Supporting those dealing with bereavement and grief during the Coronavirus pandemic

Dr Adam Rumble, Educational Psychologist, part of the Educational Psychology and Specialist Outreach (EPSO) team for Bright Futures Educational Trust offers advice for supporting those dealing with bereavement and grief during the Coronovirus pandemic.

Dealing with the death of a loved one is one of the most difficult emotional experiences that we can have in life, and the current situation related to COVID-19 may complicate and exacerbate an already difficult situation for some.

This blog will explore how those working in schools can support children and young people (CYP) who may have experienced a bereavement during the COVID-19 pandemic.

Children’s understanding of death

The way in which CYP understand and process bereavement will vary depending on their age and any Special Educational Needs and Disabilities (SEND). Cruse Bereavement Care provide a useful summary of how children’s understanding of death differs across developmental stages.

How do people typically respond to bereavement?

Grief is a normal response to loss and is a way of helping us to process and heal. Following bereavement, it is common for people to go through the following stages of grief:

• Shock and denial: Feeling confused or numb and finding it difficult to accept what has happened;
• Anger: Being angry or frustrated about what has happened and experiencing an outpouring of emotion. It is also common to experience feelings of anxiety and/ or guilt;
• Bargaining and reaching out: Often involves a lot of ‘what if’ and ‘if only’ statements, and thoughts around what might have been done differently. Some people may try to make a deal or promise to God or a higher power in return for healing or relief from the grief and pain. Others may want to connect with other people and tell their story. This can involve trying to make sense and find meaning from what has happened;
• Depression and detachment: Feeling very sad and low in mood and/ or energy. At this stage it is common to feel overwhelmed or helpless;
• Acceptance: Being able to accept what has happened and find a way forward.

Be aware that people experience and demonstrate their grief in different ways. People may experience the stages of grief in any order and any number of times.

It is completely normal to experience intense grief for up to six months and it can take up to two years to reach and experience acceptance.

Grief can have an impact on physical health as well as emotional wellbeing and mental health. It is common for this to result in changes in behaviour – it can be helpful to view these new behaviours as the CYP communicating and attempting to deal with their grief.

How to support those who have been bereaved

Allow time to grieve

One of the most important things for any school to do for a bereaved child is to allow them to grieve and to be sensitive and aware that different people will grieve in different ways.

Routine and structure

Routine and structure provide a much-needed sense of security and predictability, and schools are fantastic places for providing this. As much as possible, support the bereaved person to return to normal activities and to re-engage with routines. If the CYP is not in school, help them and their family to think about how they might introduce more routine and structure on a day-to-day basis.

Talking, listening and validating

Having a safe space to talk and a trusted person to talk to is very important. Ensure any bereaved child knows they can talk to an adult in school if they need to and ensure they know who those adults are. Some CYP will want and need to talk more than others – this is fine.

It’s not unusual to worry that you might say the wrong thing to someone who is recently bereaved, however these worries can lead to that person being avoided or spoken to less than normal during a very lonely and painful time. Show you care by simply expressing your condolences and asking how they are. If they need to talk, they will, and you can be guided by them.

Try to listen more than you talk. Validate their emotions and let them know that it is ok to feel and show any emotion. Avoid phrases that may make CYP feel they should hide or repress their feelings (e.g. ‘be brave’, ‘don’t cry’). It can be helpful tell them that it’s ok to be upset and to cry if they need to, as this is a healthy way of releasing emotions.

Some children may struggle to express their feelings or talk about the bereavement. Where this is the case, visual support and resources can help. Some examples include:

• Lost for words – a free e-book containing insights and advice for bereaved children, by bereaved children (edited by Benjamin Brooks-Dutton);
• Thunks on death – a set of question cards designed to open up thinking and discussion around death, grief and bereavement (from Winston’s Wish and Independent Thinking;
• Completing a memory book – Child Bereavement UK has a range for different ages under the ‘resources for children and young people’ heading.

Talking about and answering questions about death

It can seem daunting and difficult to talk to CYP about death. Be as honest as you can, in a sensitive and age-appropriate way. Be clear and factual. Avoid euphemisms, metaphors or abstract concepts as they can be confusing and misleading.

Be mindful and respectful of the religious and cultural beliefs and practices of the family.

Some children with certain SEND and diagnoses may require additional support, resources or adaptations to help them to understand. Child Bereavement UK has published an excellent information sheet around supporting bereaved CYP with autism.

Acknowledge fears and reassure

CYP will have fears which may seem irrational, but which are very real to them. Listen to their fears and reassure them (as much as you can do so honestly). If the CYP is worried about themselves or other family members dying (which may be more prevalent during the COVID-19 pandemic), don’t simply say it won’t happen. Instead, acknowledge the worry, counter with facts about how rare it is and reassure them that an adult will always be there to make sure they’re safe.

Support and encourage self-care

Encourage CYP to eat, exercise and rest regularly, whilst acknowledging that their appetite, motivation or ability to sleep may have decreased significantly due to their grief. It may be appropriate to share mindfulness or relaxation techniques with older CYP.

Remembrance and rituals

Allow, support or encourage CYP to attend any ceremonies or rituals (e.g. funerals). It may be helpful to plan remembrance activities such as creating a memory book.

Be aware that significant occasions (e.g. anniversaries, birthdays and Christmas) can intensify feelings of grief. Try to consider whether any learning activities may be a potential trigger and offer additional support at these times (e.g. time to talk, time out to reflect or opportunities to engage in remembrance activities).

Monitor and signpost

People grieve for different lengths of time (e.g. six months to two years) and a typical grief response will not necessarily require in-depth specialist support. It will be important for a named member of staff to monitor the response and emotional wellbeing of bereaved CYP.

Some CYP may benefit from early signposting to bereavement charities and support services.

If the intensity of feelings or responses are impacting on their functioning and adversely affecting their daily life, consider encouraging them and/ or their families to contact their GP or refer them to appropriate support services (see links below).

Look after yourself

Be mindful of the impact that supporting a bereaved child may have on you. It is important that you recognise and take care of your own needs so that you are in the best place to support others.

Implications of COVID-19

Grief at any time is difficult and painful. COVID-19 may present additional challenges and stressors, which will be in addition to the normal pain of loss and separation.

Typical responses to supporting those who have experienced bereavement (as outlined above) remain useful and appropriate, however the following points should be taken into consideration if a bereavement has occurred during the COVID-19 pandemic:

• There may not have been the opportunity to engage in typical rituals around death (e.g. viewing the deceased, attending the funeral), so it is possible that the bereaved person may not have accepted the truth or may be slower to move through the stages of grief;
• There is likely to be increased exposure to information that may be upsetting through news and social media (e.g. stories about deaths related to COVID-19, regular updates about infection and death rates). Encourage and support CYP to limit their consumption of news and social media;
• Those isolating with a family could find comfort and support in being together, however tensions and arguments could seem bigger and more upsetting. CYP in this situation will benefit from having time to talk in a safe space;
• If you are aware of a bereavement but the CYP is not yet back at school, consider whether it is appropriate and possible to reach out to offer condolences and to offer to talk via telephone or virtual conferencing. They may not have support at home and may feel very isolated and lonely.

The Greater Manchester Bereavement Service contains some excellent advice and resources related to dealing with bereavement at the current time.

School leaders should consider how they would respond if there was an increase in sudden deaths or if there was the need to support high numbers of CYP, families or staff members at one time. The following articles from The Key for School Leaders contain excellent advice:
Coronavirus: Supporting pupils through bereavement
Coronavirus: Supporting staff who are grieving

Sources, links and resources

National Covid-19 NHS Bereavement helpline (8am-8pm): 0800 2600 400

Child Bereavement UK: 0800 02 888 40   https://www.childbereavementuk.org/

Cruse Bereavement Care:  0808 808 1677  www.cruse.org.uk

The Good Grief Trust: https://www.thegoodgrieftrust.org/

Greater Manchester Bereavement Service: https://greater-manchester-bereavement-service.org.uk/

The Key for School Leaders: The Key for School Leaders COVID-19 resource hub

Once upon a smile: 0161 711 0339   www.onceuponasmile.org.uk

Winston’s Wish: 08088 020 021 https://www.winstonswish.org/

Young Minds: Parents Helpline: 0808 802 5544 https://youngminds.org.uk/