Grief and COVID-19: A fact-sheet for older adults

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COVID-19 has left many experiencing high levels of grief and loss around the world. 1, 2 As an older adult, you may be dealing with other losses in your life (mobility, work, relationships, health-related, etc.).3-5 This makes it especially challenging to work through the feelings of loss and loneliness you may be experiencing due to the pandemic guidelines, such as stay-at-home orders. While these guidelines keep us safe physically, they may also keep us apart from our support network and usual routines.  

This fact-sheet is meant to give you a better understanding of the feelings you may be experiencing and strategies you and/or your loved ones can use to cope during the COVID-19 pandemic.

What is grief?

Grief is a normal reaction to the loss of something or someone important to us. When we experience loss, it can affect our sense of self and identity and significantly disrupt our usual lifestyle, as well as how we interact with others.6 During the pandemic, you may have lived through:

  • the loss of a friend or loved one
  • the loss of a job or income
  • the loss of regular contact and celebrations
  • the loss of community and your normal support systems.

 

The more loss one experiences, the harder it can be to process and cope. It is important to raise awareness of this by talking about the pandemic and the losses we face, so that we can recognize where we are struggling and seek help if and/or when we need it.

Signs of grief

There is no “right” way to grieve a loss. Everyone experiences loss differently and the experience is often shaped by your own early experience with loss, your culture and belief system, as well as your support network.8-11 However, we do know of several feelings and behaviours that are commonly experienced while grieving. These can include:

  • feeling sad and crying
  • anger at the situation
  • fatigue and changes in sleep (difficulty sleeping/sleeping more)
  • feeling alone
  • guilt and anxiety over the current situation
  • decreased desire to engage in your routine.12-14

Types of grief

Did you know that a “normal” grief reaction can linger for several months? Having a healthy social support system and responding to your pain with self-compassion and kindness can be helpful to support your healing. Typically, during a “normal” grief reaction, you are able to continue with your day-to-day routine, although it may feel hard. Sometimes, grief can progress to something more complicated that can require more formalized support, such as therapy. 15-18

Grief and trauma

Other types of grief you may have experienced during the COVID-19 pandemic include anticipatory grief, which can happen when we are expecting a big loss,19 or disenfranchised grief, which can happen when we cannot share our grief with others or use the rituals we usually practice.20

This pandemic, co-occurring societal events, and shelter-in-place guidelines have changed our lives in many ways. These changes have been a traumatic experience for many older adults. Trauma increases the likelihood of a more difficult grief experience.15-18 If this sounds true for you, please seek support from a clinical professional.

How can I cope with grief during the COVID-19 pandemic?

  • Connect as regularly as you wish with loved ones (i.e., family, friends, trusted community members) using a long-distance communication medium of your choice (i.e., letters, telephone calls, or video- conferencing software). See the Resources list for links to download and learn more about connecting through different media.21-22
  • When it feels safe to do so, “name and claim” your grief. Identify and write down the losses you’ve experienced. Then, consider your strengths and possible coping strategies for each.
  • Maintain healthy eating habits and incorporate indoor fitness activities into your daily routine. Try your best to eat a well-balanced diet consisting of vegetables, fruits, nuts, and lean proteins, and aim for 150 minutes of aerobic exercise per week.22
  • Don’t hesitate to seek help from professionals when you need it.

Resources

Regarding grief management, by the Centre for Addiction and Mental Health (CAMH)

Regarding grief management, by organizations external to CAMH

Specific to Indigenous communities

Telephone support lines for older adults

  • Talk2NICE by the National Initiative for the Care of the Elderly (NICE)
    • Call or request to receive a friendly outreach/brief support service call from NICE social workers or social work students. Note: This is not a crisis line.
  • Seniors’ Safety Line (toll-free from anywhere in Ontario)

General Wellness Tips

Geriatric Psychiatry Community Services of Ottawa (2020): Five Winter Wellness Tips for Older Adults

Learn the basics of video-conferencing

References

  1. Berinato, S. (2020). That discomfort you’re feeling is grief. Harvard Business Review. Available: https:// hbr.org/2020/03/that-discomfort-youre-feeling-is-grief. Accessed December 11, 2020. Canadian Centre on Substance Use and Addiction. (2020).
  2. Weir, K. (2020). Grief and COVID-19: Mourning our bygone lives. American Psychological Association News & Events. Consultable à l’adresse: https://www.apa.org/news/apa/2020/04/grief-covid-19. Accessed December 11, 2020.
  3. Windsor, T.D., Burns, R.A. et Byles, J.E. (2013). Age, physical functioning, and affect in midlife and older adulthood. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 68 (3), 395–399.
  4. Campbell, A.D. (2020, June 5). Practical implications of physical distancing, social isolation, and reduced physicality for older adults in response to COVID-19. Journal of Gerontological Social Work, 1–3.
  5. Courtin, E. et Knapp, M. (2017). Social isolation, loneliness and health in old age: A scoping review. Health & Social Care in the Community, 25 (3), 799–812.
  6. Gillies, J. et Neimeyer, R.A. (2006). Loss, grief, and the search for significance: Toward a model of meaning reconstruction in bereavement. Journal of Constructivist Psychology, 19 (1), 31–65.
  7. Papa, A. et Maitoza, R. (2013). The role of loss in the experience of grief: The case of job loss. Journal of Loss and Trauma, 18 (2), 152–169.
  8. Kokou-Kpolou, K., Mbassa, M.D., Moukouta, C.S., Baugnet, L. et Kpelly, D.E. (2017). A cross-cultural approach to complicated grief reactions among Togo–Western African immigrants in Europe. Journal of Cross-Cultural Psychology, 48 (8), 1247–1262.
  9. Shimizu, K. (2020). Risk factors of severe prolonged grief disorder among individuals experiencing late-life bereavement in Japan: A qualitative study. Death Studies, 1–9.
  10. Spiwak, R., Sareen, J., Elias, B., Martens, P., Munro, G. et Bolton, J. (2012). Complicated grief in Aboriginal populations. Dialogues in Clinical Neuroscience, 14 (2), 204–209.
  11. Oyebode, J.R. et Owens, R.G. (2013). Bereavement and the role of religious and cultural factors. Bereavement Care, 32 (2), 60–64.
  12. Kavan, M.G. et Barone, E.J. (2014). Grief and major depression: Controversy over changes in DSM-5 diagnostic criteria. American Family Physician, 90 (10), 693–694.
  13. Friedman, R.A. (2012). Grief, depression, and the DSM-5. The New England Journal of Medicine, 366 (20), 1855–1857.
  14. Goveas, J.S. & Shear, M.K. (2020). Grief and the COVID-19 pandemic in older adults. The American Journal of Geriatric Psychiatry, 28 (10), 1119–1125.
  15. Shear, K.M. (2012). Grief and mourning gone awry: Pathway and course of complicated grief. Dialogues in Clinical Neuroscience, 14 (2), 119–128.
  16. Shear, M.K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N. et al. (2011). Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety, 28 (2), 103–117.
  17. Prigerson, H.G., Horowitz, M.J., Jacobs S.C., Parkes, C.M, Aslan, M., Goodkin, K. et al. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med, 6 (8), e1000121.
  18. Wetherell, J.L. (2012). Complicated grief therapy as a new treatment approach. Dialogues in Clinical Neuroscience, 14 (2), 159–166.
  19. Shore, J.C., Gelber, M.W., Koch, L.M. & Sower, E. (2016). Anticipatory grief. Journal of Hospice & Palliative Nursing, 18 (1), 15–19.
  20. Mortell, S. (2015). Assissting clients with disenfranchised grief. Mental Health Services, 53 (4), 52–57.
  21. CAMH. (2020). Perte, chagrin et guérison. La santé mentale et la pandémie de COVID-19. Available at: https://www.camh.ca/fr/info-sante/mental-health-and-covid-19/loss-grief-and- healing. Consulté December 11, 2020.
  22. A guide to getting through grief: Harvard Mental Health Letter. Retrieved from Harvard Health Publishing. Available at: https://www.health.harvard.edu/blog_extra/a-guide-to-getting-through-grief.
  23. Pennebaker, J.W. (2018). Expressive writing in psychological science. Perspectives on Psychological Science, 13 (2), 226–229.