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Working quietly behind the scenes, members of our Spiritual Care, Hospice and Bereavement teams have been supporting patients, families and communities throughout the COVID-19 pandemic. In observance of Home Care, Hospice and Palliative Care Month, we salute their compassionate work and share this look at some of what they’ve done, and continue to do, to support the sick, the dying and those grieving the loss of a loved one.

Grief, a natural response to loss, is an emotion that one day touches us all.

It is painful, and it is hard. And in the midst of this pandemic, it is touching many of us simultaneously.

For families losing loved ones to COVID-19, grieving can be especially difficult. Tradition, a usually reliable source of stability, some solace and predictability, has been upended. Rituals intended to comfort the dying and those left behind — bedside vigils, wakes, funerals, burials, shivas — have become difficult or impossible as the virus continues to force physical distance from one another. We wear masks while consoling others.

Grief intensified

“Grief is very isolating,” observes Ally Parker, bereavement coordinator for The University of Vermont Health Network – Home Health & Hospice, serving Chittenden and Grand Isle counties. “Grievers often experience a sense of isolation, even when they can gather with others. One of the biggest ways COVID has impacted the grieving process seems to be an intensifying of this experience.”

In the midst of this health crisis, and in the absence of the comfort loved ones and familiar customs can bring, families, friends and professionals are creating new ways of summoning strength, feeling supported and mourning those lost.

Bereavement counselors like Parker are responding to this deep and growing need. They recognize that the loss of tradition, the inability to fully express grief in the moment, in traditional ways — and the element of trauma this pandemic layers onto loss — can make death even more distressing.

“It’s hard for the griever to not get the support and hugs, the company of people who knew their person — to cry and reminisce, honor the memory of, and share stories with others,” Parker notes. “These kinds of experiences help the griever feel a sense of connection to the deceased and to other people.”

“Another piece that has been challenging for grievers is not knowing when a service or burial can be planned or scheduled,” she continues. “Not having a good sense of what the future holds can be especially distressing.”

Support for families

For 12 years, Parker has witnessed grief and held space for families and friends who’ve lost loved ones of all ages. Times are different now, she observes, with grief impacting many — even those who haven’t lost loved ones — in new, profound ways.

Parker, a mental health counselor, and Joan Newton-O’Gorman, hospice chaplain, are offering individual counseling sessions for Home Health & Hospice staff during the pandemic — one of many ways mental health professionals are rising to meet the emotional needs of the grieving.

Home Health & Hospice’s Bereavement Services team — Parker and colleagues Julie Jacob-Ochs and Jeanne Sullivan — also offers a support group for those who’ve lost loved ones to COVID, facilitate a longtime community-based adult support group, and in local long-term care facilities, guide staff support meetings. Each of these groups is currently offered weekly or biweekly on Zoom or in person.

While the bereaved currently can’t gather in one single safe space as they did in the past, participants can still see, talk and process emotions with others virtually. Despite physical distance, the compassionate, supportive energy the groups generate remains remarkably powerful and healing.

“Using Zoom has worked well in terms of people coming together and getting support,” Parker says. “It’s just nice to see each other, too.”

To meet the emotional concerns of the grieving, The University of Vermont Medical Center, in partnership with Home Health & Hospice, provides longstanding family bereavement support, which throughout the pandemic has been offered virtually. This includes a support group for grieving children and teens, as well as an accompanying group to support their parents, guardians and loved ones.

“It is so important to continue to provide bereavement support to our families whose loss happened prior to the pandemic,” Parker explains. “It’s like a double trauma for these families whose lives had already been turned upside down by their loss — to also have to contend with the world shutting down and changing overnight.”

Support for front line workers

Clinicians and other front line workers benefit from additional support too. A partnership between The UVM Health Network and Burlington’s Birchwood Terrace Rehabilitation and Healthcare, one of Vermont’s hardest-hit congregate-living facilities, expanded to meet the need for emotional and spiritual support at the facility.

Bronwyn Becker, Home Health & Hospice spiritual caregiver, has been on site at Birchwood with other UVM Health Network Palliative Care team members since April, bearing witness as residents, families and staff come to terms with illness and loss there.

“It reminds me very much of Vermont’s response after Tropical Storm Irene,” Becker says. “That ethic of ‘Our community is in need’ and whoever can steps forward and offers what they have to offer.”

Inside the facility, “We witnessed staff working with astonishingly steadfast commitment and compassion under very difficult circumstances,” Becker recalls. “They brought everything they had to care for their community — both residents and each other — all while weathering exhaustion, groundlessness and grief.”

As COVID cases slowed, staff acknowledged the toll such caregiving exacts. “At the beginning, if we asked staff members how they were doing, many would mention exhaustion, then say simply, ‘But I’m here,’” Becker says. “In time, they began to acknowledge the traumatic nature of their experience and wonder aloud how they would process it.”

Outreach at Birchwood

To support the Birchwood community, Becker, Parker, the Home Health & Hospice team, and Birchwood Terrace staff Tiffany Smith and Paul Newhouse designed a support system of individual and group bereavement consultations, an educational series focused on learning and applying resilience, coping strategies and gentle restorative movement practices, and a memorial service to permit Birchwood staff to honor those who died.

“It has been a collaboration all the way along,” Becker acknowledges. “Birchwood extended hospitality to us and welcomed us in. The staff did everything they could to meet their community’s needs. And because they were willing to allow us to be guests in their home, we were able to help them care for those residents who were ill or dying from a novel cause.”

Because of this hard experience, “Birchwood now is the most experienced skilled nursing facility for COVID-positive loved ones,” Becker observes. “Their staff members have both the heart they’ve always had and skills few others in the community have.”

[Here, members of the network’s Birchwood Crisis team — from background forward, Colleen Roach, Bronwyn Becker, Laurel Audy and Sue Thibault — are pictured holding their morning meeting before heading in to work for the day with COVID-positive patients. “It was too cold for us to do an outside huddle, so we lined up our cars and did a morning report/check in/planning from our cars,” Thibault explained.]

Advice for comforting friends and family

Friends and loved ones sometimes worry about discussing death for fear of upsetting the bereaved, but Parker acknowledges that being forthright remains the best approach.

“Don’t be afraid to bring up the loss — you won’t be bringing anything up for your friend that s/he isn’t already thinking about,” she says. “Typically, grievers want a chance to talk about what they are going through and are well aware that many people are really uncomfortable talking about it. If they don’t feel like talking about it, they will let you know. When people stop talking about the deceased, grievers start to feel like they are the only ones who remember that the person even existed. That’s part of what contributes to a sense of isolation.”

Concern about finding the right words shouldn’t trouble supportive friends either, she adds. “Don’t worry that you don’t know the right thing to say. Be authentic, genuine, yourself — that’s what your friend needs from you.”

Anticipating the future

Parker observes that one specific challenge of grief can be simply recognizing it.

“I think the most important thing for people to do is to acknowledge the pain of the loss,” she says. “So often I think we work really hard to submerge the pain, store it away, or run away from it. I think what actually helps us in our healing process is acknowledging that we are in emotional pain, and that pain is part of us. We don’t have to live in that pain, or let it dominate or define who we are, but we absolutely have to make room for it in our lives.”

Looking forward, as stay-at-home orders relax and gatherings become increasingly possible, “Grievers may be wondering, ‘When we can have a family get-together or family vacation? Should we plan those things?’ It’s helpful for grievers to be able to plan things in the future to look forward to — it helps them to keep putting one foot in front of the other. Kids too,” Parker says.”
Responding to changes one day at a time with their palliative care, spiritual and bereavement support colleagues, Parker, Becker, Brayton, Farr and others continue striving to provide structure, solace and certainty in an unnervingly uncertain moment in time.

To learn about grief support resources available in Chittenden and Grand Isle counties, contact:

The University of Vermont Health Network – Home Health & Hospice

Bereavement Support
Phone: (802) 860-4497, ext. 3405

Email: Allyson.Parker@uvmhomehealth.org