Guidance on COVID 19

Guidance on COVID-19 Children and young people

Children and young people will be hugely affected by what is going on around them at this difficult time. Their lives are changing and they will have picked up worries and fears about the virus and the possibility that they or someone they love and depend on may get ill. They may be particularly worried that grandparents, older relatives and family members with health conditions or disabilities might die. They will also pick up on other worries parents and carers may have about the situation. For children who have already been bereaved, anxiety may be worse.

If you are isolating as a family this can mean that activities which help children and young people switch off, relax and cope with stress are not available. It is normal for tempers to fray when families are thrown together for long periods, sometimes in close quarters.

How you can help

Talk honestly with your children about both facts and emotions. Ask what they know – they may be getting information that is incorrect or distorted from friends or social media. Don't overload children and consider their age and understanding. With a younger child you may need to give information in small chunks. Talking about the situation and about the possibility of death and dying is an ongoing conversation.

Ask what they know, and be reassuring. Explain that the illness is often mild and most people recover. But be honest about the fact that, very sadly some people will die. It’s OK to let them know if you don’t know the answers to some of their questions.

Don’t make promises (‘Grandma will be fine’) but reassure them that they are loved and supported. Let them know about any plans for what might happen if one of the family gets ill. Focus on what you’re doing to stay safe. An important way to reassure children and young people is to emphasise the safety precautions that you are taking. Children feel empowered when they know what to do to keep safe so explain about the importance of washing their hands.

It can help to keep to a routine, especially when everything has been disrupted. Structured days with regular mealtimes, school work, breaks, playtime and bedtime can help younger children happy and healthy. Help them get some exercise even if they can’t leave the house. Help them keep in contact with friends and relatives over the phone or internet.

At the same time don’t be hard on yourself or set unrealistic goals about what you can do under exceptional circumstances. Try to make sure you all get some time apart, and time to relax. Where possible, let children and young people make some choices about what they are doing, as this may help give them some sense of control over their lives.

Guidance on COVID-19
Coping with talk of death and dying

At times like these it can be impossible to escape from constant discussion of the crisis going on around us. All news, social media and conversations are about the current situation. Many of the activities which people use to relax or distract themselves are being cancelled, and an increasing number of people are in isolation.

In a pandemic situation, there is inevitably lots of discussion of death and dying, and this can bring up difficult feelings for those with anxiety and mental health issues. It can also bring up difficult feelings and memories of past bereavements. It may also bring up feelings of fear about dying yourself.

How to help yourself

It can help to take regular breaks from the news and social media. You may want to limit yourself to a few trusted news sources and check only at certain times of the day. You may also like to take regular breaks from social media. It is helpful to keep to a regular daily routine which also includes some time to relax. Think about what activities are the best distraction for you – this could be watching old films or tv series, reading, arts and crafts, or getting on with some jobs around the house.

If friends or relatives are talking constantly about the situation, try asking them if you can talk about other things for a while. They might appreciate it too.

If reading or hearing things is making it difficult for you to cope with a bereavement, you can call our Helpline (see main webpage for details www.crusescotland.org.uk) or email us support@crusescotland.org.uk

How you can help other people

If you know a friend is feeling anxious, you could suggest talking about something else for a while. Even if you cannot meet in person try to keep in contact as isolation can make it difficult for some people to cope.

Guidance on COVID-19
Feeling your bereavement is not a priority

There can be a strong spoken or unspoken feeling that certain deaths are more tragic than others. Whilst most people would agree that it is particularly shocking and heart-breaking when a child or younger person dies, every death can be a tragedy for friends and relatives left behind.

At times of national crisis like these people may feel that others consider some losses less worthy of sympathy. The media can exacerbate this by constantly mentioning that people who died had underlying health conditions or were over a certain age. It has been common for people to post messages on social along the lines that ‘if you’re young and healthy you’ll probably be fine’. Even if it was not the intention it can feel as if people are saying older and vulnerable people are worth less.

People may also feel that their own troubles are less worthy of attention, and feel guilty about asking for help and support. This can apply if they have been recently bereaved from an unrelated cause, and it can feel hurtful if everyone becomes too preoccupied with their own situation to offer as much practical or emotional support as they might at other times.

How to help yourself

Try to remember that while many people are struggling, it is OK to ask for help. Your own feelings are valid even if others are facing their own tragic circumstances. Talking about how you feel can help, as can remembering someone who has died and sharing memories. If your friends and family are unable to help, you can call the Cruse National Helpline.

If you are upset by media coverage it can help to take regular breaks from the news and social media.

How you can help other people

If you have a bereaved friend or relative try to remember them and stay in touch, even if they or you are isolating. In times where larger numbers of people are bereaved, we can continue to support each other and remember that every bereavement is individual, and that every death that happens before its time is a tragedy.

Whoever you are talking to, try to remember that everyone who dies (whether of COVID-19 or another cause) is likely to be someone’s loved one. The person you are talking to may be vulnerable themselves or have vulnerable friends and family.

Guidance on COVID-19 Funerals and memorials

The current restrictions during the covid-19 pandemic mean many people are unable to attend funerals, cremations and wakes. This is a very distressing reality for thousands of people at this time. Each month in the UK there are around 50,000 deaths, so many people, maybe like yourself, are unable to say goodbye in the way they expected.

You may have come to this page because you have heard about the restrictions and are desperate to know how you can still grieve and honour the life of the person who has died. You may also be on your own, self-isolating, feeling the waves of grief even more acutely. You may be coming here because you want to help a friend and need some practical information.

Whatever the reason, we want to let you know you are not alone. We have trained experts available to help and support you on our helpline.

What are the rules?

As of 24 March 2020, in the UK funerals can only go ahead at a crematorium or graveside. Only 'immediate family' are able to attend (many funeral directors are limiting numbers to 10) and they must abide by social distancing rules. That means unless you are attending with the family you are isolating with; you need to stay two meters apart.

We understand this will be heart-breaking – being unable even to reach out and give a loved one a hug – but it will save lives. Anyone with COVID-19 symptoms, who is self-isolating after being exposed, or who is in a high-risk group, is not able to attend.

It will also be really tough for anyone far away, or who doesn’t qualify as immediate family who also would want to be there. We have given some ways to try and help include them below. Funerals may be shorter than normal and likely to be delayed which for certain cultures will compound the distress.

The rules are the same whether or not the person died of COVID-19, and whether the funeral has been planned in advance or not.

If you are planning a funeral

Speak to your funeral director or celebrant to make sure you are clear on the rules (they can vary between providers). Discuss with them how you can share the service. They may be able to live stream it on Facebook, or you could film it or take photos to share afterwards.

Contact all the people you would normally tell and let them know the date and time (the government ask that the place isn’t shared on social media). If you have chosen not to film it or it’s not possible then they will have the chance to mark the occasion at the right time in their homes. If it’s overwhelming to contact everyone yourself, ask people to call five people each or post on social media, or send an email (blind copied to avoid sharing everyone's address).

You could also ask people to share an anecdote of the person, and if you are attending you could read it out for them so they could feel their memory is honoured.

You could set a time for the same day to hold a wake or gathering online or on the phone.

How you can help yourself if you can’t attend

Contact the next of kin and find out if they are streaming or filming the service. Even if you cannot watch in real time, or the funeral is delayed or reduced to a very short service you can still set some time aside to have your own private goodbye or memorial at home. Look at pictures, play some of the person’s favourite music, write a message to them, light a candle or follow any of your own cultural rituals.

Ask those who have been able to attend to call you afterwards so you can hear their account of the event, and take the time to share your memories of the person.

We will not be under these restrictions forever, and at some future point you may be able to hold a formal or informal memorial to those who have died. And we are here to speak to if you need us.

How you can help someone else who cannot attend, when you can

If you know that someone you care about is not able to attend a funeral, you may be able to help them at what is a very difficult time. If you are attending the funeral, find out if it is possible to take pictures, record the event or even live stream it. They may like to record their own message to read out or play at the funeral.

Offer to call them afterwards and let them know how it went. They may appreciate the chance to share their memories of the person who has died, and hear your memories too.

As time goes on after a funeral and people continue their lives, some bereaved people find that messages of support tail off. In times of social isolation, it will be even more important that they have someone to talk to, so try and stay in touch and let them know you are thinking of them.

How you can help someone when you didn’t know the person who has died

If you can find it in yourself to reach out, please do. Especially if they are on their own. They may want to just share their favourite memories or how painful it is. We all struggle with what the right and wrong this to say but avoiding the subject can compound their grief and make them feel more alone. Acknowledge the person who has died, use their name, text, call and check in regularly.

You can offer them some practical advice too. Share the information and suggestions on this page, or offer to help tell people about the alternative funeral arrangements.

Listening to a distressed loved one, whether you knew the person who died or not, will be hard for you too. We are here to support you if you need to talk.

Guidance on COVID-19 Grief and isolation

This is a strange and distressing time to be grieving and isolated, but we are here to help you. Being bereaved can be one of the loneliest experiences you or someone you love may go through. Talking, and being with friends and family, can be one of the most helpful ways to cope after someone close to us dies. Our advice is usually to avoid isolating yourself, but we are in a situation where remaining physically isolated from others is sadly necessary – to prevent many more people becoming bereaved.

This isolation can make feelings of loneliness and grief much more intense. It could mean having to stay by themselves in the same house you shared with the person who has died, bringing up painful reminders at every turn. You might be isolated together with your family, and although this at times may be a support, at other times tensions and resentments can be magnified making it difficult to help each other. If your children and teenagers are isolated it can be difficult to keep them occupied and deal with your own emotions and fears at the same time. The impact of dealing with a bereavement, compounded with feelings of worry about external situations can mean that feelings of grief aren’t fully expressed.

Isolation can also make it harder to process grief. At times like this when there is a constant stream of new and distressing information, you can find yourself distracted from dealing with your grief. You might be worrying about the situation as a whole, or worrying about yourself or others.

Practical concerns and considerations may also come up. The person who died may have been a partner, parent or carer and you may have been left without practical or emotional support at a time when you need it most. Friends and relatives who might otherwise have been able to provide practical support, eg help with meals and shopping may also be isolating or preoccupied with their own family’s situation.

How you can help yourself

Firstly, while you may feel alone (and in some cases are, physically) know that you don’t have to be alone with your grief. We are here for you – we have a helpline you can call see the main page of our website for details of opening times. You can also call or text your friends and family. If you find some of them are not responding in the way you hoped this is often about their own fears and situation. Or they might be feeling helpless, as they know they can't fix your grief. It can help to explain what you need at this time – whether that is someone to call in the middle of the night or someone you can share funny stories about the person who has died with.

Look after yourself and get rest. This can sound obvious but at these times it is so easy to want to hide away. We are being encouraged to! But do try and get some fresh air or sunlight each day - even opening a window can help. If you are allowed, go for a walk or run, or do some exercise in your home - exercise can be really helpful. Try to keep to a regular routine of getting up and dressed and eating meals at the usual time, whether you are on your own or part of a family group. The structure will help, even if only a little.

You may find you have days when you have more energy and the grief isn’t as consuming - this is normal. Some people can feel guilty when this happens, but there is no need. It is all a normal part of grieving. Equally if you are really struggling that is also normal. Please don’t feel guilty or angry with yourself. It is a journey and we are here to help if you need us. You could also reach out to others who might also be finding it difficult, you may be able to help each other. Seek practical help from friends, family or neighbours.

It is very common to see, hear or feel the presence of someone who has died so don't feel worried if this happens. This can be more common in the case of traumatic bereavement, and if someone is isolated in a location where they saw the person die, or where they are constantly reminded of their illness.

How you can help another person

You might have friends or family that have been bereaved a long time ago or just today. And you may not know how to best help and support them.

At this time of uncertainty and fear many people may struggle more than usual, but you can help them just by being you. Being the friend, partner, colleague, son they love is all you need to be. Being present with someone in their grief is not easy, but is one of the best gifts you can give to someone you care about.

Stay in contact more – ask whether they prefer phone, text or video call (if they have it). Let them talk about how they are feeling and about the person who has died – talking can be one of the most helpful things after someone dies.

You can also call our helpline and ask us specific questions about how you are feeling. If you’d rather not call, you can email. And remember that while you can't take someone's grief away, you can make them feel less alone.

Guidance on COVID-19 Grief and trauma

If someone dies of COVID-19 or complications resulting from the virus, a number of things may be particularly hard for family and friends to deal with.

Infection controls may mean that family members do not have an opportunity to spend time with someone who is dying, or to say goodbye in person.

Depending on the person, the illness may have progressed and become serious very quickly, which can lead to feelings of shock. If they were not able to be present for the death and cannot view the body, it may be difficult to accept the reality of a bereavement.

At times of considerable trauma, people tend to look for certainty. However, at the moment, that certainty is not there. This can amplify any feelings of angst and distress.

Bereaved people may be exposed to stories in the media which highlight the traumatic nature of death in these circumstances. Or they may have witnessed distressing scenes directly. People may become disturbed by mental images, which in a severe form can become Post-Traumatic-Stress Disorder (PTSD).

If the health services become stretched, friends or family may also have concerns about the care the person received before they died. This in turn can lead to feelings of anger and guilt.

How you can help yourself

Talking things through with friends and family can be very comforting. This can be done remotely if you or they are isolating.

If you are feeling very distressed, share your feelings with someone you trust. If feelings persist your GP is usually the first port of call for access to more specialist services. At the present time there may be some additional delays here if GPs are under pressure from the pandemic. You can also contact Cruse for advice on the next steps.

How you can help another person

Try to stay in contact with bereaved friends and family (even if you cannot visit in person if you or they are isolating). Let them talk about how they are feeling and about the person who has died – talking can be one of the most helpful things after someone dies. If you are worried, they are experiencing very severe symptoms or flashbacks you could suggest they contact Cruse or their GP for further advice and support. However, it is likely that GP services will be under additional pressures at this time.

Guidance on COVID-19 Guilt

Feeling guilty is very common when someone is bereaved. The need to blame someone after a traumatic or untimely death can be very strong. No-one is perfect and sometimes blaming ourselves can be easier than blaming the person who died or others. If someone has died of coronavirus, or under circumstances affected by the pandemic this can make things worse. A bereaved person might blame themselves for infecting the person who died, or for not being able to protect them. They may feel very guilty if they were not able to be with the person and pass on any last messages, even if this was not their fault.

How you can help yourself

Coming to terms with guilt will take time and may be a difficult emotional balancing act. Talking about your feelings with someone you trust may help. Remind yourself that these are exceptional times, and you, like most people have been trying to do their best without the usual rules to help.

How you can help another person

Try to stay in contact with bereaved friends and family (even if you cannot visit in person if you or they are isolating). Let them talk about how they are feeling and about the person who has died – talking can be one of the most helpful things after someone dies. You can tell someone not to blame themselves, but be patient. Feelings cannot always be switched on and off at will and it may take a long time for someone to feel better.

Guidance on COVID-19
What to do if someone is grieving

At the best of times we can feel uncomfortable about what to say when someone you know has been bereaved. But in these unprecedented times it matters more than ever that you reach out to those who are suffering after someone dies, while they are likely to be more isolated than ever.

Many more people are going to be bereaved because of Covid-19 and even more people are not going to grieve in the way they would expect during more normal times. Many people will be on their own dealing with grief, unable to even have a hug from a friend. Many will not attend a funeral and some will have multiple bereavements.

Many friends and family who want to support people can feel overwhelmed by these situations. It is normal to feel worried about saying the wrong thing. It is normal to feel helpless, or trapped in your own fears. But if you find yourself unable to reach out, or not able to talk about the person who died, it can result in the bereaved person feeling even more isolated. They might also start to feel like a burden or even push down their grief to try and not make others feel uncomfortable.

If you are finding it very difficult (perhaps because you have been bereaved yourself) we have some suggestions below which might help. Acknowledge your worries and fears, but try not to let them stop you supporting your friend or family member. There is a lot you can do to make them feel less alone, more loved and supported.

What can you say?

Be honest. Acknowledge the news by sharing your condolences, saying how sorry you are that their friend or relative has died. Share your thoughts about the person who died (if appropriate), tell your friend or relative how much the person will be missed and that you are thinking of them. Remind them that you are there for them, as much as you can be.

Sending a card, text or email can mean the world.

Don’t worry too much about saying exactly the right thing. The feeling will come across and it is more important that you say something than that you find the perfect words. Here are some suggestions if you are finding it difficult.

• I don’t know what to say but I am so sorry to hear this news.
• I am so sorry for your loss – you are in my thoughts.
• I’m so sad to hear this and I’m here if you need to talk.
• He/she was such a wonderful person/so selfless – full of positivity/kindness [whatever feels appropriate] – they will be hugely missed.
• He/she will be missed so much – they were so special. You are in my thoughts
• I am so very sorry to hear this sad news. I cannot imagine how devasted you are.
• I cannot imagine the hole that she/he will have left. If you need anything, let me know.
• So very shocked and saddened by this sad news. Hard to believe [name] has gone. I am here when you need me.
• This is so heart-breaking – I wish I could be there to give you a hug.

After a death it is common for bereaved people to want to go over the events leading up to the death, sometimes many times. They may want to talk about the person and tell you stories, they may cry through these stories or just cry down the phone. Again, some people find this really hard to hear but just being there can be a great comfort.

Know that you can’t fix their pain but you can make it a little less lonely by listening or asking more about the person, and what has happened, and allowing them to talk. Many people can find this challenging to do. But just listening, and allowing someone to share their feelings with you, can make a real difference.

As time goes on you may be able to offer more practical help with the arrangements and practical tasks hat come after someone dies. It can help to offer something specific rather than just saying ‘let me know if there’s anything I can do’. If they are struggling you could also offer our number or direct them to www.crusescotland.org.uk

Helping yourself

If someone else’s situation is causing you distress then we are here for you too.

Confronting someone else’s grief may bring up difficult feelings from your own bereavements and that’s OK and normal.

Even if you haven’t lost anyone close to you, you may be very fearful that it might happen. At the present time there is so much in the news about death and dying, and many of us are feeling anxious. It might help to line up someone you can call yourself, after speaking to your bereaved friend or relative, to share your own feelings. You can also call our helpline and talk to someone about how it’s affected you.