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no chance to say goodbye: how covid-19 has changed grief
"i made sure my kids had a chance to say goodbye to grandma. people were going to the hospital, and that was it."
may 3 2020
6 minute read
ottawa - april 29, 2020 - rebecca tiessen poses for a photo at her house in ottawa wednesday. rebecca's mother died april 12 of covid complications and did not have a chance to say goodbye.
tony caldwell
/
postmedia
erika tiessen was 71 when she died of covid-19 complications more than two weeks after she first entered the hospital.
an energetic grandmother who divided her time between florida and a cottage near kingston, tiessen spent a few weeks every spring and fall in the home of her daughter rebecca tiessen, a university of ottawa professor.
on march 28, rebecca brought her mother, who was complaining of shortness of breath and gastrointestinal symptoms, to the montfort hospital.
erika thought she might spend a few hours in hospital for a few tests, but rebecca felt uneasy. she made sure her mother had her ipad, cellphone and chargers.
“i made sure my kids had a chance to say goodbye to grandma. people were going to the hospital, and that was it.”
soon after she returned home, rebecca also experienced mild covid-19 symptoms. she and her husband were tested and found positive.
rebecca, who is the only family member in ottawa, was too much of a risk to visit her mother. erika’s brothers and children spoke to her by phone on a rotating basis. two days before her death on april 12, erika was no longer able to speak.
“the hardest thing was not being able to see her when i knew she wasn’t coming home,” said rebecca.
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covid deaths have created a landscape of bereavement unlike any other in recent history, leaving people struggling not just with grief but also with the knowledge that they were not able to hold their loved one’s hand or share a few last words, face to face.
six days after erika tiessen died, former governor general micha ë lle jean tweeted about the death of her aunt in a long-term care centre in montreal.
“the family could neither assist nor accompany her in her last moments. the funeral services were responsible for cremating her remains. no farewell ceremonies. confined in sorrow.”
the grief that has come with covid-19 is a “very different grief,” said susan mccoy, a former police sergeant who is now a grief and bereavement counsellor and the chair of bereavement ontario network, whose members range from social workers and nurses to funeral directors and hospice workers.
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“the difference here is that we are already grieving. we had lost the world we knew. we found ourselves at war with a virus that acts like a terrorist. you know what it can do, but you don’t know who it will strike, or when,” said mccoy.
“you have the traumatic grief of a sudden death. it’s sudden, it’s violent and you can’t be there. and when this happens, there’s unresolved trauma and grief that comes to the surface.”
at the same time, within weeks, many of the structures and rituals that have helped people grieve have been swept away under new funeral restrictions introduced by the province on april 14.
“all of these measures affect everyone, regardless of how the person has died,” said david brazeau, a spokesman for the bereavement authority of ontario, which administers the province’s funeral, burial and cremation services act and its regulations.
the guidelines force families to decide where to send the body an hour after a death in hospital, or three hours for the families of those who die in long-term care.
funerals and visitations in ontario funeral homes are limited to 10 people, not including funeral home staff.
“it’s a real hardship for families,” said brazeau. “and people have to practise physical distancing. they can’t hug or touch each other. it’s a big part of the grieving process.”
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ron mckenzie’s mother, lorraine, was 87 when she died on april 21 in a covid-19 unit in montreal’s lasalle hospital.
lorraine loved socializing, whether it was playing cards with friends or going to the bingo hall. some of her children lived nearby and visited frequently.
she developed a fever and cough in her retirement home on march 21 and was transferred to the jewish general hospital on march 23. her condition improved and she returned to the residence on april 3.
but lorraine’s condition got worse, not better. “the virus took too much out of her,” said mckenzie, who lives in ottawa.
on april 21, lorraine returned to hospital in palliative care and lost consciousness.
“my mother died among strangers. that was the hardest part. when that happens, there is no sense of closure. it’s like someone is missing and you know they’re gone. you want to see them, but you can’t,” said mckenzie.
lorraine had made her own funeral arrangements, but her family learned this week that she would not be cremated for at least 15 days because of a backlog.
“it only makes the ‘no closure’ more difficult,” said mckenzie.
there is a psychological term for this lack of closure — ambiguous loss. the term was coined in the late 70s by researcher pauline boss, who studied the families of soldiers missing in action.
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“it really is like when people go off to war. are they going to come back or not?” said mccoy.
“the inability to be with loved ones during their final days, the lack of physical presence or gatherings can increase the feeling of ambiguous loss,” said dr. katy kamkar, a clinical psychologist and chair of the canadian psychological association’s trauma sector.
every culture has customs and rituals around death and grief.
“the one shared feature is social connection and close proximity. when people are in close proximity, positive hormones are released. this is tremendously healthy and helpful,” said kamkar.
“under these circumstances, there is no physical proximity.”
even for those who believe they are prepared for a death are never truly ready, said kamkar.
“the last moment is never expected.”
kathleen, who asked that her last name not be used, lost her 96-year-old mother-in-law to covid-19.
kathleen describes her as warm and powerful, the deeply religious matriarch of the family. when her mother-in-law decided she could no longer live on her own, she continued to live with verve when she moved into long-term care at carlingwood manor.
“she was the belle of the ball,” said kathleen. “people adored her.”
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kathleen and her husband were not able to visit during her illness because they were self-isolating after a trip.
“we were a big part of her life when she was living. but we couldn’t be there,” she said. “there was no closure. we couldn’t have the kind of religious funeral she would have wanted.”
herbert northcott, a professor of sociology at the university of alberta and co-author of death and dying in canada, said grieving brings up a complicated range of feelings.
there is sadness, yes, but there is also anger, regret, guilt, release and joy. regret and guilt are already part of the grieving process. covid-19 has amplified those feelings, he said.
“how people die affects how people grieve,” said northcott.
erika tiessen was the kind of person who had an encyclopedic knowledge of practical matters — and how to keep things running. only days before she went into hospital, she diagnosed her daughter’s ailing dishwasher with needing a new filter.
“my mom always knew how to fix things. if you had a problem, she knew what to do. she didn’t have to google,” said rebecca tiessen.
erika was an avid gardener. when rebecca was cleaning out her mother’s car, she found chicken wire erika planned to use for her tomato plants.
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“she was planning a future for herself that didn’t materialize.”
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