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Unprecedented Challenges for anyone bereaved and those supporting them Everyone within the bereavement sector is dealing with unprecedented challenges and coming together to play a vital role, supporting communities and ensuring respect for the dead and care of those who are bereaved. They are doing this whilst also having to think about their own health and wellbeing and that of their families. The current national emergency has led to changes in practices, including care of the dying, funerals and rituals which will have an impact on all those bereaved, whether from COVID-19 or other causes, both in the short and long term. Not being able to go with someone as they are taken to hospital and be with them as they are dying is heart-breaking. People are questioning what their loved one’s death was like, how much did they suffer and did they die alone. There is no chance to tell someone how much you loved them and to say goodbye. With COVID-19 someone may have become ill and very quickly deteriorated, with no time at all to try and emotionally prepare. Everyone’s experience of bereavement is unique but feelings that are so often associated with grief such as shock, guilt, anger, denial, isolation and vulnerability are likely to be even more prevalent and intense. With the focus on COVID-19, those bereaved through other causes may feel that their grief is not being recognised or considered to be as significant. Those grieving the death of someone older may be extremely distressed by implications in the media that their death matters less. People may be suffering multiple bereavements and live in fear that they, family members and friends will also become ill and die, especially if they have been in close proximity with someone who died of COVID-19. At a time when those bereaved desperately need the support of those around them, being in quarantine, self-isolating or at the very least social distancing, they are cut off from their usual support networks – family, friends, neighbours, work colleagues and any faith and community network. They are dealing with their grief and bereavement as well as trying to cope with an unparalleled situation. In the days after a death, family and friends will often provide both practical and emotional support - providing meals, helping with childcare, supporting someone with practicalities such as registration, as well as sitting alongside and talking about the person who has died and sharing memories. Some faiths have particular rituals to observe that provide support. COVID-19 has removed this significant level of immediate support. With funeral directors now registering deaths and submitting documentation electronically, this takes pressure off families, but again these practicalities are part of taking in the reality of what has happened. Planning for a funeral usually involves face to face discussions between those bereaved and the funeral director and a faith leader or celebrant, talking through options and exploring what is right for the family. These discussions can be extremely valuable, giving bereaved people the chance to talk about the person that has died and what they’ve lost, what the funeral means to them and what matters most to them. Official guidance now is that discussions should take place, wherever possible, by phone and with the pressure on funeral directors and staff shortages due to sickness and self-isolation as well as the number of deaths, conversations may have to take place with less experienced or even new staff. A funeral is often considered to be the last thing you can do for someone who has died. For some people, it is important to have the cars, a large number of people and a wake afterwards. For others, they would have chosen something more scaled down, but they would each have had choices. For many years there has been a push to try and get people to make their funeral wishes known. We are in a situation, however, where even if these have been recorded or discussed, they cannot be honoured, again causing guilt and anguish for bereaved families. Viewing a body can bring comfort to some who are bereaved. Not being able to do this at a chapel of rest or because coffins are closed adds to the difficulty of taking in that someone has died and the feeling of being denied the opportunity to say goodbye. The number of direct cremations has been rising in recent years, but it is a very different situation if this is forced on a family. The thought of not having the funeral can be devastating. Someone tweeted hours after her father’s death, Necee @ Craden924Lost my dad today to COVID-19. I can’t see him. I have 2 choices direct burial or direct cremation. I’m so angry!! My heart is aching for all who is effected by this. No-one should die alone, no family should be kept from saying goodbye. With numbers attending a funeral being restricted, as a necessary action to protect mourners, clergy, funeral directors and crematorium/cemetery staff, it necessitates impossible decisions for families to make as to who should take the few places. Modern day families are?complicated and so often do not fit the traditional model of two parents and two children.?Today’s society is made up, for example, of many blended families;?those without children may be incredibly close to nieces and nephews and someone may have been in a same-sex relationship not known to their family or may have been having an affair. A best friend may have been closer to the person who died than their parents. There are all sorts of situations that complicate deciding who can attend, including who makes the ultimate decision. Conflict within families is so often a factor following bereavement and having to make choices like this is only going to add to this. The need to self-isolate for those who are elderly, vulnerable or showing any symptoms as well as travel restrictions may mean that those closest to the person who died are not able to be at any service, even if they are the most immediate family. The likelihood is that children and young people will be excluded and yet they need the chance to say goodbye just as much as adults. Normally having the choice of whether or not to attend a funeral can be an important part of this. There will be many who are distressed at being unable to attend the funeral and this will be exacerbated for some if they have been unable to see the person for some time because of self-isolation, travel restrictions or visits to a care home no longer being permitted. For many people it is important to be with their loved one as they are dying and at the point of death and being unable to do so is particularly traumatic. Funerals serve many purposes in addition to disposing of the body. These include celebrating a life and putting the person who has died centre stage for the last time; paying tribute to the life they have lived; acknowledging the impact they have had; remembering their personality, their qualities and their attributes; giving thanks for the life that’s been lived, to a god if one believes and also to the person who has died. For those with a faith, a funeral can include important religious traditions, acts of worship, proclamation of faith and prayers for the dead. One of the most important aspects of a funeral is sharing the impact that someone has had and what they meant to people. Part of this can be shown by the people who attend, and the memories shared at the service and afterwards. The funeral and any wake/get together afterwards are a chance to say goodbye and for family, friends and community to give support and comfort to those who are bereaved. With what is happening now, those bereaved have lost the rituals they were expecting to have and are isolated from those best-placed to be there for them. Supporting Bereaved People Remembering, celebrating, saying goodbye With all of the challenges set out above, and these are just some of those arising, it is vital that bereaved people can have something that offers some meaning and supports them in their grief and bereavement. Those in the bereavement sector are working tirelessly to provide this. This includes finding ways of enabling people to be involved in funerals, even if they cannot be physically present. Some of these will have existed previously but not have been so widely used, others will be emerging in response to the extraordinary times we are living through. Bereaved people, overwhelmed by all that has happened and what they cannot do will need support to think of new and creative ways of being involved, remembering, celebrating and saying goodbye as well as accessing support. It may not be possible to view a body, but someone can be shown a photograph; they cannot touch a coffin, but mourners can wave or blow a kiss. One mum whose child Holly died, arranged for all her family and friends to wear pink on the day of the funeral and take a photo or film themselves. She is intending to put a film together of all of these.Hayley Smallman@hayleysmallman 30.3.20Thank you to everyone who turned the world a little bit pinker on Friday to say goodnight to my Hol I’m heartbroken beyond words but you all gave me strength and even in an empty crem due to COVID19 you helped us not feel so alone #wearpinkforhol #forevergreatful #myHol Technology can be used in many ways including, for example, planning a funeral using Zoom (an online meeting service), livestreaming the service through to having a virtual wake with a Spotify playlist. However, for the non-technical 85-year-old whose partner has died and who is now living alone in self-isolation, straightforward guidance may need to be provided to enable access to any of these. Those unable to attend can send in words to be read out or record a message or a piece of music; write something to go in the coffin; suggest something to be included in the service such as a reading, poem or prayer and/or write something to be included on the service sheet. This may particularly helpful to enable children and young people to have some involvement. The timing of the service may be shared with particular individuals, along with the service sheet setting out readings, prayers and details of the music that will be played, to enable someone to take part in the service while at home, even possibly choosing to dress in what they would have worn had they been able to attend. The eulogy could be shared afterwards. Photographs can be used to prepare those who are attending as to what the crematorium will look like with the chairs spaced out because of the need for social distancing. Photos of the crematorium, the coffin, the hearse and those involved in the service can be taken and some may want to film or record the service themselves on mobile phones, again to share with those unable to attend. Remembering together could be something as simple as sending a text to all family and friends suggesting a time when each will listen to a piece of music, light a candle, raise a glass, plant seeds and think of the person who has died. Communities need to be given ideas on how they can show their support for those who have been bereaved. Just as children are putting up drawings of rainbows in windows, those wanting to reach out to those bereaved could put up a picture or light a candle in the window. Sending words of condolence will continue to be so important. One community came out of their homes and stood outside their homes as the coffin passed, socially distancing and standing the required distance apart, but still showing their respects. One local newspaper has urged family and community members to contact with information about those who have recently died so that detailed obituaries can be compiled to stand as a permanent record of them. Online tribute sites present a vital opportunity to share memories and thoughts. The latest community show of support planned is to shine a torch into the sky, at a particular time on a particular day, to remember those who have died as well as those suffering from COVID-19. Such displays show those who are bereaved that they are being thought of. Accessing SupportThere is a real danger that those bereaved will put their grief on hold feeling that they cannot deal with it at present, but grief is not something that can be put away for another day. It has to be faced now and in the days, weeks, months and years ahead. Bereaved people will need the support of all those closest to them, even if it is virtual contact, as well as guidance and advice from those they come into contact with in the bereavement sector. They need information about grief and bereavement and what, for example, are common reactions. They will need reassurance that the intense feelings they might be experiencing are normal. Expression of the many feelings surrounding bereavement is essential to healthy grieving and people need to be encouraged to connect in any way they can via, for example, phone, Skype and online forums. Whoever bereaved people would normally have talked to face-to-face, whether their child, their next-door-neighbour, their friend, their faith leader, they still need to do this. Thought needs to be given to all those who might be disenfranchised including children and young people, those who are homeless and those in prison. Talking about the person who has died could be encouraged by emailing family and friends and asking them to share memories with some simple prompts such as ‘tell me how you knew my dad’, ‘what will you remember most about him?’, ‘what special memories can you share?’ Those who are bereaved need to be encouraged to think that the funeral is not the last thing that can be done for someone. The scattering of the ashes and/or a thanksgiving/memorial service, for example, can be planned when this is all over, which will celebrate the person’s life. This is not the only chance or indeed the only way to say goodbye. There is no time limit to grief and there is no time limit to celebrating, paying tribute to and remembering loved ones. Bereaved people need to be signposted to the available support. There are a whole range of organisations continuing to support bereaved children, young people and adults, adapting their services for the world we now find ourselves in. Helpline and online services have been in place for some time, but they may not have been used to the extent that they will be now. Resources have been developed specific to the current emergency. Set out below are links to just some of the organisations providing support. All those working in the bereavement sector including funeral directors, faith leaders, celebrants, those working in cemeteries and crematoria and those in the Voluntary Sector have always gone the extra mile to be there for bereaved people. It may be that they now have to go one mile more. By developing and sharing new ways of working; doing what we can to enhance bereavement awareness; encouraging community support and by signposting to support services, together we will continue to be there for people at the worst time of their lives. Debbie Kerslake Support Organisations Cruse Bereavement Care .uk .uk for anyone bereaved. Freephone national helpline, email support and online resources. Childhood Bereavement Network updates, key resources and networking opportunities for all those supporting bereaved children and young people. Directory of services for bereaved children and young people. Childhood Bereavement UK families and educate professionals when a baby or child of any age dies or is dying and when a child is facing bereavement. Winstons Wish children and their families after the death of a parent or sibling. Quaker Social Action a Loss information and resources to help anyone bereaved, whatever the cause of death. WAY support for anyone who has lost a partner before their 51st birthday. Mind advice and support to empower anyone with a mental health problem and campaigns to improve services, raise awareness and promote understanding. Sands - Stillbirth and Neonatal Death Society to support anyone affected by the death of a baby, improve the care bereaved parents receive and create a world where fewer babies die. SOBS the needs and overcomes the isolation experienced by people over 18 who have been bereaved by suicide. Irish Hospice Foundation to all matters related to dying, death and bereavement in Ireland. Debbie KerslakeTrustee of the Cremation Society ................
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