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Looking back on the past year and a half, it’s almost impossible not to get overwhelmed by the sheer magnitude of the pandemic’s toll. Numbers and graphs don’t even begin to illustrate what it means to have lost over 4.5 million people around the world—for their loved ones, for medical staff continually overwhelmed at hospitals, and for the death workers who have also been on the front lines caring for the dead, arranging funerals, and comforting the grieving. This is particularly true as the Delta variant rages through many of our communities while many continue to go about their lives as usual.

The crisis has never stopped, and death workers have been there day after day, showing up for people despite exceptional circumstances.

Given the lack of spotlight on this dedication, we wanted to feature the ongoing experiences of death workers or “last responders,” whose voices deserve to be heard and honored. We reached out to those in the TalkDeath community and received an outpouring of responses. Those who wrote to us underlined the difficulty of showing up for the dead and grieving during unprecedented times, detailing situations of incredible hardship, surreality, and risks to themselves and their families. But we also heard about resolve, moments of ingenuity, the love of this work, and how important it is to be that person who can lead others through one of the most painful experiences of their lives.

Here, we give you these unedited perspectives from around the world and all different positions in death care. They speak louder than we ever could.

A COVID-19 Death Care Retrospective: Stories from our Forgotten Last Responders

Image via Omar Yildiz

On Separation and a Changed World

One of the most common themes that death workers cited in the early days of the pandemic was the pain of separation for both themselves and the families they worked with. Humans are meant to be in community, especially during the dying process and mourning period. Many wrote on how funeral restrictions and having to care for people through plastic felt wrong and unnatural. Some even described being called in to be with those otherwise dying alone—a heartbreaking but necessary service.

 Our normal cooler space is a maximum of 9 bodies, but anything over 4 to 5 is considered full. We brought in a special ‘COVID’ cooler with a maximum of 18, plus room for more. Anonymous

“One of the most difficult things about the pandemic has been the physical separation required by PPE and infection prevention protocols. Death work is a very hands-on art, and I have found it challenging to comfort patients and grieving family members through masks, gowns, and goggles. It is hard to provide that nuanced emotional support with so many physical barriers. We don’t hug very much anymore, and sometimes I can’t use the gentle tone I would like while trying to communicate clearly through a mask. It may seem like a small difference, but every interaction is so important in death work.”
-Annie Thacker, home hospice nurse in Appalachia 




“Nursing home pick ups have really changed, with the elderly being very vulnerable during this time. It has been devastating to see how they have been living. That’s not to say the nursing staff aren’t looking after them correctly, but just the force of the pandemic and what that means for their day-to-day lives. Families standing outside to talk with their loved ones, plastic walls, ALL THE PPE, everything is disposable. At one point, residents weren’t allowed out of their rooms and were dying alone, having not seen their loved ones for weeks or months. It was truly sad and scary seeing these homes transformed into what you’d see in a Hollywood movie portraying a pandemic to be! It just doesn’t feel real some days.”
-Erin McCarthy, funeral director and mortician in Melbourne, Australia

“In 2020 I was managing a very high volume corporate funeral home, located where the first COVID outbreaks were happening in the lower mainland. I made the call on March 16th that we would not be meeting families in-person in our small arrangement rooms until we knew more. Typically we would have at least two, sometimes up to five families a day coming in for meetings, so this was a significant disruption. About ten minutes after I made that announcement to the staff I received a call from a family of a young person who had completed suicide over the weekend. They were in the car on their way in, a family member had flown in the day before. I saw them in person, before masks and before we understood what the risk was. I couldn’t bring myself to say no, as that did not feel like an empowered and empathetic death care provider. I felt like I was putting my family, staff, and self at risk, due to simply lacking the strength and energy at that time to say no. A year and a half into social distancing, restrictions, lockdowns, reduced events, I have become a lot better at saying ‘no’, but I have not yet regained the feeling that I am serving my families as best I can.”
-Emily Bootle of KORU Cremation in Vancouver, British Columbia 

“I’m used to holding hands and looking people in their full faces. There’s just something off about not being able to do so, even when I’m doing my best to provide everything else that I can. It’s harder to make those connections and I feel like people are having a really hard time mourning without them. Especially because they didn’t get to see or touch the dead and get that sense of closure.”
-Rowan, funeral celebrant and doula in Scotland 

“Nothing will ever make me forget sitting bedside with a dying man as his family stood outside the window and looked on. I know they were happy that someone could be with him, but I just imagine the death they could have had if none of this had happened.”
-Neveah, hospice chaplain in Ohio   


On Surreal Moments in Death Care during COVID-19

Aside from the separations of social distancing, many death workers wrote in with some of their most exceptional experiences. The details differed based on their role, but the reactions were often the same: how could this be happening? When would it stop? How do we respond? Multiple folks underlined that it was almost impossible for others to understand what it was like to watch these developments in real-time: “watching the bodies pile up on TV is nowhere near the same.”

“A moment that really stood out to me during this whole pandemic so far was when our shop was at capacity and the calls never stopped… I remember our fax machine going steady for at least 30 minutes of just cremation permits.”
-Kady, mortuary apprentice in Oklahoma 

“In July 2020, I led a service for a 96 year-old woman. Two weeks later, I led a one for her youngest son who took his life. Although neither died of COVID, his death was a consequence of the pandemic. Was it the crushing grief of his mother’s loss, the isolation and loneliness of the lockdown, the desperation of losing a job he loved, or the difficulty accessing overwhelmed mental health care services—I will never know. What I have since learnt, sadly through leading similar services over these terrible 18 months, is the effects this pandemic has had on mental health, especially for young people.”
-Stephanie Longmuir, funeral celebrant in Melbourne, Australia

“There have been so many times we’ve had to turn families away because we were already overwhelmed with bodies. It’s heartbreaking to hear the frustration and desperation in their voices and know I can’t do anything about it. I almost broke down at one point when a family tried to show up in person to plead with us to take their dad. It’s a tsunami that never ends.”
-Dawn, funeral service manager in Louisiana 

“Our normal cooler space is a maximum of 9 bodies, but anything over 4 to 5 is considered full. We brought in a special ‘COVID’ cooler with a maximum of 18, plus room for more. The most we had in there at one time was 12… and all 12 were COVID positive.”
-Anonymous, deputy coroner in Colorado




“An experience that has stood out to me since the beginning of the pandemic was the observation of the excess – bile like fluid that builds up specifically in COVID cases. The difference between a COVID and non-COVID is visible during abdominal aspiration.”
Rebecca Manning, embalming apprentice, crematory operator, and funeral associate in Jacksonville, Florida

“Our network witnessed how badly people wanted to talk about death, dying, end-of-life planning, our failing health care, and how we can better support our communities in living and dying well, on our own terms; plus the burning desire to take back our roles as caregivers for our own ill and dying. The pandemic has called us to rethink the control we’ve handed over to medical professionals and despite our discomfort, it has created a desire to relearn how to support our loved ones through illness, dying and loss. We witnessed this repeatedly as we took our workshops to the virtual realm and began connecting with people all over the world. It is a universal need we are awakening to.”
-Karen Hendrickson, death educator and doula in Maple Ridge, British Columbia


On Personal Loss and Grief During COVID-19

On top of the demands of responding to a global crisis, some death workers also had loved ones die—from friends and family to colleagues. They had to balance their grief with their jobs, which at times, felt like an almost impossible task.

“During southern California’s peak of COVID deaths, my uncle suffered a fatal stroke and he was isolated in the ICU. I handled all parts of his arrangements. From taking the first call, going to hospital to make the removal, being in the arrangement office with my aunt and even embalming him. I think this moment defined me as a funeral service practitioner because I was experiencing everything from all sides. I was in school too so I had finals for my mortuary science program. I had to work through the pandemic assisting other families while at the same time trying to keep mine together as it felt like everything was falling apart. The restrictions kept services small so it felt like my family was fractured during our mourning.”
-Soraya Pitram, apprentice embalmer and service director in Orange County, California  

“Those in the funeral industry intimately know that we’re going to die one day, but that doesn’t necessarily make it easier. We lost a body transporter due to COVID last year. We didn’t know where he got it, but it was hard not to assume it was through the job. He was my friend. He shouldn’t have died.”
-Isis, death worker in North Carolina 

“Experiencing deaths in my family in the early days of the pandemic really brought home for me how important the work is. It was so hard, I won’t lie, there was even a time when I thought about taking a break from being there for my dying clients for my own mental health and grieving process. But I realized that this is my calling and that I could use my experience to support others, especially as society at-large refused to acknowledge COVID deaths.”
-Anonymous, full spectrum doula in Chicago, Illinois


On Lack of Recognition for Last Responders 

 I wish they understood how many of us would’ve liked to close our front doors and immerse ourselves in jigsaw puzzles, Netflix and sourdough baking instead of turning up everyday and putting ourselves and our families at risk. Stephanie Longmuir

Perhaps out of all the questions we asked death workers, the one that got the most answers by far was what they wished people knew about being a last responder. Some mentioned having to field ill-timed jokes that the funeral industry must be booming, while almost everyone talked about their exhaustion and wanting people to have just as much respect for them as medical workers. As one individual said, we need to re-frame who we understand to work on the front lines, as they have put themselves at risk again and again.

“I really believe that people think we are just in suits, pushing papers and have ‘sorry for your loss’ on repeat… It broke our hearts to say to people that they couldn’t grieve how they needed to. We weren’t only exhausted by the amount we were working, we were exhausted because we were emotionally drained. We were going into places and homes that had COVID-19 and we were putting ourselves and our families at risk.”
-Kate Davignon, apprentice funeral director in Palmer, Massachusetts

“I wish we were more of a presence in day to day working life, I am in total awe of all of our key workers, but we had to fight to become ones. The NAFD (National Association of Funeral Directors) fought for us to do so, which I feel sad that there seems to be such a stigma around death. I feel most people would rather ignore it and not recognize our work than come to terms with it.”
Bethany Agar, funeral arranger in Bournemouth, England

“Being a last responder, I wish people knew the stress we have been under since the beginning of this pandemic. Hearing people talk about how the virus isn’t real, or how they simply don’t care, while we are out working endlessly, putting ourselves and our own families at risk to care for the families of our community is beyond disrespectful. We are all in this together. We are all a piece of the puzzle.”
-Rebecca Manning, embalming apprentice, crematory operator, and funeral associate in Jacksonville, Florida

“I wish they understood how many of us would’ve liked to close our front doors and immerse ourselves in jigsaw puzzles, Netflix and sourdough baking instead of turning up everyday and putting ourselves and our families at risk. I also wish I could put into words the trauma that we took on not just in serving families who had lost family members to COVID but also families who were unable to have access to the people they loved during the final stages of their lives because of restricted access to aged care, hospital and hospice facilities and then not being able to come together as a grieving community because of restrictions on travel and numbers at funeral services.”
-Stephanie Longmuir, funeral celebrant in Melbourne, Australia




“People often forget about the death carers, even the government. In the first lockdown, last responders weren’t listed as essential (which promptly changed when pointed out). It’s been incredibly difficult and scary during this pandemic; the fatigue is real. It is eerie seeing no cars on the road when there’s a call out at 2 AM, but our life hasn’t slowed down at all. It sped up and became so much more complicated. Please be compassionate to last responders when you can: keep in mind we work for 14 hours straight sometimes and are drastically underpaid in some cases. First responders definitely deserve as much limelight as possible, they are heroes, but once their job is done, it’s the last responders time to step in and care for the deceased, family, and friends. We are going into the same environments and the same risks the first responders are going into. Hospital COVID wards, hotspots, private homes. The grief and exhaustion are very real some days and we need support and awareness just as much as first responders.”
-Erin McCarthy, funeral director and mortician in Melbourne, Australia 

“It was probably the most difficult time in our history. In the UK, we clapped for the NHS (National Health Service) and careers at our doorstep every Thursday night, while a lot of people in the funeral industry said that we were the forgotten profession. There were comments from the public about us making loads of money from the pandemic when actually most of us cut our costs. In the UK we saw images of other countries struggling to deal with the dead, coffins lined up in Churches in Italy, temporary refrigerated trucks in the USA. But we just carried on in the quiet unassuming dignified way which we always do, it was a credit to our profession. Ultimately, we all tried our hardest for each and every loved one that we looked after and the public should take a huge comfort from that.”
Tracey Warren, funeral director in Somerset, England

“I wish people understood that the toll on us is high. Many of us worked through a pandemic under stressful situations, long hours, PPE shortages, and received very little mention. But as death care workers that is what we do: make it happen.”
-Anonymous, funeral director and embalmer in California


On Shifting Funerals during COVID-19

Given the popular discourses about how funerals have had to adapt to the pandemic, we also asked respondents if they thought services have changed and what shifts might be here to stay. Many cited more people embracing technology, which forced some funeral homes to update their practices and facilities in ways they might now have otherwise. Others talked about how funerals have become dramatically more modest, with more families opting for cremation or no service.

“Prior to the pandemic, it was often common for patients and families to fear death and insist on aggressive, painful treatments to ‘keep hope.’  The pandemic has really forced many people to face their own mortality and realize that none of us are getting out alive, we will all die, as it is a normal part of life. Realizing that there is a time for comfort measures, and that it’s humane to do so. I hope this stays.  Seeing 99 year-old people on ventilators and getting CPR and aggressive chemo because the family isn’t ‘ready to let go’ is so heartbreaking.”
Carrie Montemarano, hospice nurse in Metro Phoenix, Arizona

“The death care profession in Australia has been dragged into the 21st century. Webcast services are here to stay. Video recordings are replacing in person tributes and eulogies, especially as borders remain closed in Australia and travel is difficult. Funeral Directors and Celebrants no longer visit family homes; meetings are conducted via Zoom/Teams or in the funeral company’s offices. Official documents have been digitised—gone is the fax machine!!”
-Stephanie Longmuir, funeral celebrant in Melbourne, Australia

“I feel like switching to virtual has not only opened the door for more options in attendee participation, but has also encouraged more families to look online for alternative options. Being forced to interact more with our computers has opened the door for more choice, option, and possibility. I also think that, now that we have opened the door to the virtual memorial experience, more families will see this as an opportunity to include more of their friends, family, and community into their events… Also, with a virtual component, any guests who don’t feel like they are in the “inner circle” or “close enough” to the honoree will now be able to attend and grieve and leave messages for the family without having to arrange to be there in person (i.e. if you heard a favourite teacher from high school passed away, you can now attend via a remote option as opposed to feeling uncomfortable or unsure if you are actually invited to attend).”
-Christina of New Narrative Memorials in Vancouver, British Columbia

“My hope is a turn towards more creative options. In America, there is little ritual associated with death aside from embalming for the sake of embalming. I look forward to bringing back personal or cultural traditions & potentially keeping people in their homes, to bring death positivity and personalization.”
-Katie Sue Van Valkenburg, MSW and volunteer hospice in Denver, Colorado

“Funerals will be changed because we have now seen the power of a small gathering. I believe this has been a powerful lesson in returning to the basics of what funerals are, which is gathering around the space left by an important person. We have honed our digital gathering and learned to set boundaries around our bubbles both in grief and in living. I do wonder if death care will be considered more carefully alongside other aspects of care moving forward. In Canada, we have a publicly-funded healthcare system which looks after our bodies up until the moment of death. We are then transported into the private death system which requires families to shop and pay for what many see as a continuation of care for the body. How and why the system became what it is hasn’t been scrutinized much in the past, I think all these challenges we’ve experienced could change that. As a holistically-minded funeral director I wish this on every shooting star.”
-Emily Bootle of KORU Cremation in Vancouver, British Columbia 


Conclusion

It’s impossible to know when the pandemic might be “over.” Likely, we will be living with COVID-19 for a long time. But as we look to the future, it is as clear as ever that we must make mortality less of a taboo subject to heal from the trauma that so many have experienced. Like many of those who contributed to this retrospective, we have hope that the devastation of the past nineteen months will eventually lead to lasting shifts in how people think about death and relate to the death workers in their communities. Their care deserves to be more visible and valued. We’ll leave the last words with them:

“Working in and around death is hard. In this line of work we have all seen things that most people couldn’t handle, couldn’t conjure up in their worst nightmares, and then to throw a pandemic into the mix is crazy. We all need to remember just how bloody amazing we are. I’m proud of the job that I do, and I’m proud of each and every one of you that work in death care and have managed to survive this pandemic and still have a smile on your face at the end of the day.”
-Anonymous death worker in the United Kingdom


  

Note

A big thank you to everyone who shared their thoughts and experiences with us. You are all rock stars!

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