Counselling the dying and the bereaved

Photo: Juan Munévar

By Tim Maby

The ability of chaplains, imams and rabbis to console the dying has been seriously curtailed by the Covid-19 pandemic, says the Rev Mark Burleigh, head of chaplaincy and bereavement services at Leicester University hospitals.

In a briefing for the Religion Media Centre, he said chaplains can contact the dying only in negotiation with wards,  to choose either phone, iPad or by wearing full personal protective equipment (PPE). In some cases it is decided that the last rites have to be performed remotely, by phone or computer, but this can be difficult for Roman Catholics, where liturgy involves anointing with oil.

The Catholic bishops have suggested putting oil on some small device like an ear bud, to wipe on the lips, which can then be disposed of clinically without any contamination.

“So many of the normal behaviours around bereavement, death and mourning are facing upheaval,” according to Rabbi Josh Levy of the Alyth Reform Synagogue in northwest London. “One of the greatest traumas for the relatives of the dying is that they can’t be with them when they die,” nor during a “substantial period of illness”, so “we are having to find new ways of being with the dying”. But he says that there are “some amazing things happening” in the NHS, such as when family members are able to talk to the dying using a mobile phone held to the ear.

Then there is another “gap in the mourning process”, because a family cannot attend the burial, as in the Jewish tradition.

In the Muslim community this means imams have to manage their congregations’s expectations, then “build spiritual as well as mental resilience”, says Imam Qari Asim. who chairs the Mosques and Imams National Advisory Board.

Muslims would normally expect to be able to wash the body and like the Jews are trying to avoid cremation, other than in exceptional circumstances.  The Board of Mosques is now providing pastoral as much as religious guidance and,, with the British Board of Scholars and Imams,  is advising Imams how to deal with the family members of the bereaved and on the care of families in hospital.

Hospices have not yet had a significant influx of patients with Covid-19, but Dr Nadia Khan of the British Islamic Medical Foundation, who works in a Midlands hospice, is being consulted by mainstream hospital colleagues. She says that the problem is that deterioration with Covid-19 is quick, while much palliative care involves human contact, “not just medication and algorithms”.

“How can one deliver that, really, when you’ve got your mask on and your gown and you’re not able to hold people’s hands in the way that you normally would?” she asked.

Felicity Warner, founder of Soul Midwives, which works to support the dying from “point of diagnosis right through to the end”, would expect to spend a lot of time at the bedside. So her 900 members have been transferring their skills into the “virtual” world, and have set up a support network, SOS, to advise families in hospitals, hospices and care homes. She suggests that because hearing is one of the last faculties to go when you are dying, she recommends families to record messages that can be played at the bedside by hospital staff.

The difficulty of direct contact is also having an effect on staff and creates another area of distress, says Dr Khan. In Leeds, Imam Asim says he asks families of the dying to talk to them on the phone “in a soothing voice” and he will be on one end of the phone and recite some “end of life” verses. He finds that mostly patients are not conscious, or not responding.

Rabbi Levy of Golders Green says he is transforming his community centre into an online world, but “how can you do funerals in an age when people cannot gather? How do you support people when you can’t meet them? There’s a great deal of fear out there.” Mr Burleigh reports that support of the NHS staff is now a large part of a chaplain’s work, such as dropping in to their offices or attending “ward huddles” at the end of shifts.

Dr Khan has been finding senior staff training their colleagues in practices such as breathing techniques, using social media such as WhatsApp:  “I’ve never seen anything like this before. Those boundaries between professional and patient – they’re definitely shifting, and I think it’s got massive implications for healthcare after the pandemic,” she adds.

The Religion Media Centre runs weekly zoom briefings on Tuesdays at 1200, with speakers who explain the background to religious stories in the news. To join please email Our next briefing on Tuesday 14th April at 1200 will consider ‘The NHS – Britain’s new religion?’, with Professors Linda Woodhead and Matthew Thomson.