This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

For Wyoming, Mich. resident Isabel Romero and her family, COVID-19 has meant great loss while also being unable to participate in many of the traditional rituals of grief. 

Early in the pandemic, Romero lost her uncle, Elias Garcia. A month after that, her grandfather, Auner Garcia Martínez, died of pneumonia that doctors attributed to COVID-19. Then the virus took Romero’s great-aunt and -uncle. 

"Family member after family member has died," she says. "It's been hard. It still is hard on the family."

Romero travelled to Texas for her grandfather’s funeral. While the service was supposed to be shared online, technical difficulties at the funeral home prevented other family members from being able to connect. When Romero attended her aunts’ funerals, family members asked her to stream them via Facebook Live – a request Romero understood, but which she says she also felt uncomfortable with.

"I was there to grieve with my grandmother," Romero says. "... I was trying to respect my aunt, her children, her grandkids, and then you have to pass the camera to video an individual who was dead. I wouldn’t want that for my funeral, but that was the only way to allow our family members and friends to view services."
Isabel Romero holds a pillow made from a shirt that belonged to her grandfather, who died of COVID-19.
Like Romero, the pandemic has forced many Michiganders to grieve in extremely unusual ways, as people have had to attend funerals or memorial services masked and distanced, via Zoom, or not at all. Organizations across Michigan have worked to support Michiganders in grieving under unprecedented circumstances.

Adult groups facilitate good grief

Even before the pandemic, Hospice of Michigan’s (HOM) grief support groups helped people through loss — and now there is more need than ever before. When face-to-face grief support became undoable, the groups went online, with the positive result of being available to more people in more Michigan locations.

"There are elements that are unique to this kind of loss," says Wes Lawton, HOM grief support services manager. "It’s a new virus. Losses were unexpected. There are specific kinds of anger or guilt coming up. Everyone feels their loss may have been prevented if people had taken precautions. They may think they themselves had spread it."

When face-to-face group meetings were put on hold due to COVID-19, HOM began providing clients tablets loaded with information relevant to their needs, as well as Zoom and other apps that let them connect with their support groups. 
 
"Connecting this way is still not ideal but it’s much better than no contact at all," Lawton says. "It provides a little more peace and closure with death."
Wes Lawton.
HOM hosts nearly a dozen different online grief support groups for different populations. For example, a young adult group that Lawton facilitates supports people in their 20s and 30s. 
 
"They may have young kids, be in the early or mid-stages of their careers, and looking forward to their futures," Lawton says. "They need to figure out how to make the most of their lives; how to heal at this point; maybe find love again, if that’s their situation; or raise kids without grandparents around."  

Other groups provide solace specifically for parents of young or adult children, men, and those who have lost a spouse or partner. Lawton notes that the past year's focus on COVID-19 has caused some people who've lost loved ones to other causes to feel that their loss is not as important.

"They may feel that their loved one didn’t get the attention or respect needed because so much attention was being given to people with this new illness that we didn’t understand," Lawton says. "So there can be resentment and other kinds of feelings that come out of that."

Secondary losses – the loss of the roles, routines, and responsibilities that a loved one handled in people’s lives – also hit grieving people hard. HOM’s "Loss from COVID" support group deals with all of the different types of losses that the pandemic has brought.

"With the pandemic, we’ve also been facing other types of losses, other than death," Lawton says. "Those losses may not be as big as death but they step on top of one another and make everybody feel a little bit more anxious. Our emotions are a little closer to the surface and we’re having a harder time receiving support."

Helping children grieve

As much as COVID-related grief has affected adults, its toll on children and young adults will continue to change and reverberate throughout their lives. Romero says her family’s experience of COVID-19 has had a huge impact on her teenage sons.

"It gave them a second view of life," she says. "They realized that lives were being lost."

JAMA Pediatrics reported that by February 2021, nearly 40,000 U.S. children had lost at least one parent to COVID-19. This number does not reflect children who have lost more than one parent, or children who lost a primary caregiver who was not their parent. 

"Sweeping national reforms are needed to address the health, educational, and economic fallout affecting children," the report warns. "Parentally bereaved children will also need targeted support to help with grief, particularly during this period of heightened social isolation."

Ele’s Place is a no-cost healing center for grieving children, teens, young adults, and their families, with locations in Ann Arbor, Lansing, Flint, and Grand Rapids. The organization has been serving more children who have lost loved ones to COVID-19.
Kelly Koerner.
"As an organization, we’re all learning how the pandemic is changing grief," says Ele’s Place Program Director Kelly Koerner. "For many, it’s been more difficult to find closure. They haven’t been able to say goodbye to their person. That closure has been taken away and that’s something they’ll never get back. I have a feeling that our services are going to be needed more than ever."

"It’s a challenge to go through the regular grief process," adds Daniel Layman, Ele’s Place CEO. "This all exacerbates the isolation that kids feel."  

According to Koerner, children grieve much differently from adults. While adults might sit in sadness for hours upon hours, children experience grief intermittently, in spurts. Parents often worry that children are not grieving properly.

"A child will maybe cry and, in five minutes, want to go out and play with friends. They cannot tolerate the sadness and pain for extended periods of time," Koerner says. "Also, children re-grieve at each developmental stage and at different monumental periods of time – for example, when they are at graduation, going to prom, getting married, or having their own child."

Ele’s Place staff encourage adults to use concrete facts when explaining the death of a loved one to a young child. A child will resonate more with information like "Mom’s body stopped working" rather than "Mom is asleep."

"If we tell kids that Mom is asleep, they may be afraid to go to sleep. If we tell them that Mom is in heaven, they might say, ‘Let’s get a ladder and go up and find her,’" Koerner says. "Kids may be very repetitive, asking the same questions multiple times. It’s important to be aware and be understanding and patient with them."

Being unable to express grief through customary traditions like wakes, visitations, and in-person funeral services makes the process even more difficult.

"The organic and natural supports that happen at funerals are gone," Koerner says. "Some have done outdoor memorial services, but it still looks very different. There’s not that ability to do that natural hugging and such, the supports we naturally provide each other."

Long road to healing

Although COVID-19 vaccinations have rolled out and businesses are reopening, COVID-19-related grieving is far from over for many Michiganders. When 2021 arrived, Romero and her family cheered the New Year, thinking COVID-19 was behind them. But on January 2, she tested positive for the virus. She recovered, but her husband came down with the virus in May. COVID-19 hit him harder. He developed pneumonia and had to have fluids administered intravenously in the emergency room. He now seems to be on the mend.

"It was really scary for me. Here we were with COVID knowing that I lost an uncle, lost a grandparent, lost aunts, but trying to stay positive," she says. "This is no joke, losing family members."

For Romero, her grandfather's and uncle’s faith-filled legacy guides her through her grief. Her grandfather was a pastor for 48 years, while her uncle worked as assistant pastor of a small church he helped start in Mexico.
Isabel Romero holds a mug bearing a photo of her uncle, who died of COVID-19.
"Whatever spiritual support you can get, go out and look for that, whatever faith it is," Romero says. "With COVID, I can't get together with my cousins, my aunts. It's even hard to get together with my mom because I'm trying to protect her. Being alone, which is how COVID has left us, I feel that you have to comfort yourself with your faith. That’s how I comforted myself and how I keep comforting myself."

Lawton advises those experiencing grief to engage in self-care and to reach out for support. 

"In our society, people have a tendency to minimize just how hard grief is. When they get there themselves, they can feel like they should be having an easier time when in reality their grief hasn’t been given the attention it needs," he says. "If you have lost somebody or even if you are just dealing with the result of this pandemic and the ways that our lives have changed, I encourage you to open up a little bit and ask for help. We really need each other, especially in this time."

A freelance writer and editor, Estelle Slootmaker is happiest writing about social justice, wellness, and the arts. She is development news editor for Rapid Growth Media and chairs The Tree Amigos, City of Wyoming Tree Commission. Her finest accomplishment is her five amazing adult children. You can contact Estelle at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Isabel Romero photos by Kristina Bird. All other photos courtesy of the subjects.