Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 3;S0885-3924(20)30244-X.
doi: 10.1016/j.jpainsymman.2020.04.024. Online ahead of print.

Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians

Free PMC article

Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians

Lucy E Selman et al. J Pain Symptom Manage. .
Free PMC article


Deaths due to COVID-19 are associated with risk factors which can lead to prolonged grief disorder, post-traumatic stress and other poor bereavement outcomes among relatives, as well as moral injury and distress in frontline staff. Here we review relevant research evidence, and provide evidence-based recommendations and resources for hospital clinicians to mitigate poor bereavement outcomes and support staff. For relatives, bereavement risk factors include dying in an intensive care unit, severe breathlessness, patient isolation or restricted access, significant patient and family emotional distress, and disruption to relatives' social support networks. Recommendations include advance care planning; proactive, sensitive and regular communication with family members alongside accurate information provision; enabling family members to say goodbye in person where possible; supporting virtual communication; providing excellent symptom management and emotional and spiritual support; and providing and/or sign-posting to bereavement services. To mitigate effects of this emotionally challenging work on staff, we recommend an organisational and systemic approach which includes access to informal and professional support.

Keywords: Bereavement; Coronavirus; Family Caregivers; Grief; Palliative Care; Pandemics.

Similar articles

See all similar articles


    1. Lundorff M., Holmgren H., Zachariae R., Farver-Vestergaard I., O'Connor M. Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. J Affect Disord. 2017;212:138–149. - PubMed
    1. Wallace C., Wladkowski S.P., Gibson A., White P. Grief during the COVID-19 pandemic: Considerations for palliative care providers. Journal of Pain and Symptom Management. 2020 in press.
    1. Billings J.A., Bernacki R. Strategic Targeting of Advance Care Planning Interventions: The Goldilocks Phenomenon. JAMA Internal Medicine. 2014;174(4):620–624. - PubMed
    1. Bajwah S., Wilcock A., Towers R., Costantini M., Bausewein C., Simon S.T. Managing the supportive care needs of those affected by COVID-19. Eur Respir J. 2020 (in press)
    1. Khandelwal N., Long A.C., Lee R.Y., McDermott C.L., Engelberg R.A., Curtis J.R. Pragmatic methods to avoid intensive care unit admission when it does not align with patient and family goals. The Lancet Respiratory Medicine. 2019;7(7):613–625. - PMC - PubMed