerations for palliative care providers.Crossref | GoogleScholarGoogle Scholar |

[8]  Mclachlan L-M. COVID-19 funeral restrictions leave families grieving in isolation. New Zealand: Radio New Zealand; 2020. Available at https://www.rnz.co.nz/news/te-manu-korihi/412705/covid-19-funeral-restrictions-leave-families-grieving-in-isolation [Updated 26 March 2020; Accessed 22 July 2020].

[9]  Burrell A, Selman LE. How do funeral practices impact bereaved relatives’ mental health, grief and bereavement? A mixed methods review with implications for COVID-19. OMEGA J Death Dying 2020; 85 345–83.
How do funeral practices impact bereaved relatives’ mental health, grief and bereavement? A mixed methods review with implications for COVID-19.Crossref | GoogleScholarGoogle Scholar |

[10]  Bear L, Simpson N, Angland M, et al‘A good death’ during the Covid-19 pandemic in the UK: A report on key findings and recommendations. 2020. Available at http://eprints.lse.ac.uk/104143/

[11]  Oetzel J, Simpson M, Berryman K, et al. Managing communication tensions and challenges during the end-of-life journey: perspectives of Māori kaumātua and their whānau. Health Commun 2015; 30 350–60.
Managing communication tensions and challenges during the end-of-life journey: perspectives of Māori kaumātua and their whānau.Crossref | GoogleScholarGoogle Scholar |

[12]  Moeke-Maxwell T, Nikora LW, Mason K, et al. Te Whakatara! – Tangihanga and bereavement COVID-19. Ethnographic Edge 2020; 4 19–34.
Te Whakatara! – Tangihanga and bereavement COVID-19.Crossref | GoogleScholarGoogle Scholar |

[13]  Borghi L, Menichetti J, Vegni E, et al. A phone-based early psychological intervention for supporting bereaved families in the time of COVID-19. Front Public Health 2021; 9 625691
A phone-based early psychological intervention for supporting bereaved families in the time of COVID-19.Crossref | GoogleScholarGoogle Scholar |

[14]  Morris SE, Moment A, Thomas Jd. Caring for bereaved family members during the COVID-19 pandemic: before and after the death of a patient. J Pain Symptom Manage 2020; 60 e70–4.
Caring for bereaved family members during the COVID-19 pandemic: before and after the death of a patient.Crossref | GoogleScholarGoogle Scholar |

[15]  Donnelly S, McDonald F, Goodyer C. Whānau experiences of patients’ deaths in Wellington Hospital during 2020 COVID-19 pandemic Levels 3 & 4. N Z Med J 2022; 135 16

[16]  Eisma MC, Boelen PA, Lenferink LIM. Prolonged grief disorder following the Coronavirus (COVID-19) pandemic. Psychiatry Res 2020; 288 113031
Prolonged grief disorder following the Coronavirus (COVID-19) pandemic.Crossref | GoogleScholarGoogle Scholar |

[17]  Carr D, Boerner K, Moorman S. Bereavement in the time of coronavirus: unprecedented challenges demand novel interventions. J Aging Soc Policy 2020; 32 425–31.
Bereavement in the time of coronavirus: unprecedented challenges demand novel interventions.Crossref | GoogleScholarGoogle Scholar |

[18]  Goveas JS, Shear MK. Grief and the COVID-19 pandemic in older adults. Am J Geriatr Psychiatry 2020; 28 1119–25.
Grief and the COVID-19 pandemic in older adults.Crossref | GoogleScholarGoogle Scholar |

[19]  Mortazavi SS, Assari S, Alimohamadi A, et al. Fear, loss, social isolation, and incomplete grief due to COVID-19: a recipe for a psychiatric pandemic. Basic Clin Neurosci 2020; 11 225–32.
Fear, loss, social isolation, and incomplete grief due to COVID-19: a recipe for a psychiatric pandemic.Crossref | GoogleScholarGoogle Scholar |

[20]  Stroebe M, Schut H. Bereavement in times of COVID-19: a review and theoretical framework. OMEGA J Death Dying 2021; 82 500–22.
Bereavement in times of COVID-19: a review and theoretical framework.Crossref | GoogleScholarGoogle Scholar |

[21]  Eisma MC, Tamminga A. Grief before and during the COVID-19 pandemic: multiple group comparisons. J Pain Symptom Manage 2020; 60 e1–4.
Grief before and during the COVID-19 pandemic: multiple group comparisons.Crossref | GoogleScholarGoogle Scholar |

[22]  Selman LE, Farnell D, Longo M, et al. Risk factors associated with poorer experiences of end-of-life care and challenges in early bereavement: results of a national online survey of people bereaved during the COVID-19 pandemic. Palliat Med 2022; 36 717–29.
Risk factors associated with poorer experiences of end-of-life care and challenges in early bereavement: results of a national online survey of people bereaved during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar |

[23]  Selman LE, Chao D, Sowden R, et al. Bereavement support on the frontline of COVID-19: recommendations for hospital clinicians. J Pain Symptom Manage 2020; 60 e81–6.
Bereavement support on the frontline of COVID-19: recommendations for hospital clinicians.Crossref | GoogleScholarGoogle Scholar |

[24]  Moeke-Maxwell T, Collier A, Wiles J, et al. Bereaved families’ perspectives of end-of-life care. Towards a bicultural Whare Tapa Wha older person’s palliative care model. J Cross Cult Gerontol 2020; 35 177–93.
Bereaved families’ perspectives of end-of-life care. Towards a bicultural Whare Tapa Wha older person’s palliative care model.Crossref | GoogleScholarGoogle Scholar |

[25]  Patton MQ. Qualitative research and evaluation methods, 3rd edn. Thousand Oaks: Sage; 2002.

[26]  Fletcher AJ. Applying critical realism in qualitative research: methodology meets method. Int J Soc Res Methodol 2017; 20 181–94.
Applying critical realism in qualitative research: methodology meets method.Crossref | GoogleScholarGoogle Scholar |

[27]  Underwood M, Satterthwait LD, Bartlett HP. Reflexivity and minimization of the impact of age-cohort differences between researcher and research participants. Qual Health Res 2010; 20 1585–95.
Reflexivity and minimization of the impact of age-cohort differences between researcher and research participants.Crossref | GoogleScholarGoogle Scholar |

[28]  Jamieson T. “Go hard, go early”: preliminary lessons from New Zealand’s response to COVID-19. Am Rev Public Adm 2020; 50 598–605.
“Go hard, go early”: preliminary lessons from New Zealand’s response to COVID-19.Crossref | GoogleScholarGoogle Scholar |

[29]  Cooke H. Coronavirus: public surge in trust of Government during Covid-19 crisis. Stuff, 8 April 2020. Available at https://www.stuff.co.nz/national/health/coronavirus/120911320/coronaviruspublic-surge-in-trust-of-government-and-national-pride2022 [Accessed 2 September 2022]

[30]  Selman L. Covid grief has cracked us open: how clinicians respond could reshape attitudes to bereavement—an essay by Lucy Selman. BMJ 2021; 374 n1803
Covid grief has cracked us open: how clinicians respond could reshape attitudes to bereavement—an essay by Lucy Selman.Crossref | GoogleScholarGoogle Scholar |

[31]  Hanna JR, Rapa E, Dalton LJ, et al. A qualitative study of bereaved relatives’ end of life experiences during the COVID-19 pandemic. Palliat Med 2021; 35 843–51.
A qualitative study of bereaved relatives’ end of life experiences during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar |

[32]  Eisma MC, Tamminga A, Smid GE, et al. Acute grief after deaths due to COVID-19, natural causes and unnatural causes: an empirical comparison. J Affect Disord 2021; 278 54–6.
Acute grief after deaths due to COVID-19, natural causes and unnatural causes: an empirical comparison.Crossref | GoogleScholarGoogle Scholar |

[33]  Varshney P, Prasad G, Chandra PS, et al. Grief in the COVID-19 times: are we looking at complicated grief in the future? Indian J Psychol Med 2021; 43 70–3.
Grief in the COVID-19 times: are we looking at complicated grief in the future?Crossref | GoogleScholarGoogle Scholar |

[34]  Harrop E, Goss S, Farnell D, et al. Support needs and barriers to accessing support: baseline results of a mixed-methods national survey of people bereaved during the COVID-19 pandemic. Palliat Med 2021; 35 1985–97.
Support needs and barriers to accessing support: baseline results of a mixed-methods national survey of people bereaved during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar |

[35]  Hamid W, Jahangir MS. Dying, death and mourning amid COVID-19 pandemic in Kashmir: a qualitative study. OMEGA J Death Dying 2020; 85 690–715.
Dying, death and mourning amid COVID-19 pandemic in Kashmir: a qualitative study.Crossref | GoogleScholarGoogle Scholar |