Category: COVID-19

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Plague & Prayer

— In the Midst of Pandemic Life, Religion is a Mixed Blessing

By Lila Mooney

The coronavirus pandemic has now ravaged the globe for more than a year. It has brought with it myriad difficulties; despite the fact that many have been spared from the virus itself, no one has been immune to its economic and social consequences. This dimension of the pandemic’s impact has unmistakably revealed the disproportionate distribution of privilege and hardship in societies around the world, drawing much-needed attention to the ways in which COVID-19 has been experienced very differently by racialized and ethnic minorities, the socioeconomically disadvantaged, and women.

But despite the factual relevance of race, gender, and socioeconomic status, these not the only factors with the potential to complicate pandemic life for people. In the Western world, where religion no longer plays a central role in public life, not much attention is paid to the experience of religious communities. Yet, faith has proven to have a powerful role in shaping pandemic life for believers worldwide, and while it has been a comfort to many, it is arguably a mixed blessing.  

Risks and rewards 

Given the communal aspect of most faiths, many believers have found themselves facing a difficult choice between honouring their sense of religious duty and following public health guidelines to protect their health and safety. Obviously, the degree to which this has become a reality for religious believers varies based on different religious customs regarding congregation, but, having to choose between one’s faith and, potentially, one’s life is no easy decision.

In some cases, religious communities have found ways to adapt to restrictions by holding faith services online. Religious researchers have noted that roughly two-thirds of practicing Christians in the United States are attending virtual church services during the pandemic. However, they also recorded a decline in religious participation among the same group: approximately one in three practicing Christians have stopped attending church during COVID-19. Some of those who continue to worship practices struggle with the inadequacy of online services, but nonetheless express a drive to “keep going.”

However, practitioners of certain other faiths — particularly Islam and Judaism — have, in many cases, struggled with an incompatibility between their religious practices and social distancing requirements. Measures implemented in response to the coronavirus have deeply disrupted Muslim rituals surrounding death and burial rites. Likewise, social distancing regulations conflict with many practices central to (ultra-)Orthodox Jewish life. In Orthodox communities in New York and Israel, devout Jews have defied gathering restrictions in order to attend the enormous wedding and funeral ceremonies that represent a foundational part of their culture and heritage. Attendance at such gatherings is, for many, both “a religious and personal duty.” 

Orthodox Jewish communities have been hit particularly hard by COVID-19, and many have struggled to reconcile the congregation-centred aspects of their faith and culture with public health guidelines. “Man walking beside red wall photo”

A UK study showed that coronavirus death rates were highest among Muslims, followed by those who identified as Jewish, Hindu, or Sikh. Christians had a significantly lower risk, while non-religious individuals had the lowest death rate of all surveyed groups. The researchers noted that these risk disparities could be largely attributed to differences in geographical location, socioeconomic status, and demographic and ethnic factors already linked to higher risk of COVID-19 mortality, and that these considerations could not provide a complete explanatory picture. It seems possible that differences in faith practices could perhaps play at least a minor role. Religious communities whose traditions tend to require mass gatherings could conceivably be more vulnerable to contagion and death.

Furthermore, there’s yet another risk — that of prejudice and division. The perception among the rest of society that members of religious communities are selfishly endangering others by defying restrictions in order to perform rites and duties of faith can breed resentment and deepen social divides. In New York, the government’s handling of the pandemic has largely failed to show sensitivity to the particular needs of the insular Orthodox Jewish communities there, deepening their distrust in civic administration. Efforts by these groups to uphold religious obligations and community life in spite of the pandemic has led to clashes with local government and resentment from fellow citizens. Meanwhile, in India, an outbreak of the virus at an Islamic religious conference in 2020 was followed by an outbreak of Islamophobia. Muslims became the increasingly ostracized targets of fake news claiming they were actively attempting to spread COVID-19. 

Yet, although religion has demonstrated the potential to complicate the pandemic life of its adherents in these various ways, it also brings courage and comfort to many in facing the hardships that the coronavirus has brought. For example, many religious Buddhist communities in Southeast Asia are turning to rituals, magical rites, prayer, and talismans to protect themselves against the virus. Turning to faith-based methods in combination with public health guidelines has provided comfort and relief from anxiety in the midst of the pandemic: for millions, faith can assuage fear and inspire hope and courage. There is also increasing research that supports the idea that faith can have powerful, positive effects on health, especially mental health.

Furthermore, while some like Esau McCaulley lament the loss of community and the irreplaceable experience of in-person worship, others voice enthusiasm for virtual services. A Lutheran pastor replied to McCaulley in The New York Times by pointing out that online worship can indeed provide a sense of unity and community, with the power to alleviate the isolation and loneliness most of the world currently finds itself in. Another reader celebrated the increased attendance her synagogue experienced after switching to online services. For some, the effort to find their version of divinity even in the absence of a tangible community may strengthen and deepen their sense of devotion both to their faith and to their fellow believers.

The responsibility of faith leaders

Given the ways in which religion can have an enormous impact on pandemic life, it’s clear that faith leaders have a lot of power and responsibility in terms of the guidance they offer to their followers during this troubled time.

Where religious leaders misuse their power, society at large suffers as a result. For instance, some evangelical ministers in the United States have established a reputation for denying or downplaying crucial information about the virus, encouraging their followers to put their faith in God rather than in scientific and medical experts, and refusing to suspend in-person services while denigrating those who have done so in compliance with social distancing guidelines. In-person religious gatherings can turn into super-spreader events, infecting not just religious believers, but also other members of society they may come into contact with afterwards.

The Dalai Lama is among the religious leaders who have shared messages of hope, compassion, and unity during the pandemic. “The Dalai Lama speaks at the NIH”

However, other faith leaders around the world– including the Dalai Lama and Pope Francis— have demonstrated an understanding of the responsibility that rests on their shoulders, and have shared uplifting messages of courage, hope, and compassion with their followers while also praising medical workers and encouraging their communities to be patient, heed guidelines, get vaccinated, and listen to science. An interfaith conference of religious leaders in Indonesia demonstrated a heartening logic of cooperation in the face of challenges and awareness of faith’s powerful impact on society’s experience of pandemic life. While almost everyone has recognized the vital role played by political, scientific, and medical authorities as the world struggles to tackle the virus, perhaps we should also acknowledge that similarly, religious authorities have a significant impact. The messages they send to their followers play a role in determining whether and how the faithful will adapt their worship to comply with public health guidelines. Thus, while faith has a hand in how believers suffer and overcome the hardships of navigating an isolated world, it also affects public health, as the choices religious congregations make have far-reaching effects beyond their own communities. In one way or another, faith has the potential to affect believers and non-believers alike at this fraught moment in human history.

Complete Article ↪HERE↩!

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Death-oriented doc finds poetry amid pandemic

New Orleans’ famed jazz funerals a casualty of COVID-19

The documentary Death Is Our Business looks at how the pandemic altered jazz-funeral traditions in New Orleans.

By: David Zurawik

As we reached the one year mark this month of life under COVID-19, there has been no shortage of articles about how the virus has changed us. One of the most striking and still underappreciated ways it has done so is in our thinking as a society about death.

Prior to the pandemic, we were not a people who thought a lot about dying. I believe one of the primary reasons for that is that our popular culture, at least when it came to television, has generally avoided it.

One of the primary reasons for that: The commercial networks believed death was bad for business. I know that because multiple network executives have told me so over the years as if it were a truth handed down from a mountaintop on stone tablets, even though no one could supply research supporting that claim.

Death and destruction caused by COVID-19 have changed that situation dramatically, and I believe we are better for it. Existentialism says an awareness of death leads to a fuller and more authentic life. But you don’t have to be an existentialist to appreciate the way thinking about death can at least lead to a more thoughtful and focused life, driven by the awareness that our time on earth is limited.

I have written these past 12 months about several death-oriented, life-enriching shows, ranging from the Netflix series After Life, starring Ricky Gervais as a middle-aged journalist whose wife dies young, to Elizabeth Is Missing, a PBS movie starring Glenda Jackson as a woman with early-stage Alzheimer’s disease trying to solve the disappearance of her only friend. Both rattled around in my brain long after the final credits played. And now comes a Frontline documentary, Death Is Our Business (PBS, tonight, 9 p.m.), which has had the same kind of effect on my psyche. Images from it danced through my dreams earlier this week and I have been thinking continually about some of its themes.

The documentary by filmmaker Jacqueline Olive (Always in Season) looks at the way in which COVID-19 has changed centuries-old Black funeral practices and rituals in New Orleans. That includes horse-and-carriage processions, jazz musicians and the second line of dancers. The power of the film is found in both the poetry of its imagery and the deep, cultural context and analysis it offers of the African-influenced rituals that have branded New Orleans internationally and provided its Black citizens with a wealth of tradition on which to draw at times of sorrow and loss.

The film opens with a series of images carefully edited to the words sounded in voice-over by New Orleans psychiatrist Dr. Denese Shervington.

“New Orleans is this very complex combination of suffering and joy,” Dr. Shervington says.

On the word “suffering,” the screen fills with stark images of workers in masks handing out bags of clothing and food. On “joy,” images of young musicians dancing in sync on the street as they play their drums overtake the screen.

“Katrina forced us to think a lot about what it means to heal,” Dr. Shervington continues. “I think we’re having a similar experience with COVID and this pandemic. How do individuals come back from extreme loss, loss of family members, loss of what was normal? How do you find your way back?”

Dr. Shervington’s words immediately contextualize this community’s response to COVID-19 within the history of Hurricane Katrina, an event of disproportionate suffering by Black citizens in New Orleans. She also introduces the notions of resilience and healing in asking how to rebound from events like that.

In the film, jazz trombonist Delfeayo Marsalis, a member of the famed musical family of New Orleans, offers a concrete way one of the funeral rituals of the city helps survivors come back from the loss of a loved one.

“The idea of the jazz funeral is actually to help the family,” he says in the film. “And the journey from the church to the burying ground is a process where you can not only reflect and think, but you have people who are there to support you.”

Olive says the jazz funeral has served multiple functions in Black life.

“One, it’s a way of transitioning the soul of the dead,” she says in an interview. “So, you have this sombre moment and then that turns into almost a street-festival celebration. That’s a way of cutting the body loose so it can transition to the other side.”

It also helps those left behind “to be able to deal with their grief collectively,” she says.

“They have people whose shoulders they can literally lean on,” she explains. “You see in the footage, folks hugging each other and supporting each other physically. But it also means people are sharing food and sharing space and stories about their loved ones.”

Marsalis felt the loss of that ritual at a personal level when his father Ellis, the patriarch of the family and an internationally celebrated jazz figure, died at the age of 85 last year as the pandemic worsened.

“He was buried April 4th,” Marsalis says in the film. “We had about 10 people there,” he adds, because of limits on how many mourners were allowed at a funeral at that time to stop spread of the virus.

It’s a much different look than prior to the pandemic.

“There would have been a second line and a jazz procession,” says Jasminne Navarre, director of client services for the D.W. Rhodes Funeral Home.

Louis Charbonnet III, CEO of Charbonnet, Labat-Glampion Funeral Home has similar sentiments: “We’re a jazz-funeral town, and it’s hard to tell people you can’t have a jazz funeral. But we have to.”

Even though the pandemic denied the Marsalis family the kind of grand New Orleans send-off residents wanted to give the pianist, there is a poignant moment in the film where Olive brilliantly creates a cinematic memorial for him.

She starts with the image and sound of Delfeayo Marsalis and two other musicians standing in a cemetery amid tombstones playing a slow, particularly mournful version of A Closer Walk With Thee. The music plays underneath the reciting of an excerpt of a poem written by Reynold Verret, president of Xavier University of Louisiana, in the wake of Marsalis’s death.

“Last night, Ellis Marsalis went away,” Verret says. “No second line. No coming home of acolytes, the many musician daughters and sons. None may return to ring the bell, to celebrate, to mourn. In solitude, we remember.”

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Olive brings the music, images and words together in a perfectly distilled cinematic brew that makes your heart ache at the loss of this musical giant’s life. This moment alone would make the film worth going out of the way to see.

“There would have been literally at least 15,000 people lined up for the Ellis Marsalis funeral,” Olive says.

The film goes well beyond memorializing Marsalis or any one New Orleans figure, though.

“When I finished filming, I really came to understand that this film is a memorial to all those folks who died during the pandemic in which their lives weren’t acknowledged in the way they often deserved,” Olive says.

Death Is Our Business is a tribute, too, to the power of the rich Black funeral traditions of New Orleans and the funeral directors who, like jazz musicians, have been improvising the last year to keep bits of music, dance and celebration into their services, as difficult as that has been in the face of COVID-19.

Complete Article ↪HERE↩!

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Should Everyone Have An End-Of-Life Doula?

By Anna Lyons and Louise Winter

On a crisp January morning, we carried Camilla’s purple coffin, covered in blooming yellow flowers, into the Art Deco chapel of a London crematorium as Leonard Cohen sang “Dance Me to the End of Love”. Her family and friends watched from their homes in New York City via a livestream link. They’d recorded voice notes in advance, which we’d uploaded to the music system. Camilla’s coffin rested on the marble catafalque, as their pre-recorded words of love, gratitude and admiration were played. As the curtains closed around her coffin, a recording of Camilla’s niece reading “Phenomenal Woman” by Maya Angelou echoed around the empty crematorium chapel.

Camilla lived a creative, vibrant and full life, surrounded by a wide circle of like-minded people. She died alone on a Covid-19 ward in a central London hospital. In the saddest and loneliest of circumstances, Camilla’s family and friends found a way to come together to say goodbye to the person who had been a huge force in all their lives.an end-of-life doula and a progressive funeral director. Anna supports people who are living with life-limiting illness, their family and friends, helping people to live as good a life as possible right up until the very end. In her doula role, Anna also works with people who are grieving. Louise supports people to put together funerals that honour, heal and inspire. Our joint mission is to normalise death and dying as part of life and living. Over the last year, our work, both together and separately, has changed immeasurably.

Many of us won’t have any idea that, worldwide, in an average year, around 151,600 people die every single day. That’s almost two people every second. Annually, in the UK alone, more than 500,000 people die. However, the Covid-19 pandemic has meant that death and dying have infiltrated and impacted our lives in ways we’ve never experienced before. As a society, we’ve been faced with the shock of horrifying death tolls on a daily basis. We’ve been unable to be at the hospital deathbed of someone we love, or if we were allowed, we’ve had to say goodbye through multiple layers of PPE. Some of us have attended restricted funerals, unable to engage with the rituals and traditions associated with loss

Where do we turn when someone dies? In normal times, we’d seek solace in the presence of others, we’d allow ourselves to be supported by the people around us. They would bear witness to our losses, keeping us close and secure in the knowledge they were near. Devastatingly, Covid-19 has changed all of this. We couldn’t reach out. We couldn’t physically be there. We couldn’t hold someone’s hand as they lay dying in hospital or give a friend or colleague a much-needed hug after a funeral service. Human touch and connection were replaced by a phone, an iPad or a laptop screen – a cold, hard, reflective surface with its ability to “connect” reliant on an intermittent internet connection. With the absence of human connection, of closeness, of the comforting arms of someone we love, how and where did we find consolation and care? How could we find ways to come together while staying apart?

We are privileged that our jobs have allowed us to witness a myriad of inspiring and beautiful ways people have found to do just that. The humanity of NHS staff has astounded us time and again. One nurse stayed with a young woman who was dying alone in hospital long after his shift was over, reading aloud the text messages she was receiving from family and friends. We saw a frightened young woman transferred from the hospital where she was receiving cancer treatment to hospice so she could be surrounded by those who loved her at the end. Her family played her favourite music and soothed her with stories from her childhood in a peaceful room overlooking the hospice gardens. And a newly married man, with his entire life ahead of him, died unexpectedly in a tragic accident. Hospital staff, despite restrictive regulations, rushed to find extra PPE so his new wife could be there to kiss him for the final time.

We watched a fractured community come together to share flowers from their gardens when florists were closed and funeral flowers were unavailable. A simple request via the neighbourhood WhatsApp group resulted in a widow’s doorstep overflowing with blooms for her partner’s coffin. We witnessed how the rules of social distancing have necessitated some radical creative thinking and we worked with a celebrant who designed a long multi-coloured ribbon that everyone at the funeral could touch and hold to feel connected, while still remaining physically distant.

We were asked to help facilitate a worldwide Zoom by a group of friends when one of them died by suicide. They wore his favourite colours, shared photos of the fun they’d had together and raised a glass of champagne in his honour. Separated by a virus, united in grief, connected via technology.

Who would have thought just 18 months ago that today we’d be watching the people we love dying over FaceTime and attending their funerals via video link? Yet the unimaginable has become our everyday reality. And it’s within the reality of the unimaginable that we’ve seen the infinite beauty and endless possibility of the human spirit shine. We’ve learned we can bear the unimaginable. We are bearing the unimaginable. Through kindness, creativity and determination, we’ve found hope in our heartbreak, discovered that our vulnerabilities are also our strengths, and realised that our resilience is born from finding fragments of optimism and wonder in the most unlikely of places

Now, the promise of spring sits in the cool end-of-winter air. Gone are the dark afternoons; the frost and biting wind are slowly disappearing, allowing these March days to tenderly unfurl, reaching expectantly into the longer evening light. They bring with them a degree of anticipation, hope and new life. There is life. There is hope. There’s always hope.

‘We All Know How This Ends: Lessons about Life and Living from Working with Death and Dying’ by Anna Lyons and Louise Winter is available now.

Complete Article ↪HERE↩!

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I want my dying patients to have good deaths. I grieve for all those who died alone this year.

By Roshni Kakaiya

February marked one year since I last saw somebody die in our hospital surrounded by their loved ones. To give you some context, I am a physician in training in the South Bay — a community that was hit particularly hard by the novel coronavirus that can lead to COVID-19. As a family medicine resident, I take care of patients in our clinic, admit them to the hospital, care for them in the ICU, and even deliver their babies. As such, I am no stranger to the never-ending cycle of birth, illness and death, especially during the pandemic.

Yet I can tell you that a few moments of clarity shine bright against the haze of this past year. This memory of my patient’s death stands out so strikingly to me because of the comparison with what came down just a few days later, when our lockdown began and our hospital policies changed.

One year later, I can close my eyes and still picture this patient and her family. The patient was in her 80s and the matriarch of her family. The day before she died, she had woken up with some energy and was able to speak with her daughters who were at bedside most of the day. We see this sometimes in the days before people pass — they get a burst of vivaciousness that sometimes fools us into thinking they are doing better.

The day my patient died, her daughters were holding hands and all touching some part of their mother, grieving together and comforting each other. Their husbands and children were somberly in attendance, intermittently wiping away tears. There must have been at least nine people in that room, something I can barely imagine now with our limited visitor policy. The daughters sang the patient’s favorite hymn, and they were even able to play part of a sermon their mother loved. Every time I walked into the room to check on this patient, I immediately felt the warmth, the love and the comfort the family was bringing to each other. This was a good death. This was a death filled with love, and touch, and warmth, and solidarity, and connection, and presentness. This was a death the family could remember and discuss as needed as its members mourned, which, as we have come to know, is crucial to processing such a significant event. This was a natural death of a woman in her 80s who had lived a long and wonderful life.

As a physician in training, it initially felt counterintuitive how much time we spend thinking and talking about death with our patients in both the hospital and clinic setting. However, I’ve come to realize that some of my most important work comes in the form of advocating for my patients to have a good death. A death they would have wanted, maybe even that they could have chosen for themselves — a peaceful death or a death with a fighting spirit up until the very end.

As I see our patients dying mostly alone in our hospital, with only family being able to visit, one or two at a time in the hours before a person is about to die, or looking at their loved ones through the window as they are intubated and sedated, I grieve for our community. I grieve for those who have had so many good deaths taken away from them — and had them instead replaced with a screen from which to watch their loved ones slowly dwindle away. I grieve the good death, the death that comes with a natural closure. Yet I am hopeful that one day we will return to this good death — the death that is filled with touching, hugging, crying, laughing, and snot flying everywhere. One day, togetherness will not be the vector for more deaths and more grieving. It will be the balm that heals us from the most difficult year of our lives. This is the death I wish unto you and your families in the future: the good death, a death worth dying for.

Complete Article ↪HERE↩!

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On life, death and dying

Theresa Hamilton plays tic tac toe on a window with a senior in Mt. Cartier Court as the pandemic limited in-person visitors into senior care homes.

By

Theresa Hamilton wants to help people die better.

“I find that I am a magnet to it and I really care and I want to talk to people about sad, happy, absolutely everything,” she said. “When you keep death natural you get to see the beauty in it.”

Hamilton works as the executive director for the Revelstoke Hospice Society and as a death care practitioner, also known as a death doula. She hosts monthly death cafes where people can ask questions and talk freely about dying.

“I want to teach as many people as I possibly can what they have within themselves, and I have seen how, when you do a lot of the work around creating quality of life for people before the end of life, or creating rituals or ceremonies or being able to create a legacy project with somebody before they have died, that always ends up helping the grieving process,” she said.

Hamilton and her partner bought a home in Revelstoke in 2016, but had spent the previous five winters in the city, going back and fourth between here and Grand Bend, Ont.

For five years she worked at the La Baguette at RMR.

“I was immersed in everyone riding and loving the ski hill. I think just being a happy face in people’s daily lives just really kind of launched me (in the community),” she said.

But eventually she felt she had to put her education to use.

Hamilton originally went to university intending to be a social worker. There she discovered thanatology, the scientific study of death and losses.

She also completed Indigenous Studies, which changed her views on dying and made her realize how much she had to unlearn.

“It is a more holistic method than we are used to,” she said.

Hamilton has been volunteering for hospice societies in every town she’s lived in.

“I really admired how small and mighty they were,” she said.

Revelstoke was no different, and with the previous director stepping out, Hamilton was tapped to take over. Though she is now paid by the society, she said she probably volunteers more now than she did before.

Hamilton also helps with Community Connection’s Food Recovery program, the Revelstoke Snowboard club and the Revelstoke Performing Arts Centre, when they are operating in-person.

“I just think that volunteering is your daily vote for democracy,” she said. “I am creating the world that I want to live in.”

Hamilton is also an activist and she supports everyone’s projects.

“Social justice anything is always on my radar because I think we have safety in numbers,” she said.

With all these causes under her belt, she often gets labelled a “Mother Theresa” type, which is something she brushes off.

“I don’t see it as being amazing the way my friends tell me it is amazing, it’s just like, ‘Yeah, but, that’s life,’” she said.

However, the namesake she is happy to claim is her grandmother Theresa, who she never met, but who also did death care work through the Catholic church.

“It’s really nice to know that I am fulfilling my ancestors roll,” Hamilton said.

Complete Article ↪HERE↩!

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How can we grieve our loved ones without our traditions?

By Niamh Delmar

In Ireland, wakes, removals and funerals have been an integral part of our culture. Giving the deceased a ‘good send off ‘ has been a final tribute to those who have passed. Offering our condolences, food and practical help is an inherent part of our culture.

In the past, churches have heaved with mourners and locals gathering to pay their respects. Celebrations of life, humanist services and scattering of ashes have facilitated a communal mourning. Over the years, soup and sandwiches in the pub after, morphed into meals in a hotel.

The rituals of a burial or cremation are an important part of our humanity and the grieving process. As well as handshakes, hugs and pats on the back, mourners meet people who knew the deceased at different times in their lives. Life stories are elaborated on.

The rituals of a burial or cremation are an important part of the grieving process.

The Irish wake has been passed on through generations. It facilitates the dead and the alive to come together. Traditionally a room in the person’s house is prepared, beside a window to let the spirit leave to its eternal journey. Candles are lit at the foot of the person and the corpse is dressed in their best clothes with rosary beads in their hands.

Prayers, tears, laughter, song and drinking all feature in the presence of close family or the whole neighbourhood and friends. Historically, the deceased was kept in the room for three nights with someone always attending it. There was a lead keener who would cry over the body then others would join in and wail. A wake is a mix of sorrow and celebration, but sadly has been curtailed by this pandemic.

COVID-19 has hijacked our customs around death. Rituals, such as kissing the deceased, open caskets, condolence books and even transport to the funeral have all been impacted. Churches that once heaved have now just a few pews filled with masked mourners while everyone else is watching or crying at a screen, lining a road or standing outside. The solace of connection has been taken.

Mary Cunniffe, branch manager with Massey Brothers funeral directors talked with me about the adapting they have experienced over the past year. Supporting employees at this ‘other’ frontline has been a focus as they have been exposed to suffering, while also trying to keep themselves safe from infection. Some have vulnerable people at home living with them.

Mary commented that grief has been compounded by not having had a chance to have said their goodbyes or words that were left unspoken. People have not been able to give the large repose to honour their dead. Another fall-out from restrictions is that people are unable to visit the bereaved, help hold their grief, or help with practicalities.

All of this is part of the grieving process and eases the suffering. Crying on a shoulder, sharing a cup of tea or a drink, recounting stories about the deceased carries those mourning. Landmarks such as death anniversaries, the deceased birthdays and significant dates have passed unmarked. Suffering and loss has traumatised our nation.

Dying during the pandemic with social distancing and other measures goes against our core nature. Grief has been intensified among those who are left to handle the idea of their loved ones dying alone. Holding the hand of a dying person is comforting to both.

It exacerbates grief when those close to the person can’t attend to their needs, get to know the doctors and nurses or advocate for them the same way. The role of human contact in dying and grieving is powerful. Health care workers have borne the additional brunt of this pandemic by witnessing patients dying without the usual presence of loved ones.

End of life
It is time for dying, funerals and grieving to be looked at in different ways and for us to be prepared for the aftershocks of COVID and non-COVID related deaths during this pandemic and its restrictions. Conversations can be initiated to ensure choices are made and wishes observed.

More palliative care at home is of enormous benefit to overstretched hospitals and provides comfort to the dying and their loved ones. Sharon Foley CEO of the Irish Hospice foundation has said that surveys reveal 75% of people would like to die at home but only 25% do. 

More personnel, such as Chaplains and end of life carers, are needed in Hospitals and play a significant role at the end of life and also play a supportive role to the medical team.

Hospices provide holistic care and dignity to the patient, and look after the needs of loved ones. More of this type of intervention is needed. Ten million euro was awarded to the voluntary hospice sector recently which helps bolster the loss of fundraising monies.

Studies have shown that simple acts such as sitting, rather than standing, at a patient’s bedside can have a positive impact. Open communication between healthcare workers and families is essential. Gathering information about the patient’s life story, likes and interests can facilitate connection with those who are treating and caring for them.

End of life can be personalised with photos of the person nearby, their favourite music being played and the use of technology for loved ones to be in regular contact. The medical team can have their photos and names on their uniforms to ease the distress of being treated by people in full PPE gear. Hospice professionals assert that hearing is the last thing to go so talking, music and other aural activities can be soothing interventions.

Grieving
While public health is a priority, limited visitation policies and funeral restrictions need be constantly reviewed to provide dignity to those who are nearing the end of life and solace to those grieving. Restrictions compound the process of grieving, increasing the risk of various psychiatric conditions, such as PTSD, depression, anxiety and suicidal ideation.

It also increases the risk of complicated grief or prolonged grief disorder, as not being able to say goodbye to a loved one is a risk factor. It helps if the funeral can be personalised with input from those who can’t attend and a virtual platform can be arranged where people can leave messages, memories, poetry, song and photos in honour of the deceased.

Outlets for children to express emotions can be encouraged. Regular scheduled virtual meet-ups to remember the person’s birthday, anniversary and other landmarks maintains connection. It is never too late to have a memorial, and some people I have spoken with are planning these at a later, safer stage to celebrate the person’s life.

Professionals involved with the bereaved can benefit from training in grief counselling and assessing complicated grief. We all need to be mindful of how we use the word ‘loss’. It has been thrown out there carelessly. While there have been so many losses experienced throughout this pandemic, the loss of a holiday is not at the same level as not being able to be at their loved ones bedside at the end.

Health care workers and the frontline
Counselling is also essential for those who have been at the frontline and exposed to trauma. Compassion fatigue is intensified, without the support of families being present, while a patient is ill or dying. Comforting patients with the barrier of PPE, having difficult conversations and substituting loved ones is a huge emotional responsibility. And moral injury is a systemic problem when frontline workers become frustrated as they are unable to provide care, at the level they were trained, due to constraints.

Significant distress arises when a person has to go against their value system. Psychological PPE is fundamental to protecting the mental health of the frontline. It involves assessment, identification, intervention and monitoring of staff. Debriefings, peer support, support groups, self-care practices have all been found to be beneficial.

Professor Neil Greenberg, Consultant Occupational Psychologist, trauma specialist and Forensic Psychiatrist at King’s College London has called for better identification of vulnerable workers and access to evidence- based treatment. Many others are involved in end of life care such as the funeral sector, clergy, carers and social workers.

There is, and will be collateral damage, but the systems in place within each setting can alleviate adverse symptomatology.

Communities, individuals, society, organisations and policies can interconnect to provide end of life dignity, ways to facilitate after life rituals and identify and support the bereaved. Ar dheis Dé go raibh a n-anamacha.

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‘I will hold their hands’

— Chaplains give terminal COVID patients a chance to say goodbye

By Will Peebles

Two days after a parade-less St. Patrick’s Day in Savannah last year, Mayor Van Johnson declared a local state of emergency because of COVID-19. The next day, March 20, the Georgia Department of Public Health reported the first two cases of COVID-19 in Chatham County. In the year since, Chatham County has lost more than 350 people to the virus. This article is one in a series that examines how individuals have dealt with a year-long crisis and have helped pull the community through the pandemic.

Rachel Greiner remembers when the reality of COVID-19 truly hit home for her.

In June, Greiner, the director of Memorial Health University Medical Center’s Pastoral Care team, found herself making arrangements for a mother and daughter, both sick in the hospital with COVID.

The daughter, the more serious case, was on the hospital’s COVID intensive care unitfloor.

She was dying.

Her mother was on the floor above her, reserved for patients sick enough to be in the hospital, but not yet sick enough to require ICU care.

Greiner and her staff of chaplains worked to get the mother into her daughter’s room. They were together until her final breath, a powerful, truly human moment — a final goodbye.

“And it was, of course, a sacred time, very beautiful that the hospital worked in order to get this woman down to be with her daughter,” Greiner said. “And while that was happening, my phone was ringing, and it must have rang six times.”

While Greiner was making sure a mother could be there with her dying daughter, her own children’s daycare was calling. She stepped out, in full personal protective equipment, to return the missed calls.

The daycare told her one of the teachers contracted COVID, and was calling to tell Greiner her children had been exposed.

“Now, that’s so commonplace I would roll my eyes if they called me and told me that today, but at that juncture, literally standing at the deathbed of someone with COVID-19, hearing that my children had been exposed to it — that was probably the moment that I was like okay, this is really real now,” Greiner said.

As a chaplain, Greiner deals with heart-wrenching situations on a daily basis. And for the last year, there has been no shortage of difficult work.

It’s a misunderstood profession, Greiner said. She and her team provide spiritual care to patients in the hospital, but it isn’t a single religion — in fact, it’s not inherently religious at all.

“We call it a ministry of presence. Sure, a lot of the things that we do are religious in nature. People want to pray. And they ask, and of course, we say yes,” Greiner said. “But we don’t come in the room demanding that you bow your heads and pray with us.”

If a person is in the ICU at Memorial Health, they’re going to see a chaplain at least once during their stay. But COVID, as it so often does, complicates things.

Early on in the pandemic, Memorial turned an entire medical ICU into an ICU specifically for COVID patients. Nurses were sending their children to live with grandparents to avoid possible spread.

Chaplains are in charge of facilitating patient visits. Sometimes those visits are virtual — they hold an iPad with family members on video chat. Not long ago, Greiner did a call with 48 people as they said goodbye to a family matriarch.

But it’s not the same.

“There’s no substituting what it would be for these patients to hold the hands of their spouses or their children. But in their stead, I will hold their hands and hold the iPad over them so that their loved ones can say goodbye,” Greiner said. “And my hope is that as they are transitioning from this place to the next, that that’s what they’re hearing: the love pouring out of their family’s voices coming through the iPad to them.”

For in-person visits in the COVID ICU, adults get one visitor. For kids, it’s two.

But when they’re moved to end-of-life care, that number is expanded to five.

That’s a tough restriction for some families. Only two people can go to be with their dying loved one for 30 minutes at a time.

“Let’s say it’s a spouse, they’ve been married 50 years, they have six kids. Well, they only have four more spots left, so they have to pick their four favorite children. And then of those four, only one of them can stay with dad while mom dies,” Greiner said. “I understand the reasoning behind it. But it is no less difficult to explain over and over again, and to empathize and say how sorry you are that you can’t get everybody in.”

It can be exhausting, but Greiner’s job doesn’t stop there. Her pastoral team members aren’t the only ones putting in emotional work day after day: the nurses, doctors and staff at Memorial are in the thick of the pandemic, as well.

Greiner said while her job is patient-oriented by nature, a lot of her work involves caring for her coworkers, as well. She coordinates with Memorial’s Nurse Manager Amber Schieber to host Muffins, Moments and More, a get-together at the hospital where the staff leans on each other for support, talking through situations that affected them, Schieber said.

In the breakroom is a prayer, written by Greiner, framed by Schieber.

“Rachel has really been a rock for us during this pandemic. She’s so wonderful. She’s been there for our patients and the families and the staff,” Schieber said. ”If COVID has taught us anything, it’s to really lean on your family and your support system. And Rachel has absolutely been that for us.”

“I tell everyone, it is so important to establish a counselor of some sort, especially when you work in health care,” Greiner said. “You can’t care for other people if you’re not caring for yourself.”

For Greiner, self-care is paramount. It can take the form of a monthly check-in with a therapist or a pep talk from her family. Sometimes, it’s as simple as getting out of the house to go to her happy place: the beach.

“I have a family that supports me, my husband knows if I say it’s time to go to the beach, then it’s time to go to the beach,” Greiner said.

The emotional toll of her job is enormous, and it has been especially so for the last year. But day-in and day-out, she facilitates these sacred end-of-life rituals — these final goodbyes — for those most touched by the tragedy of COVID.

“It is difficult, but it’s also very humbling. I think that the ground we stand on at that point is very sacred, and it’s an honor to stand on it with these people and to help bridge the gap from wherever their families are to that room where they can’t be,” Greiner said. “To hold their hands and stroke their faces and tell them it’s going to be okay as they leave, it is an honor.”

Complete Article ↪HERE↩!