– An introduction to a four part Expert Counsel series
Death is a part of life. It is normal. Grief is part of the process we use to cope with death and other major losses. It too is normal. Isolation? Isolation is necessary to fight a pandemic, but it is not, or should not be normal. Frankly, isolation and loneliness can be decimating.
The world has been turned upside down by Covid-19. I was speaking with a friend a few weeks ago, and her Uncle had just passed away. I offered words of solace. I wanted to give her a hug — but we cannot do that right now. In fact, I asked myself, how is it possible for her to grieve in times like this?
Kept away from our loved ones during hospitalization or hospice. Not able to have those last few days that I had with my own parents, and that I found so comforting. No funeral? No gathering of friends and family? Burial limited and social distancing in place? Are we to watch those closest to the loss and … perhaps let a tear drop, and then slowly walk away?
How do we cope with isolation, followed by death and grieving in days like these?
I had no idea. So I wrote an email to several experts whom I thought could help — I am obviously not alone with my questions. And from this email, this four part series was borne.
Over the next few days The Partners In Care Alliance will be posting a series written by experts on End-of-Life Care in isolation, Grief and loss from a distance, Dealing with the mortal remains / planning from a distance with family and Planning the eventual Memorial or Celebration of Life.
In times like this, words from those who have the experience, the knowledge and the caring can help us get through it. We are all in it together, and this is one way we hope to help.
Caring for a loved one as they enter their twilight years is a privilege as well as a challenge at the best of times, however it has taken on a whole new level of stress and challenge in the midst of the global Covid-19 Crisis.
In what was the “norm”, a loved one who required in-home care, or assisted-living and/or palliative care in a “care home” received the required specialized care, while the family was still very much present and engaged in their lives until their time of passing.
Unfortunately, the Covid-19 quarantine has required mandatory isolation thereby preventing families to be there in person for their loved ones, which has been very difficult for both parties. I understand this all too well, with my father being isolated in a Care Home. It has been difficult for the whole family, and very hard for Dad who had Mom & visitors every day.
So how can we be there for our isolated loved ones from a distance? Fortunately, technology today has enabled us to connect in ways not possible 10–15 years ago. Following are some creative practical suggestions that while not the same as in-person touch and connection, can still provide love and encouragement, helping them to not feel separated and alone.
Regular phone calls so that they can hear your voice, even of they may not be able to respond back to you.
Visual calls through apps like FaceTime, Skype or Zoom that allow for them to see and hear you. It can provide for group chats and discussions that engage them, and allow for fun and laughter. You could even have a guitar or piano and do a sing-along of their favorite songs. Even if they are not able to sing along, being able to listen and be a part of it will lift their spirits.
Use the same visual/audio apps to allow them to see their grandchildren. Have the young ones say hi, sing them a song, do a show for them, or show their arts & crafts online. Seeing the young ones brings joy and life. You could even let them see their pets online.
If possible, bring a lawn chair, gather outside their room window, and talk with them via an open window or cell phone. Bring them a coffee or special treat that most Care homes will let you leave at the door and they will deliver the treat to your loved one. You can share your treats together as you visit.
If they are in a state that does not allow for the above, send daily notes of love and encouragement that can be read to them by their caregivers.
The critical issue is taking the time to creatively connect and share your love and support for them, and remind them they are not alone or forgotten. In the Bible, Proverbs 17:22 says, “A cheerful heart is good medicine”. Though isolated, our loved ones do not need to be without cheer…. we are their cheer!
We are living in an unprecedented time of change and transition because of the Covid-19 Outbreak. Life as we know it seems to have disappeared and threatens to never return to what it was. The new normal that is being presented for the future demands social distancing and restrictions on the size of public gatherings, whether they be weddings, funerals, or religious services. The popular mantra today in BC, that has been declared so aptly by our Provincial Health Officer, Dr. Bonnie Henry, says it all, “a few faces in big spaces” seems to be the new norm.
Regardless of the religious traditions, in dealing with death and grief, many individuals congregate to mourn, remember, and comfort each other, but sadly today because of the outbreak, that is no longer acceptable. Obviously, this has created quite a few challenges to those that have suffered the loss of a loved one, as grieving individuals normally turn to their families and community of friends to help them get through their pain and loss.
How does one deal with loss and grief in this era? How can there be closure for a person or family if there cannot be a memorial or funeral service accompanied by a loving community of family and friends? These are certainly particularly challenging times for dealing with death and grieving.
On the flip side of the coin, we also live in a very technologically advanced society, that has given us the privilege of gathering on virtual platforms like Zoom, Webex, Vimeo or Facebook Live. This enables us to connect visually, audibly, emotionally, and spiritually.
Recently, I conducted my first celebration of life service on Zoom with the family and friends of a wonderful member of my Congregation, who died as a result of Cancer. What needs to be mentioned is that the Zoom platform enabled an atmosphere of connectedness, even though some of the participants were thousands of kilometers away in other countries.
The atmosphere created by the Eulogy, the Tributes and the Homily were just as moving and inspirational as it would have been if we were gathered physically, in a Temple, Synagogue, Church or Funeral Chapel.
Of course, we could not hug or kiss each other in a physical way, but the family was able to express their love and appreciation for each other and give each other virtual hugs. This really was a source of great comfort and encouragement. It was quite moving to feel the love and see the tears and hear the laughter as funny memories and stories were being shared about the deceased loved one. It was quite a unique experience for me, which sadly may not be the last time that we will be engaged in grieving from a distance. Now, I must say it clearly; a virtual gathering can never fully replace the impact of a physical one and a virtual hug cannot give you the same sense and warmth of a physical hug; but it’s the next best thing that is available for us today.
I would like to share with you a final thought in light of the challenges that we are facing today, with social distancing and the prohibition of public gatherings:
“And we know that all things work together for good to those who love God, to those who are called according to his purpose” — Romans 8:28.
This verse written by the Apostle Paul, really makes sense to me in a strange way, in this new normal.
In the absence of a close physical gathering to deal with grief and loss, today, there is an opportunity to broaden the engagement of family and friends even from distant lands because of virtual platforms. These individuals very often, would not be able to, under normal circumstances, be present in person. Now they can feel connected and share the experience together in real time, with the rest because of todays technology. That, my friends, is an incredibly good thing.
If this new normal continues for longer than we think; do not be discouraged because every crisis can, and will always, present unique opportunities.
First steps after a death during this Corona virus pandemic
If a loved one passes away during this current pandemic, there are a number of steps you need to take allowing arrangements to be made:
• Bringing your loved one into a funeral providers care (*1) • Figuring out the most appropriate arrangements possible • If possible, visiting your loved one
Bringing your loved one into your funeral providers care (*2)?
Funeral provider staff will ask you for details of where your loved one is and whether they, or anyone helping you make arrangements, may have had Coronavirus or the associated symptoms.
• If your loved one died at home, in a hospital, care home or hospice, they will arrange for them to be brought into your providers care.
• If your loved one died abroad, your funeral director will discuss your specific circumstances and advise you if and how they are able to help.
Arranging for final disposition, and registration of the death having occurred?
You will need discuss arrangements and register the death of your loved one (each jurisdiction has different laws, so your funeral provider will know what deadline your jurisdiction holds).
Your funeral provider will then need to also procure from the presiding medical authority, the medical certificate of death, which will hopefully be signed with a release, at the place your loved one lies.
Once the arrangements are confirmed as both feasible, and agreeable, you will need to sign some documents, and cover the costs, which now, most places, can also be arranged on line.
After your first appointment, your funeral director will keep in regular contact with you (by phone and/or email), to ensure that you are kept informed at all times.
Visiting your loved one?
You may wish to visit your loved one before the day of the funeral. If you wish to do so, your funeral director can guide you through your particular circumstances and the services they are able to provide.
In your region, they will likely be required to limit the numbers attending to a regionally legally predetermined maximum at any one time, or perhaps to those living in a same household. At-risk groups are likely not allowed to visit. Any viewings will likely be for immediate family only and likely, only one viewing will be available. It likely must also be only during normal business hours, and only by appointment.
If your loved one’s death was related to Coronavirus, they may be unable to allow you to visit their facility, attempting to limit further spread of infection.
(*1) In any ‘free-market’, there are all kinds of providers. Our organization (the Partners In Care Alliance Society) was formed in 1994, by end-of-life-care professionals wanting to work with ethical (family) funeral service providers. If you do not already have an ethical provider, please view our website (P-I-C-A.org), to find our member nearest you.
(*2) Levels of care available can also vary. Though our founding city had no funeral personnel licensing until 1996, Ellen Kearney Crean (the first woman to graduate from the California College of Mortuary Science in 1938, insisted on only hiring embalmers licensed from other Provinces or States. As a result, we were the only funeral home in Vancouver (Canada’s San Francisco), willing to accept victims of the AIDS epidemic in the early 1980’s. Levels of care offered to families during this crisis may also vary, according to the individual service provider.
I was asked to offer my thoughts on how the pandemic has impacted families and grieving. Where do I begin?
We’ve had problems confronting death for a long time; it took a pandemic to get the subject out in the open.
My name is Trevor Crean; I am a fourth generation funeral director and the owner/operator of Heritage Gardens Cemetery in South Surrey.
To look at how the pandemic has affected mourners, we should look at how people mourn. Whether you’re a traditional Catholic arranging for a full burial, or a complete atheist requesting a direct cremation, we mourn by gathering. Gathering for a funeral, a celebration of life, a moment of silence, a candle lighting- humans are social creatures. We soak up and release energy from being in the company of others. After a family has lost someone, especially if they were the caregivers through an illness- they are very drained of energy. Gathering is how we support one another; sharing food, stories, tears and laughter. We hug it out and cry on shoulders. At a funeral, simply being there pays respect to the deceased and their family. It shows that they matter, so much so that all of these people have taken time from their lives to be here, to say goodbye. Taking away the ability to gather, the ability to mourn with one another, is probably as painful as taking away the deceased.
Prior to this pandemic we have long been welcoming cell phones and streaming into the funeral chapel. We’re living in the global village- it’s common that a nephew in Toronto or a cousin in Houston can’t make it to the service and the family streams it for them. I don’t know if irony is the word but now that streaming is the only option for many, I doubt anyone would trade it for being present. Families we are working with have been strained and saddened by the fact that they have had to ask loved ones and friends to stay at home. I can assure you that there are few sadder sights than a graveside service of 3 or 4 family members, seeing one of their own lowered into the ground.
What remains to be seen is the thought we give to memorialization. There’s good reason why English Bay and every other beach in the city is peppered with benches dedicated to Mr. and Mrs. Jones- it’s because cremation has replaced our obligation to confront death. Families who do not ascribe their end of life practices to organized-religion have found freedom in the available and competitive direct cremation offerings. For one low price, the company will meet you in your home, sign some pages and handle the transfer and cremation of your loved one, and you get a tidy little box delivered to the house. No embalming, no visitation, no viewings, and the family can put together their own memorial or celebration of life. In a city where burial costs are some of the highest in North America, no wonder families prefer this. Today, 86% of deaths in BC result in cremation, the highest rate on our continent. But what happens to these cremated remains? Sure a good portion end up in Stanley Park or scattered off the beach, but a great deal of them remain at home, in our closets. Families who have scattered often later realize they are missing something, they have no focal point for their feelings. It’s hard to visit grandpa when he’s somewhere between Jericho Beach and Bowen Island. Before, a gathering could be held and there could be ceremony around the final scattering of the ashes. At least a cremation takes the time pressure off of the family so they have the choice to defer a memorial gathering until a later time when this pandemic settles down.
What memorial gardens offer is a place. A focal point for grief, initially, but a gathering place for friends and family in the future. A place to acknowledge the significance of a person loved, who has been lost. We built our memorial garden (cemetery) on family feedback and the experience from over 110 years in funeral service. At Heritage Gardens, we lead with compassion as we help people navigate one of their most difficult times. For better or for worse, this pandemic has changed how we live, and it has changed how we die. Perhaps the silver lining is just how much we’ll appreciate one another, and that shoulder to cry on in the future.
It’s been a privilege for PICA to present this four-part series on some real-life issues any of us and our families may have to face. These challenges are not exactly easy to handle even at the best of times. And now, in the midst of this Covid-19 pandemic, issues such as end-of-life care, dealing with grief and loss, making final arrangements, and memorialization have become much more difficult and complex due to the need for social distancing and isolation.
In providing these articles, it is our sincere hope that the ideas and suggestions offered will be found both practical and useful to you.
The Partners in Care Alliance Society (PICA) is a registered not-for-profit society in BC. For more than two decades, we have been promoting consumers’ rights and providing end-of-life care education. Building on the pioneering work of like-minded individuals and the legacy of our predecessors reaching back to the 1970’s, PICA, has continued a long history of community involvement and advocacy, particularly pertaining to the promotion of higher ethical standards in the provision of end-of-life and bereavement care.
In spite of the ravages of the pandemic, we are fortunate that Canada has been able to withstand the brunt of the virus. The diverse backgrounds, experiences and resourcefulness of all Canadians have benefited one another and the country as a whole. Without a doubt, there is a wealth of wisdom and goodwill in the community. So if you have any helpful ideas that you wish to contribute to our work, please feel free to contact us at: 1–888–665–8815.
PICA hosted its first two booths in BC, the first being Zoomer at the BC Trade and Convention Centre and the second being the Advocis Financial Planners Convention at the Vancouver Italian Cultural Centre.
Non-profit partners cosponsoring included the B.C. Bereavement Helpline, Lower Mainland Grief Recovery, B.C. Victims of Homicide, and the Gardens of Gethsemani. Four for-profit partners also co-sponsored the event: Mackenzie, Kearney, Columbia Bowell, and Kearney South Surrey Funeral Homes.
The PICA Board also engaged in two full-day workshops to update its goals, mission, and strategic plan.
Sixty Minutes broadcast a scathing report on cemetery and funeral home abuse due to inadequate regulation and enforcement in America, siting that SCI currently charged $23,000 for their plots in a Jewish Cemetery in Los Angeles. A truly shocking revelation about this observation is that plots in SCI’s Burnaby Cemetery, Ocean View, are selling for closer to double!
The Professionals in Care Alliance continues to meet with community groups and churches holding seminars to help members and residents to achieve better end of life care through increased options and education.
BC Bereavement Day this year was again marked by the fifth annual Victim’s Memorial and dove release, arranged again at Mountain View Cemetery, and this year featuring speaker Janet Wright, famed actor of the Corner Gas and Beach-comer series, again in partnership with the BC Bereavement Helpline and Victims of Homicide in Vancouver.