Andy Langford spoke at a recent In Memory Insight workshop, recounting Cruse’s experiences of managing and planning bereavement services on the pandemic frontline. He has kindly agreed for us to share their hard-learned lessons with the wider sector.

Cruse is the leading national charity supporting bereaved people in England, Wales and Northern Ireland. We provide lots of different types of support, working with people on a one-to-one basis. Our support was previously in-person but now we’re offering it over video calls or by telephone. We run a Freephone National Helpline, we have a synchronous chat service and we’ve got lots of content on our website.

Historically we’ve worked with approximately 60,000 to 70,000 bereaved people every year across the three nations, but we anticipate that when we review our figures for 2020-21 it will be nearer to 110,000 people.  When we look closely at our work over the last year and half, we can see that bereaved people’s needs have changed over this time, with several discernible trends.

At Cruse we have historically helped manage support around major incidents, such as the Grenfell Tower fire, the Manchester Arena bombing, the Tsunami, 7/7 and 9/11. We find that when there is a major incident – and the pandemic would count as one – there is generally a short-term decline in people wanting to access bereavement support services, and then it increases afterwards.

One of the main evidenced reasons for this is, similar to Maslow’s hierarchy of needs, people first want to try and secure their own personal safety, and also the safety of those close to them. In the pandemic people were concerned about their own health, about the health of others, about their childcare if the school was closed down. When people are very concerned about such matters, their emotional needs tend to be pushed down. These emotional needs then come out later, often manifesting in a physical way. This can happen through the body, presenting as stomach ulceration, back pain, neck pain or severe headaches. It’s not unusual to hear about those types of indicators of grief on our helpline.

At Cruse we found that service need dipped for the first two and a half months of the pandemic, but since then it’s just continued to rise. We’re anticipating a 150% increase in demand across all of our channels this year. As we’re stepping into a new era of life post-lockdown, we’re considering to what extent we can provide in-person support and how much to keep online and over the phone.

During the pandemic we have seen trends in bereaved peoples’ needs across several specific areas. First, there’s a desire for more instant emotional support in bereavement; this echoes throughout all of our channels.  There’s also an increased need for online accessibility, particularly from younger people, who are looking for more immediacy in their access to information, advice, and emotional support around bereavement.

There is a set of big unknowns, mainly around our presumptions that certain types of need will increase – for example, perhaps more people experiencing suicidal thoughts, difficulties with mental health, anxiety and depression. There is some evidence that these needs are increasing, but at this stage it’s simply too early to tell. However, we anticipate that there will be more ramifications around issues like these. We are also watching out for reports of increased levels of loneliness, as extreme isolation plays into grief and makes it feel worse.

When communicating with bereaved people there are several points that charities should bear in mind. At Cruse, we always stress – before anything else – offer some form of condolence. This can be as simple as “I’m really sorry to hear about your loss”.  This helps to communicate and convey the care that you feel. This is advice to follow for all times – not just during the pandemic.

The often-sudden nature of bereavement, through Covid-19 or through other causes, leaves people in shock. They are often not able to grieve in the way they would want to, with the usual rituals. This shock can compound a difficulty in concentrating; something quite commonly experienced in bereavement. There’s lots of neurological evidence which explains that it’s very hard to take in complex information when you are bereaved. We find that that difficulty is compounded by shock, the suddenness and the traumatic nature of death. We advise charities to keep communication simple, keep it clear and keep it caring, otherwise it can be very difficult for people take on board.

Be mindful that different communities have been disproportionately affected. Whilst volunteering on our Helpline, I’ve talked with people who have told me of multiple bereavements across their families. Sadly, for those cultures which have several generations dwelling in the same household, the virus sometimes spread really vigorously.

There’s lots of free support available from Cruse and there’s other practical support available from organisations like CAB, Age UK, Mind, Rethink Mental Illness and Turn2us. We are finding we’re providing more referrals or signposting through to organisations that can help with practical support, whilst we provide the important emotional support. People are coming to us with, not just their emotional needs around bereavement, but lots of the practical needs too because it’s been difficult to engage with other organisations during lockdown.

It’s important for charities to be able to let their bereaved supporters know that there is help available to support them as we navigate together through these difficult times.

Many thanks to Andy, and to his team for their work throughout the pandemic, and for giving us hope for the times to come.

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