Looking at how this industry and the grieving process has changed, Sputnik spoke to Dr Lucy Selman from the University of Bristol.
Sputnik: Has the coronavirus affected funerals and ultimately the grieving process?
Dr Lucy Selman: I think there's two main ways really. Often patients with COVID-19 are isolated due to the risk of infection - and that's especially so if they're in a hospital intensive care unit. That can make it really difficult for their relatives to see them and to share those tender conversations that can happen when someone is really ill.
The other challenge is, of course, that because of social distancing requirements, people who've been bereaved may have to grieve on their own and they may have a really reduced support network around them. Because of the social distancing requirements as well and the risk of infection, it's also, as you mentioned, affected the possibility of having the funeral that they would have wanted and then that can be really difficult for someone who's just been bereaved.
Sputnik: How important could an advance care plan be?
Dr Lucy Selman: Advance care planning is where you discuss and then document what your wishes and preferences are about your future care if you do become seriously ill with something like COVID-19, but it could be other health care crises which can happen at any time. Advance care plans are really important because they can help ensure that you get the care you would like if you become so ill that you can't express it yourself.
In an emergency situation that means that clinicians and relatives have a much clearer idea of what you as a patient would want in terms of your care. Research shows that with an advance care plan in place, patients are much more likely to get the care which matches their wishes and preferences, because we all have different ideas. For some people, they think I want to have all the treatment I can possibly get, I don't mind about side effects, I don't mind if there's only a small chance of that treatment being effective, I want clinicians to try everything to save my life. Whereas other people think actually, quality of life is really important to me. I don't want to have very aggressive treatments right at the end of my life and I would rather opt for care that has a good chance of being effective and a good chance of leaving me with a good quality of life and if I do die, not having lots of aggressive treatment in those final moments. If the worst happens and the patient does die, we also know that the bereaved relatives have a better bereavement process if an advance care plan was in place for that patient.
Sputnik: How important is it to say goodbye to a loved one and what solutions would you recommend to people grieving in social isolation?
Dr Lucy Selman: In answer to your first question about saying goodbye: we know from research in intensive care units, in particular, that not being able to say goodbye can lead to problems in bereavement and such as what is sometimes called "complicated grief", which is kind of a longer-term ongoing problems related to coming to terms with a loss.
I think it's really important that relatives are able to say goodbye if a patient has сoronavirus and in hospital wards and care homes that should now be possible in person. New announcements last week that people in care homes and in hospital worlds should do their best to enable relatives to see a person who's very sick from COVID-19 - as long as, obviously, they're wearing personal protective equipment.
In those situations, other forms of communication like telephone, but also tablet computers and virtual ways of saying goodbye and communicating when someone is ill are really important. For people who find themselves in a situation where they're grieving and social distancing measures are in place and their social network is much reduced, I think I would say just "reach out to people however you can".
If you're close to your neighbours, speak to them over the fence, use the Internet and the phone to stay in touch with your family members and your loved ones and I would also urge people to use bereavement charities like Cruise - who have really useful information about COVID-19 on their website, but they've also adapted a lot of their bereavement services and support to use the telephone and the Internet; that can be really helpful to people, I think.