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Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers
Open accessAbstract
The COVID-19 pandemic is anticipated to continue spreading widely across the globe throughout 2020. To mitigate the devastating impact of COVID-19, social distancing and visitor restrictions in health care facilities have been widely implemented. Such policies and practices, along with the direct impact of the spread of COVID-19, complicate issues of grief that are relevant to medical providers. We describe the relationship of the COVID-19 pandemic to anticipatory grief, disenfranchised grief, and complicated grief for individuals, families, and their providers. Furthermore, we provide discussion regarding countering this grief through communication, advance care planning, and self-care practices. We provide resources for health care providers, in addition to calling on palliative care providers to consider their own role as a resource to other specialties during this public health emergency.
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“the pathological or chronic grief may appear complicated (Lobb et al., 2010; Wallace et al., 2020).”
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“With the high COVID‐19 death rate in the UK, grief is likely to be implicated in mental health challenges (Wallace et al., 2020).”
From Living through lockdown: A qualitative exploration of individuals' experiences in the UK. (2022) · cites this paper as Wallace et al., 2020
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Commentary on: A Call to Action: Facing the Shadow Pandemic of Complicated Forms of Grief
Eisma, M. C., & Boelen, P. A. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211016227 · Cited by 21
“In April 2020, Wallace et al. (2020) and Eisma et al. (2020) were among the first to share their scientifically informed opinions about the consequences of the United States titled ‘A Call to Action: Facing the Shadow Pandemic of ComplicatedForms of Grief’ recently published in Omega: Journal of…”
BackgroundDeath, Funeral Rituals, and Stigma: Perspectives from Mortuary Workers and Bereaved Families
Mas’amah, M., Adu, A. A., Bunga, B. N., Liem, A., & Kiling, I. Y. (2023) · Pastoral Psychology · doi:10.1007/s11089-022-01053-9 · Cited by 18
“1 In response to the pandemic, new policies and protocols for the management of bodies of the dead and funerals were instituted worldwide beginning in 2020, including in Indonesia, to prevent further spread of the infection (Wallace et al., 2020).”
BackgroundPai, R. R., Nayak, M. G., & Sangeetha, N. (2020) · Indian Journal of Palliative Care · doi:10.4103/ijpc.ijpc_182_20 · Cited by 19
“Patient and family members need to be explained regarding the type of services offered by the hospital during this lockdown and the symptoms which they can manage at home.[18]”
BackgroundInfluentialSilent suffering of the dying and their families: impact of COVID‐19
Katz, N. T., McInerney, M., Ravindran, G., & Gold, M. (2021) · Internal Medicine Journal · doi:10.1111/imj.15101 · Cited by 18
Lin, X., Li, X., Liu, Q., Shao, S., & Xiang, W. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252430 · Cited by 17
“Various emotional experiences including fearfulness, guilt and self-blame emerged in nurses following patient death [14], suggesting they lacked the ability to cope with death.”
BackgroundInfluentialFilling the void: Grieving and healing during a socially isolating global pandemic
Scheinfeld, E., Barney, K. A., Gangi, K., Nelson, E. C., & Sinardi, C. C. (2021) · Journal of Social and Personal Relationships · doi:10.1177/02654075211034914 · Cited by 17
“Specifically, people anticipate the inability to have end-of-life conversations, which may increase grief symptoms and guilt for not having supported their loved one (Kokou-Kpolou et al., 2020; Wallace et al., 2020).”
BackgroundInfluentialTur, C., Campos, D., Suso‐Ribera, C., Kazlauskas, E., Castilla, D., Zaragozá, I., García‐Palacios, A., & Quero, S. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100558 · Cited by 19
Palliative and hospice social workers’ moral distress during the COVID-19 pandemic
Latimer, A., Fantus, S., Pachner, T. M., Benner, K., & Leff, V. (2022) · Palliative & Supportive Care · doi:10.1017/s1478951522001341 · Cited by 17
Medicalização do luto: limites e perspectivas no manejo do sofrimento durante a pandemia
Alves, A. M., Couto, S. B., Santana, M. D. P., Baggio, M. R. V., & Gazarini, L. (2021) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00133221 · Cited by 19
A dor que não pode calar: reflexões sobre o luto em tempos de Covid-19
Lopes, F. G., Lima, M. J. V., Arrais, R. H., & do Amaral, N. D. (2021) · Psicologia USP · doi:10.1590/0103-6564e210112 · Cited by 16
Akbari, M., Seydavi, M., Babaeifard, M., Firoozabadi, M. A., Nikčević, A. V., & Spada, M. M. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2861 · Cited by 16
Impacto emocional en pacientes y familiares durante la pandemia por COVID-19. Un duelo diferente
Lacasta, M. A., Lacasta, M., Zarcero, M. T., López-Pérez, Y., Sanchidrián, D. C., Pérez-Manrique, T., CASADO, C., González, C. R., Rosado, L. B., Gutiérrez, N. I., et al. (2020) · Medicina Paliativa · doi:10.20986/medpal.2020.1188/2020 · Cited by 20
“Características sociodemográficas de la muestra Edad (años), N (%) 0-18 0 (0) 18-44 4 (2,1) 45-64 29 (14,9) 65-80 70 (35,9) 81-90 74 (37,9) >90 18 (9,2) Sexo, n (%) Hombre 116 (58,6) Mujer 82 (41,4)”
Rosenberg, A. R., Weaver, M. S., Fry, A., & Wiener, L. S. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.09.037 · Cited by 16
COVID-19 and First Responder Social Workers: An Unexpected Mental Health Storm
Davies, H., & Cheung, M. (2022) · Social Work · doi:10.1093/sw/swac007 · Cited by 20
Does Post-Traumatic Growth Follow Parental Death in Adulthood? An Empirical Investigation
Qasim, K., & Carson, J. F. (2020) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222820961956 · Cited by 15
“Therefore, in the case of any death, the possibility of complicated grief as a result of physical, mental and social distancing will be much higher (Wallace et al., 2020).”
BackgroundJúnior, J. G., do Nascimento, T. G. L., Pereira, M. M. D. M., & Moreira, E. B. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.599722 · Cited by 15
“, sedoanalgesia) to the detriment of terms such as “she/he are sleeping under medication” (13, 14, 19); c.”
BackgroundBrusadelli, E., Ferrari, L. D., Benetti, M., Bruzzese, S., Tonelli, G. M., & Gullo, S. (2021) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2020.501 · Cited by 20
Kamp, K. S., Steffen, E. M., Moskowitz, A. K., & Spindler, H. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211016224 · Cited by 16
“…relevant in the current context of the worldwide Covid-19 pandemic where the conditions of grieving often have become more restricted, potentially resulting in increased feelings of isolation and loneliness (Wallace et al., 2020) – feelings associated with SED (Grimby, 1993; Kamp et al., 2019).”
BackgroundKaasalainen, S., McCleary, L., Vellani, S., & Pereira, J. L. (2021) · Canadian Geriatrics Journal · doi:10.5770/cgj.24.493 · Cited by 15
Death and Dying in a Digitalized World
Asgari, Z., Naghavi, A., & Abedi, M. R. (2022) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221130617 · Cited by 15
“The topic of digitalization of death-related issues has attracted much more attention since the 2019 pandemic when many countries placed strict restrictions on social gatherings (Mortazavi et al., 2020; Wallace et al., 2020) such as funeral ceremonies.”
Neuropalliative care essentials for the COVID-19 crisis
Kluger, B. M., Vaughan, C. L., Robinson, M. T., Creutzfeldt, C. J., Subramanian, I., & Holloway, R. G. (2020) · Neurology · doi:10.1212/wnl.0000000000010211 · Cited by 15
Rowe, J., Potts, M., McGhie, R., Dinh, A., Engel, I., England, K., & Sinclair, C. T. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.06.013 · Cited by 15
“Visitor and contact restrictions caused patients, families, and clinicians to experience isolation, grief, and exhaustion.(3,4)”
BackgroundHardy, M., Fanaki, C., Savoie, C., Dallaire, C., Wilchesky, M., Gallani, M. C. B. J., Gagnon, M., Laberge, M., Voyer, P., Côtéc, A., et al. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.09.006 · Cited by 14
“7 (53,8) 3 (23,1) Time since LTCH admission [Months: mean § SD (range)] 31,3 § 20,9 (7-87) Family caregivers (n = 13) Age (years) [mean § SD (range)] 59,6 § 10,3 (42-74) Gender Female [number.”
Grief of COVID-19 is a mental contagion, first family suicide in Iran
Pirnia, B., Dezhakam, H., Pirnia, K., Malekanmehr, P., & Rezaeian, M. (2020) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102340 · Cited by 14
“For loved ones, funerals and burials are postponed or performed without the presence of loved ones, which is a new experience of grief (Wallace et al., 2020).”
BackgroundÍñiguez‐Berrozpe, T., Lozano-Blasco, R., Quílez-Robres, A., & Pascual, M. D. P. A. C. (2020) · Revista Internacional de Educación para la Justicia Social · doi:10.15366/riejs2020.9.3.016 · Cited by 14
COVID-19: Protecting Health-Care Workers in South Korea
Jeon, Y., & Kim, Y. (2021) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2021.165 · Cited by 14
Schallenburger, M., Reuters, M. C., Schwartz, J., Fischer, M., Roch, C., Werner, L., Bausewein, C., Simon, S. T., van Oorschot, B., & Neukirchen, M. (2022) · BMC Palliative Care · doi:10.1186/s12904-022-00958-9 · Cited by 14
Addressing Grief and Bereavement in Covid-19 Pandemic
Arora, S., & Bhatia, S. (2023) · Illness Crisis & Loss · doi:10.1177/10541373221145536 · Cited by 20
“Anticipatory grief reactions are likely to occur during the covid 19 pandemic as most people experience worry about losing their loved ones to the virus and come in touch with their mortality (Wallace, Wladkowski, Gibson, & White, 2020).”
Reduced child maltreatment prevention service case openings during COVID-19Preprint
Whaling, K. M., Sarkissian, A. D., Lárez, N. A., Sharkey, J. D., Allen, M. A., & Nylund-Gibson, K. K. (2020) · doi:10.21203/rs.3.rs-30930/v1 · Cited by 14
“…with other circumstances caused by COVID–19 that are traditionally linked to harmful sequelae, including, but not limited to: job loss and unemployment (Coibion et al., 2020), global economic recession (Fernandes, 2020), grief (Wallace et al., 2020), and anxiety about infection (Ho et al., 2020).”
BackgroundMcNeil, M. J., Kaye, E. C., Vedaraju, Y., Baker, J. N., Devidas, M., Downing, J. D., Graetz, D. E., Ranadive, R., Rosenberg, A. R., Wiener, L. S., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.03.016 · Cited by 13
Wiebe, E. R., Kelly, M., McMorrow, T. B., Tremblay-Huet, S., Sum, B., & Hennawy, M. (2021) · CMAJ Open · doi:10.9778/cmajo.20200163 · Cited by 13
Investigation into Grief Experiences of the Bereaved During the Covid-19 Pandemic
Asgari, M., Ghasemzadeh, M., Alimohamadi, A., Sakhaei, S., Killikelly, C., & Nikfar, E. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231173075 · Cited by 13
“Similarly, Wallace et al. (2020) found that bereaved person may be susceptible to experience feelings of loneliness, chronic fatigue, and even psychological shock during COVID-19 pandemic.”
Prolonged Grief in Times of Lockdown During the COVID-19 Pandemic
von Blanckenburg, P., Seifart, C., Ramaswamy, A., Berthold, D., & Volberg, C. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231182738 · Cited by 12
“Morris and colleagues suggested multiple steps for hospitals and intensive care units to care for bereaved family members during the COVID-19 pandemic, both before and after the death of a patient (Morris et al., 2020; Wallace et al., 2020).”
Maccallum, F., Breen, L. J., Phillips, J. L., Agar, M. R., Hosie, A., Tieman, J., DiGiacomo, M. L., Luckett, T., Philip, J. A. M., Ivynian, S. E., et al. (2024) · Psychological Medicine · doi:10.1017/s0033291723003227 · Cited by 13
Metadata
- Authors
- Wallace, C. L., Wladkowski, S. P., Gibson, A., & White, P.
- Affiliations
- Saint Louis University (US)
- Eastern Michigan University (US)
- University of Kentucky (US)
- Washington University in St. Louis (US)
- Corresponding author
- Wallace, Cara L.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 60
- Issue
- 1
- Pages
- e70-e76
- ISSN
- 0885-3924 (ISSN-L)
- PMC
- PMC7153515
- OpenAlex
- W3016258882
- Cited by
- 635
- References
- 37
- Citations by year
- 2026: 17 · 2025: 31 · 2024: 58 · 2023: 103 · 2022: 140 · 2021: 173 · 2020: 112
- FWCI
- 52.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- COVID-19 pandemic, grief, palliative care providers, anticipatory grief, disenfranchised grief, complicated grief, advance care planning, self-care, communication, social distancing, visitor restrictions, healthcare workers
- MeSH terms
- COVID-19, Communication, Grief, Humans, Palliative Care, Pneumonia, Viral, Self Care, Coronavirus Infections, Advance Care Planning, Pandemics
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