With the COVID-19 death toll continuing to rise, life feels more precarious than ever. Recent data from bereavement charity Sudden suggest more than a quarter of a million people in the UK have been suddenly bereaved as a result of COVID-19.(1)
From their position at the frontline of healthcare, as well as at the forefront of local communities, community pharmacy staff will often be among the first to become aware of the death of customers or their loved ones or carers – from whatever cause – giving teams an important role in identifying and supporting people who are bereaved.
Risks from sudden loss
Losing a loved one not only causes shock and distress, but often comes with associated health and wellbeing challenges.
If someone dies suddenly – as can happen with COVID-19 or complications resulting from the virus – family and friends may find it hard to deal with the fact that were unable to say goodbye, or to spend time with the person before they died. Or even attend the funeral with changes also having been made to funeral arrangements to stop the spread of COVID-19.
Without early access to care and support, a sudden bereavement can cause profound shock and grief, putting the bereaved person at increased risk of serious mental health conditions such as post traumatic stress disorder.(1)
Physical effects of bereavement
Grief can also have common physical effects such as headaches, loss of appetite, disturbed sleep, anxiety and worry about one’s own health and wellbeing.(2)
Some people report physical aches and pains after the death of a loved one, and grief can also reduce the body’s ability to defend against minor infections.(2)
It is normal to withdraw, eat too little or drink too much and indulge in other unhealthy behaviours as a response to grief. Encouraging customers to rest, eat healthily and keep up some gentle exercise are all vital ways in which they can safeguard their own health while they are grieving. However, it is also important that they know to speak to their GP if they are finding it difficult to cope.
Lonely and alone
Older people can be particularly vulnerable, especially if the person who has died was their only companion or main carer. Finding themselves suddenly alone can jeopardise their basic needs – such as access to food, medicines or accommodation, and they may also have leftover medicines from the person who has died.
Pharmacy staff are in the ideal position to notice if this is likely to be the case. Asking open questions such as, “who has been to see you this week?” may help start conversations with customers who could be at risk of being unable to properly look after themselves. Pharmacy staff can ensure the safe disposal of unused medicines.
This can be particularly important for people with dementia who have suffered a loss. While some will understand what has happened, people in the later stages of dementia may forget that the person has died and find it distressing to be repeatedly reminded. This can be difficult for friends and family members also coming to terms with the death.(3)
Staff who are grieving
As the pandemic continues, it is also likely that pharmacy staff themselves may also be grieving the loss of a loved one or colleagues or be affected by the death of a customer or someone in their professional care.
Everyone processes and expresses grief differently, so managers and colleagues should bear in mind that while some people might want to talk about how they feel, others may prefer to keep things to themselves – and that these reactions could change over time.
Make sure staff know there is time and space available for them to talk if they would like to, and perhaps discuss whether they – and the wider team – could benefit from resilience training and support. At an individual level, resilience is the ability to deal with pressure – even during challenging circumstances such as bereavement – and recover from stress. Being resilient also increases a person’s capacity to work safely and effectively.
Signposting and support
NHS staff who are struggling with grief – as well as a range of other issues – can find tailored information and support at NHS people, and all keyworkers can access round-the-clock one-to-one support from trained volunteers, plus resources, tips and ideas to look after their mental health from Our Frontline – a partnership between Shout, Samaritans, Mind, Hospice UK and The Royal Foundation of the Duke and Duchess of Cambridge.
There are many grief and bereavement services that pharmacy staff can signpost customers to, depending on the circumstances the person finds themselves in.
The Good Grief Trust has collated a list of bereavement services around the country to enable people to receive the support they need in the locations most accessible to them.
The Cruse national freephone helpline offers emotional help and signposting by calling 0808 808 1677 and has local branches to offer targeted support.
Sudden is a support charity for those who find themselves suddenly bereaved and has a bereavement helpline on 0800 2600 400.
More information on bereavement support and advice during COVID-19 is available on the NHS website.