Dismembered grief might best describe grieving during the current COVID-19 pandemic.

A son mourns the death of his mother, 3000 miles away. Travel quarantines and hospital restrictions kept him from saying goodbye in person. A phone held to her ear was too late; she never regained consciousness.

She begged her snowbird parents not to go south during the pandemic; they traveled anyway. Now, she flies cross-country to be with her mother as her father lies hospitalized, dying of COVID.

A wife races to the hospital after her husband arrives by ambulance. Blood clots, a heart attack, death. Many people assumed that he died of COVID.

A husband outlives his prognosis and fights valiantly to spend more time with his family, but dies of cancer during the COVID pandemic. COVID deaths dominate the media, but cancer continues to claim lives.

Grief, grief, and more grief. All grief hurts, and the current pandemic deeply impacts how people live, die, and grieve. Who could predict so much death—over half of a million deaths in this country alone—due to SARS-CoV-2, the virus that causes COVID-19 disease? In the United States, COVID deaths now exceed mortality rates due to other causes. Whether someone dies of COVID or another cause, this pandemic affects the mourning and grieving of all deaths. This coronavirus impacts specific aspects of grief: anticipatory, disenfranchised, and complicated.

Anticipatory Grief

Anticipatory grief offers the chance to acknowledge and gradually adjust to the upcoming loss and grief. For example, a terminally ill person and his family might prepare emotionally and logistically for the inevitable death. In contrast, COVID-19 robs people of time for anticipatory grief, as the disease may suddenly progress from cold symptoms to dangerously low oxygen levels, sometimes resulting in ventilator dependence and death before diagnosis.

COVID-imposed restrictions also impair anticipatory grief. With multiple household gatherings discouraged, extended families cannot gather at the bedside as their loved one dies. How can traditional rituals surrounding death and dying be implemented in the midst of shutdowns and quarantines?

Disenfranchised Grief

Kenneth Doka, a death education and counseling expert for over 30 years, wrote the book that defines disenfranchised grief as “not socially sanctioned, openly acknowledged, or publicly mourned.” The COVID-19 pandemic contributes to these aspects of disenfranchisement. Efforts to prevent virus transmission curtail or even prohibit public expressions of community grief or rituals focused on the dying family member. What about the sorrow and guilt people experience when they cannot host visitations, wakes, reviewals, or other mourning traditions to honor their deceased loved ones? Large funerals and food-serving receptions are viewed as virus-spreading events instead of valued as comforting family reunions. Funerals and memorial services are indefinitely postponed until after the pandemic, depriving mourners of public acknowledgment and spiritual community as they grieve alone.

Complicated Grief

What aspects of COVID disease and deaths have not complicated the process of grieving?! Whereas complicated grief used to be an ill-defined term in the clinical context, now Persistent Complex Bereavement Disorder (PCBD), categorizes complicated grief in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM–5). Whether COVID-related emotional trauma persists and propels a person’s complicated grief into a PCBD diagnosis might not be evident until after the pandemic.

Dismembered Grief

The COVID pandemic may prevent anticipatory grief, result in disenfranchised grief, and further complicate grief. I call these pandemic effects dismembered grief, because COVID-related restrictions separate grieving people from their loved ones, cut off emotional and spiritual supports, and deprive loved ones of time together, both before and after death. Grieving during this time can feel lonely and disjointed. Socialization limitations, travel quarantines, solitary living, separation mandates, in-person events moved online—all of these lifestyle changes lead to what I identify as dismembered grief during the coronavirus chaos.

Comfort in Grief

How do we comfort those who grieve during this pandemic? In my experience, when grief interfered with eating, sleeping, and much of my life, I relied on others for emotional, physical, and spiritual support. These seven ideas help acknowledge, comfort, and support a grieving person, during this pandemic and beyond:

• mention their loved one’s name
• listen to them talk about their loved one
• write them an encouraging note
• talk/write about a memory of their loved one
• drop off a meal
• offer to help with one task: e.g. household chore, errand, event
• ask what you can do for/with their kids: take them on an outing, give rides, teach them a skill, etc.

Helping with a specific task, or just sitting with a grieving person, provides more connection and assistance in an overwhelming situation than a vague offer of “call me if you need something.” The shock and trauma of a loved one’s death may block any ability to reach out for help. COVID-19 restrictions require creative problem-solving, but safe and relevant help will decrease the isolation of grief.

Note: If you are grieving, consider joining an online grief support group (e.g. GriefShare). For specific grief resources, contact your local faith community, counseling center, hospice program, or funeral home.

[Originally posted March 2021]