COVID-19: looking after bereaved families

05 May 2020

The Academy of Medical Royal Colleges and Faculties in Scotland (“the Scottish Academy”) has published new “ethical and practical principles” – in partnership with the Scottish Partnership for Palliative Care and the Royal College of Physicians and Surgeons of Glasgow – to ensure excellent care for bereaved families both during and after the COVID-19 pandemic.

Caring for people does not stop with death; rather the caring changes focus to the bereaved family guided by the principles of kindness, respect, fairness and of minimising harm. It is essential, therefore, that staff caring for recently bereaved families have the tools they need to assist them, point them to useful advice and minimize their upset.

The Scottish Academy has, therefore, set out 15 guiding principles, ranging from the viewing of a deceased’s body, post-mortem examinations, funeral arrangements and organ donation. The overarching principle is that staff should clearly and effectively communicate current, new or changed processes to bereaved families, considering the wide-ranging needs of differing faiths and cultures in Scotland.

The COVID-19 pandemic has already changed the way that the care of patients and their families is delivered. Following the death of someone who has or is suspected of having COVID-19, infection control measures will be in place. This is in recognition of the need to protect staff and families as transmission of the coronavirus can occur for 48-72 hours.

The Scottish Academy has said that care should be taken, to ensure that dignity and respect for the deceased is maintained through infection control procedures. In hospital or public mortuaries, every effort should be made to ensure that close relatives can view the deceased unless circumstances make it unsafe or impractical to do so.

Finally, the Scottish Academy said that for cremations, funerals or burials attendees must observe two metre physical distancing (except between two members of the same household, or those being assisted by a carer) and organ donation should continue as long as there is no risk of COVID-19 transmission.

Dr Miles Mack, Chair of the Scottish Academy and north of Scotland GP, said:

“Following on from our previous guidance on the compassionate care of patients at the end of life we realised there was a need for a further document on care after death and the compassionate care of the bereaved. This is in the context off significant variation in the application of regulations and guidance during the COVID-19 pandemic. For anyone of us, the loss of our loved ones is a traumatic event and the bereavement is often prolonged and painful. We hope that bringing this information together in one document will enable all agencies to act consistently and with compassion for those who are facing the loss of a loved one. Thank you to all my colleagues in Scottish Academy and to all the other agencies who assisted us in developing this guidance.”

Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow, said:

“We welcome this guidance from Scottish Academy on care of patients and families after death. This is always a very traumatic time for relatives and carers, but several factors associated with the COVID-19 pandemic can make it more distressing. When a patient dies, our responsibility to them does not disappear; the focus simply moves to the bereaved family. This guidance brings welcome clarity to the processes which need to be followed after death: it dispels some misconceptions about funeral arrangements and we hope that will remove some of the uncertainties and stresses which families may have been subject to.”

Mark Hazelwood, CEO of the Scottish Partnership for Palliative Care, said:

“Many of the usual processes and regulations surrounding the care of a person and their family after they have died have changed as a result of the pandemic. People’s experiences of these immediate post-death processes can cast a long shadow over the rest of a bereavement and so everything must be done to provide support and clear information. This new guidance from the Scottish Academy is a welcome help to practitioners who need to understand and navigate these new circumstances as part of their support to the newly bereaved.”