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Grief in the time of COVID-19

This is the story of my grandmother's passing.

There is no doubt that COVID-19 (coronavirus) disproportionately impacts those who are already marginalized and vulnerable – individuals in homeless shelters or nursing homes, who are susceptible to the spread of disease due to their close proximity to others; individuals uninsured or in poverty, who cannot access to testing and treatment; individuals with underlying health conditions or the elderly, whose bodies are hardest hit by the virus – and who are perhaps least likely to be granted access to life-saving health equipment in overstretched health systems.

Underlying inequities in access to health and economic security will certainly be exacerbated by COVID-19. What’s more, the damage done by the virus is leaving a trail of unexpressed grief. Without traditional opportunities to mourn the loss of loved ones who have fallen victim to the virus, grief may become bottled up and held in our bodies.

Yet many of us are also relearning ways to grieve in this strange new virtual landscape that we are inhabiting. For example, an article in the Harvard Gazette suggests finding creative ways to connect with friends in mourning and inviting them to share the story of the death. So, here’s mine.

On Sunday, April 26th, I lost my eldest grandmother. She had been living in a nursing home outside of London when she came down with a fever and cough. The nursing home had already been shut down to visitors to prevent the spread of COVID-19, but somehow, the virus found its way into the facility. My grandma was not tested, but at least three other residents of the nursing home, who all fell ill the same day, had confirmed positive cases. Due to her close proximity with the other residents, we can only assume that her untimely illness was also COVID-19.

The outbreak hit my grandma's nursing home hard - leading about six residents, three healthcare workers, and three nuns who prayed for the elderly to lose their lives. Although we will never know with complete certainty that the virus infected her, my grandma will be counted as a statistic as COVID-19 was listed as her ultimate cause of death.

Nonetheless, my grandma was already weak before she became ill and isolated. Dementia had led her body into a steady decline that was suddenly fast-tracked by the virus. Three days after starting to show symptoms, she went into a minimally conscious state. My family had already arranged for the nursing home to allow for a natural death in the case that she became unresponsive, so she was not given a feeding tube or IV fluids. Without food or water, most people only survive three days. Whether it was by physical capacity or sheer will, my grandma managed to make it through day seven before she passed away.

When I initially heard the news of her unofficial diagnosis, I was surprisingly numb. The only emotion I felt was guilt that I could feel nothing. She was my grandma, after all, and the first person I’ve been close to who has died.

But then, a few days later, my father informed me that no one in the family had spoken with her since she had become minimally conscious in isolation. After 18 months of supporting my grandma in the nursing home, of course my family was not emotionally abandoning her.

But wasn’t there something more that could be done to let her know she was not alone in her final days?

“Yes, you should Skype her,” I told my father.

He said he didn’t know what she would be able to understand. Besides, it was nearly 7 pm on the East Coast, and the nurses in England wouldn’t respond to his request until the next morning. By then, it might be too late.

After my phone call with my father, grief hit me like a riptide as I felt the magnitude of what it meant to die without family physically present in an environment that was not home.

I was swept away into the night with waves of emotion. They mercilessly crashed over me as I attempted to chop onions for dinner, as I realized when opening a package of baby clothes that my grandma would never meet her first great-granddaughter, as my baby’s kick startled me awake at 3 a.m., and as I (sleeplessly) walked Blue to Mount Auburn Cemetery early the next morning.

My memories of my grandma were vivid enough that I felt I must have been dreaming each time my body heaved with fresh tears. Behind my eyelids, I could see my grandma’s muted smile, feel the cool English air of the village dog walks she would take each day, taste the chocolate biscuits she would serve (and I would devour) with tea, smell the wine she used to dilute in her water glass, and hear her voice like as she spoke to me like a talking doll in her later years.

“I wouldn’t eat that – I’ve got a funny tummy”; “what’s Dylan going to do with himself?”; and “you’re small like me.” These were phrases she said to me as if set on repeat during one of my final visits with her before she moved to the nursing home. At that point, her dementia was coming to a tipping point at which it could no longer go unacknowledged. In addition to repeating herself, she had trouble choosing what to wear and she had started obsessively stockpiling certain foods despite being unable to cook independently. And yet, years before she reached this pivotal moment, she may have started experiencing personality changes – one of the early warning signs of dementia.

Sometimes, I wonder if I ever knew who my grandmother really was – the stern woman with an English stiff upper lip whose house rules felt as black and white as the Miss Marple books she shared with me as a child; the jovial spirit she became later in life; the lost soul in the nursing home who packed her bags for an imaginary train ride to Italy and accused my grandad of make believe affairs; or someone else. Whoever she was, I was scared that she would be dying alone – something that no one deserved.

One more ripple of grief washed over me after I returned from walking Blue that morning. Mourning doves pierced the newfound silence of the city, and my eyes flooded with fresh tears of relief. I read a message from my father saying that he had the opportunity to Skype my grandma one last time.

In his final call, my father read aloud the images of nature from her dog-walking diary that he had been transcribing in a Word document: “Nice sunny morning, slight rain during the night, but still cold. Bluebells are well out, strange to see wood anemones, ladies smock, and bluebells all out together. Trees are now full of small light green leaves.”

Her jumbled descriptions of the seasons read like poetry – or a lullaby.

Although my father doesn’t know if his words registered, he told her he loved her, and he told her goodbye.


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