bereavement, cancer, COVID-19, family caregivers, hospice



  1. Tay, Djin L. PhD, RN
  2. Thompson, Casidee
  3. Jones, Miranda BS
  4. Gettens, Caroline BS
  5. Cloyes, Kristin G. PhD, MN, RN
  6. Reblin, Maija PhD
  7. Thomas Hebdon, Megan C. PhD, DNP, RN, NP-C
  8. Beck, Anna C. MD
  9. Mooney, Kathleen PhD, RN, FAAN
  10. Ellington, Lee PhD


The COVID-19 pandemic has dramatically changed social life. This secondary qualitative analysis aimed to better understand the impact of the pandemic on bereaved hospice family caregivers' experiences of social connection and isolation in a time of social distancing and general anxiety. Six caregivers in 3 states recorded audio diaries (N = 59) between March 13 and May 15, 2020. Caregivers were, on average, 56.80 years old (SD, 14.22; range, 32-67 years old) and consisted of spouses (n = 2), adult children (n = 3), and a sibling (n = 1). Using NVIVO 12, caregiver diaries were coded for (1) "social connection" (n = 23), defined as being able to access or seeking informal or formal social support networks; (2) "isolation" (n = 17), defined as being unable or reluctant to access informal or formal social support networks, or feeling alone; and (3) "bereavement processes" (n = 147), informed by the dual process model of bereavement (restoration and loss-oriented stressors). Content analysis revealed that caregivers were able to connect with others despite physical distancing expectations, expressed loneliness and grief while in isolation, and described moving on in the face of uncertainty. Findings provide insight into how caregivers experienced bereavement during the initial period of the pandemic and highlight implications for hospice bereavement services.