FARGO — Erin Hagen feels as though she lost her grandmother twice due to the harsh realities of the coronavirus pandemic.

First, she lost her to visitation restrictions to protect residents of the nursing home from COVID-19. The virus ravaged many long-term care centers.

As a result of the restrictions, Hagen was allowed to see her grandmother only a couple of times during the last months of her life and was unable to see her when she was slipping away at the age of 93.

“She was an active part of my life, day to day,” said Hagen, who lives in Pelican Rapids, Minn.

The disruptions caused by the pandemic kept many families from their loved ones at the end of their lives and interfered with traditional grieving rituals, forcing funerals to be significantly scaled back, canceled or postponed.

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The prolonged end-of-life separation was difficult for Hagen, who was close to her grandmother, Gladys Carlson of Fergus Falls, Minn. Before the pandemic struck, she saw her grandmother regularly on visits and joint shopping outings.

Because her grandmother had dementia, she was confused and couldn’t always understand the need for the separation. Phone calls and video visits proved cumbersome and didn’t work well.

“She definitely had her good days and bad days,” Hagen said. “She was confused about it. This whole COVID thing, she didn’t get it. She missed everyone so much.”

Hagen’s mother was allowed to visit as the designated caregiver. Then, when she became terminally ill, an aunt and uncle also were allowed compassionate care visits.

Her last visit with her grandmother was several months before she died on Dec. 6, 2020.

“Unfortunately, it wasn’t a good day for her,” she said. Dementia had dimmed her memory and clouded her perceptions.

The pandemic, with its ebbs and flows, added another layer of uncertainty and difficulty.

“It was such an uncertain time of not knowing what was going to happen next,” Hagen said.

Normally, a large circle of extended family and friends would have gathered for the funeral and a meal afterward. But large gatherings weren’t allowed, so 10 or 15 family members met for a small memorial service in the funeral home chapel.

“We had a very small family gathering,” Hagen said. For those who were unable to attend, the funeral home broadcast the service over the internet. The service honored Carlson's requests, including playing one of her favorite songs, “Happy Trails.”

But the constrained funeral and the lack of the comforting community rituals detracted from the experience, Hagen said.

“It’s an uncommon grieving process,” she said. “It didn’t feel real in a way. It felt like a funeral, but it didn’t feel like a funeral.”

At the graveside, the frigid December weather kept the service brief. There was no time to linger and share favorite memories.

Gladys Carlson, who died in December 2020, watches a baseball game in her nursing home room before the COVID-19 pandemic. Special to The Forum
Gladys Carlson, who died in December 2020, watches a baseball game in her nursing home room before the COVID-19 pandemic. Special to The Forum

* * *

Kriston Wenzel, a grief specialist at Hospice of the Red River Valley, said families are learning how to adapt to the limitations imposed by the long pandemic.

“People are figuring out how to make this happen,” she said. “It’s very different than early COVID.”

Cremation allows more time and flexibility in scheduling funerals, an option that more families are turning to, Wenzel said. Her own family had to cope with the restrictions when her mother-in-law died in late January.

“We had a very small service,” Wenzel said. Even a small, scaled back funeral can provide comfort to a grieving family. “There is a sense of peace by being able to have them in any way you could,” she said.

The inability to attend the funeral of a loved one is a common source of guilt during the pandemic, when travel restrictions and limitations on gatherings have made it difficult or impossible for many to attend.

“It comes up in every single conversation that families have not been able to be there,” Wenzel said, adding that it’s often discussed in support groups. “There’s still that sense of loss, that you weren’t able to be there, you couldn’t hold their hand, you couldn’t be at the bedside.”

Wenzel tries to reassure people who couldn’t attend the funeral of a loved one. That’s actually a common regret, even when there isn’t a major public health crisis, she said.

“There’s always that sense of what we didn’t do and what we could have done,” Wenzel said. “We do hear from a lot of people who have that regret, but that happens even when there isn’t COVID. My hope for people is they’re able to bypass the things they couldn’t do and focus on the things they could do.”

The inability to visit a dying loved one or attend the funeral and be comforted by friends and family adds another dimension.

“They can’t reach out to their friends,” Wenzel said. “Their isolation is causing their grief to look very different.”

She added: “There’s almost that sense of it not being real if you can’t be present or can’t be part of the service. You miss that one-on-one support.”

The isolation also takes its toll on those who are ill. A man in one of Wenzel’s grief support groups lost an uncle who was in good health before getting sick from COVID-19. He was unable to receive visitors in his nursing home and lost the will to live. “Because he was isolated, he decided he was done,” she said.

Because the uncle had been doing well before he caught COVID-19, his nephew had difficulty accepting his death, Wenzel said.

“There is such an unknown aspect of this,” she said. “This unknown ... is what causes people to say it’s overwhelming.”

Still, for other families, the pandemic has been a blessing, allowing more work flexibility to tend to a dying family member and more time to be at the bedside. The pandemic also has provided more time to plan funerals.

“Maybe there’s some good to come from this,” Wenzel said. “So it kind of goes both ways.”

Although COVID-19 presents unique challenges and difficulties for mourning families, coping with the loss of a loved one is universal.

“Grief is grief,” Wenzel said.

* * *

In some ways, it still feels to Erin Hagen as if her grandmother is in the nursing home.

“In a way, it doesn’t seem like she’s dead,” she said. “It almost seems like she’s on COVID restriction.”

Before the pandemic, Hagen saw her grandmother regularly and her presence was a major part of her life. Now that’s missing.

“It was just weird,” she said. “She was a part of my everyday life.”

The family plans to hold a memorial service in July, on the anniversary of her grandparents’ wedding date. “We’ll probably do something small.”

It won’t be the same without her grandmother, a woman who rose before the sunrise and was always punctual, usually the first to arrive at a funeral.

“She was the thread that held the family together,” Hagen said.

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Source: Hospice of the Red River Valley