Exploring Funeral Directors’ Experience and Perceived Impact of Providing Funeral Services During COVID-19 Restrictions

Introduction

In December 2019, the first cases of a new and rapidly spreading virus, later named COVID-19, were detected in China. On January 30, 2020, the World Health Organisation (WHO) declared a Public Health Emergency of International Concern and went on to characterise the global outbreak as a pandemic on March 11, 2020. Since then, until April 2023 there have been over 760 million cases of COVID-19 reported worldwide, including nearly seven million deaths. Ireland recorded its first death from the virus on March 12, 2020, and on that day all schools, colleges, churches, and other public places were closed. Ireland has reported more than 1.7 million cases of the virus and more than 9300 deaths (World Health Organization, 2024).

Much of the research and media reporting has focused on impact on the bereaved, and on nurses, doctors, and other hospital care staff during and following the pandemic. Health care workers (HCWs) represent a cohort who carried a significant burden from the COVID-19 pandemic. A meta-analysis by Gómez-Ochoa et al. (2021) found a higher prevalence of the virus among HCWs when compared with the general population. However, the experiences of funeral service providers, described as “one of the underrecognized “first responders” in the COVID-19 pandemic”, (Bensimon, 2021, p. S57) and how they have responded to the new demands, have received substantially less attention. Early responders, due to their physical and temporal proximity to the death, provide a crucial support to the bereaved (Duval et al., 2023).

In Belgium, Van Overmeire et al. (2022) studied post-traumatic stress symptoms (PTSS) amongst funeral directors after the first wave of COVID-19. The percentage of those with possible PTSS (12.3%) was low compared to those of HCWs and less than a quarter of them feared infection from the virus. Almost half of these had more stress during COVID-19 than before, while one-third experienced no changes and almost 17% experienced less stress during the pandemic than before. Less than a quarter of those surveyed feared infection from COVID-19, but more than 40% of them feared infecting their family and friends.

In addition to the impact on staff, COVID-19 restrictions impacted on funeral rituals. The importance of ritual and ceremony following bereavement is well documented in the literature (Rumbold et al., 2021). However, restrictions removed the relative freedom, that families previously had, to bury their loved ones according to their beliefs and traditions (Bank et al., 2020). In Ireland, wakes, a well-known part of Irish funeral tradition where family, neighbours and friends came together to celebrate the deceased person’s life, could no longer take place and gatherings in funeral homes were also prohibited. In their guidelines to funeral directors, the Health Services Executive (HSE) stipulated that “the decision to allow an open coffin should be based on an assessment of the potential distress caused to bereaved relatives and friends from not being able to say goodbye, and the potential infection risk” (HSE, 2021, p. 15). Furthermore, embalming, washing the body, and kissing the deceased all ceased, with the HSE guidelines noting funeral directors were to “advise mourners discreetly that they should preferably not kiss the deceased person and should clean their hands after touching them” (p.15).

Funeral directors were advised to organise services by phone and to avoid direct contact with any family member identified as being a close contact of the deceased. People had to be informed privately of funeral arrangements as death notices were not allowed to publish times or venues of the funeral. Government guidelines advised, where possible, that close contacts and relatives of the deceased use their own transport for attendance at the funeral and banned all post-funeral gatherings. Funeral services and graveside attendances were limited to no more than 10 people. At these funerals social distancing had to be observed so, shaking hands, hugging, and embracing all disappeared to reduce the risk of infection from close contact between mourners (HSE, 2021). The traditional shouldering of the coffin had to be suspended due to the requirements of social distancing, resulting in the body of the deceased being brought from the hearse to the graveside by trolley. In some cases, the deceased person was afforded no service at all but was transferred straight from hospital to the crematorium. Signing the book of condolences was no longer a feature due to the risks of infection and people were recommended to send condolences through social media, online websites, text or by letter.

Since funeral directors were in the position of enforcing government regulations, they were continuously placed in a sensitive situation with the families of the deceased, and in Ireland particularly, this created a profound change in how they traditionally interacted with the bereaved. It was not until October 20, 2020, following much public pressure, that Government increased attendance at funerals to 25. It is perhaps not surprising that, in the absence of the traditional funeral facilitated by the funeral director new, private rituals emerged such as mourners lining the road outside the cemetery to pay their respects. Research by the Irish Hospice Foundation (IHF, 2023), which conducted a survey of 2259 people, highlights the negative impact of restrictions on the experience of death, dying and bereavement, but also the extent to which these new rituals were welcomed. Nevertheless, the restrictions placed on funeral practices because of COVID-19 and the subsequent rise of informal memorialisation rituals have served to blur the interface between the roles of the bereaved community and formal industry service providers (Lowe et al., 2021).

Funeral directors have been identified, pre-pandemic, as among the top three sources of bereavement support, after family and friends. (Aoun et al., 2015). Their study notes, however, that it is unclear whether the level of perceived support received is because funeral directors provided a formalised after-care service or whether the quality of the relatively brief involvement during the immediate post-death period accounted for the lasting positive effect. The pandemic limited the sources of support usually available to the bereaved, making the role of funeral directors even more relevant (Burrell & Selman, 2022). The restrictions of the pandemic prevented funeral personnel from being supportive to the families as they would have in earlier times. However, it is worth noting, that pre-pandemic, where the bereaved were free to choose what best suited them, a study by Birrell et al. (2020) found no association between levels of grief and the elaborateness of the cremation ceremony.

A scoping review, which explored the use of virtual funerals during the COVID-19 pandemic, reported that virtual funeral practices have highlighted the resilience of families and communities during the grieving process, and their ability to find new avenues of meaning despite the social distancing requirements (MacNeil et al., 2021). However, the study also notes that the increased dependence on the use of virtual funerals posed greater challenges on the funeral industry. The review found that opinions varied regarding the effectiveness of the use of technology in the conducting of funerals. On the one hand, accessibility was lauded while, on the other, concerns regarding the infringement on emotional connection was noted. One clear advantage mentioned was the ability of a virtual funeral to reach large, global audiences who could not otherwise attend and concluded that the popularity of this aspect would continue, post-pandemic.

The study by Lowe et al. (2021) mentioned earlier concluded that a blending of traditional, public, and newly emerging, private forms of memorialisation are likely to continue in the post-pandemic world. This may result in new role definition for funeral directors and so require some navigation. Reaching a new understanding of the experiences of funeral directors during the COVID-19 pandemic would inform how this group of grief practitioners could be more included as essential voices in future death conversations.

Methodology

Participants and Sampling

An exhaustive sampling approach was adopted using membership of the IAFD as the population. A sampling frame of all companies providing funeral services who were members of the IAFD was generated using publicly available material. This resulted in a list of 249 individual directors, companies, or regional/local offices of larger companies. IAFD members conduct 80% of funerals on the island of Ireland (IAFD, nd, https://www.iafd.ie/). It is possible that humanistic funerals or less traditional ones are under-represented in the sample. It must be noted that The Humanist Association of Ireland (HAI) is an Associate Member of the IAFD.

Recruitment generated a volunteer response of 80 individuals, however non-consenters and entries with 100% missing data were excluded (participants had to have provided at least partial demographic information to be included), and so a final sample of 58 was identified.

The sample included individuals who identified as male (72.4%, n = 42) and female (22.4%, n = 13), with 3.4% indicating they preferred not to say and 1.7% not responding. The age profile of participants is reported in Table 1. Respondents were drawn from 17 different counties, with Dublin being the most common response (n = 10, 17.2%).

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Table 1.

Age Profile of Survey Participants.

Age Group	N	%
30–39	3	5.2
40–49	12	20.7
50–64	33	56.9
65+	9	15.5
Missing	1	1.7

Two-thirds of respondents were the owner of the company (67.2%, n = 39), and just under 60% working in a funeral director role (58.6%, n = 34), with other roles (funeral assistant and administration) also included. The largest group were employed fulltime by the company (74.1%, n = 43). Table 2 reports the length of time the participants had been in the profession.

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Table 2.

Length of Time Participants are in the Profession.

Time in profession	N	%
0 – 5 year	8	13.8
6 – 10 years	4	6.9
11 – 15 years	4	6.9
16 – 20 years	6	10.3
21 – 25 years	7	12.1
26 – 30 years	9	15.5
30 + years	19	32.8
Missing	1	1.7

A large proportion of the sample were members of the IAFD (89.6%, n = 52), though 39.6% (n = 23) reported multiple memberships. Finally, participants were asked about any qualifications, awards, or certification they had received. Just over one-third of the sample responded (37.1%, n = 23), with the IAFD certificate in funeral directing, or equivalent, the most common response (n = 13).

Results

As context for examining the experience of supporting families during COVID-19, participants were asked about the grief resources and follow up contact that they provide to bereaved families. Most participants (91.4%, n = 53) reported the grief resources they provide (multiple responses were possible), while 84.5% (n = 44) responded to a question about provision of follow up. Table 3 reports the frequency with which each type of resource or follow-up was indicated (as a percentage of the total sample). In reporting the other follow up methods, responses ranged from operational aspects (e.g., the bill for services provided) to those more focused on support.

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Table 3.

Provision of Resources and Follow up.

Resources Provided	% (n)	Follow-up Provided	% (n)
Traumatic/sudden death	25.8% (15)	Phone call	44.8% (26)
Death by homicide	22.4% (13)	Letter	13.8% (8)
Death by suicide	29.3% (17)	Other	24.1% (14)
Miscarriage/stillbirth	22.4% (13)	Do not provide follow up	18.9% (11)
Death during COVID-19	31% (18)
Death from COVID-19	24.1% (14)
Children	27.5% (16)
Families	46.5% (27)
Extended family/friends	25.8% (15)
Wider community	24.1% (14)
Local resources/referrals	29.3% (17)
Other resources	5.2% (3)
Do not provide resources	39.6% (23)

Perceived Impact of COVID-19 & Confidence

In assessing their ability to function at a high level during the pandemic, most participants agreed/strongly agreed with this view (86.5%, n = 45), while almost all (92.3%, n = 48) agreed/strongly agreed that their organisation was able to function effectively during this period.

Looking at the impact of COVID-19 in more detail, total scores for the Impact (Total and Personal) and Confidence scales were calculated. Table 4 reports summary descriptive statistics for both scales. For the Overall Impact scale and Personal Impact subscale, the mean and median scores are in the moderate range of possible scores. In the case of the Confidence scale however, the mean and median scores are more in the upper moderate but almost the full range of possible scores are evident.

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Table 4.

Summary Descriptives for Impact and Confidence Scales.

	Overall Impact	Personal Impact	Confidence Scale
Valid response	50	51	46
Mean	2.79	2.51	3.87
Median	2.75	2.54	3.87
Std. Deviation	0.424	0.544	0.711
Possible range	1–5	1–5	1–5
Minimum	1.90	1.38	1.42
Maximum	4.40	4.62	5.00

Participants were asked if their previous training had prepared them for supporting bereaved familiars during COVID-19, and Table 5 reports their responses. Statistical analysis did not identify any differences across the three groups.

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Table 5.

Responses to Whether Previous Training has Prepared Them to Support Families.

Response	N	%
Strongly agree/Agree	24	41.4
Neither agree/Disagree	20	34.5
Strongly disagree/Disagree	6	10.3
Missing	8	13.8

Factors Impacting Work during COVID-19

This research question was addressed by the qualitative analysis of responses to open-ended questions. Over three-quarters of the sample (n = 43, 78.2%) responded to the open-ended questions to some extent. From the analysis of the qualitative responses to these questions, a total of five themes were generated, reflecting the things that supported and challenged their work and these are shown in Table 6.

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Table 6.

Themes Extracted From Open-Ended Responses, With Reported Frequency.

Theme	n (%)
Funeral directors’ sense of being undervalued and unrecognised at a policy level, while receiving enhanced appreciation for their work in difficult circumstances from those bereaved	12 (21.8%)
Discomfort for funeral directors of the conducting of funerals with imposed social distancing and restrictions coupled with having responsibility for communicating and enforcing guidelines	22 (40.0%)
Funeral directors’ experience of both the comfort and limitations of technology in aiding access	13 (23.6%)
Experience of and response to the change to traditional rituals: Observation of the benefits of the reduction in pageantry	20 (36.4%)
Prioritising duty of care to staff	12 (21.8%)

Unrecognised by Policy, Appreciated by the Public

The first of these themes illustrates FDs’ sense of being underacknowledged at a policy level as first responders during the COVID-19 pandemic. This quote from one of them summarises their sense of frustration and disappointment:

“As anticipated, at the beginning, there was complete disdain and contempt for funeral service, until the government woke up and realised that they had no idea of what we do, or how we manage to function and soon realised, that if we ‘broke’ it would have been complete carnage. Of course, funeral companies were still never seen as essential, and we were not even considered to be added to the early vaccine list.”

This sense of being under-recognised was manifested in a variety of ways: FDs reported not being eligible for early vaccination and the inadequate provision of personal protective equipment, for example. As one FD put it, “Funeral Directors were on their own, effectively”. However, juxtaposed with this lack of acknowledgement at policy level, FDs reported increased job satisfaction in being able to be, “a support to families in the most unusual times”, and “to give them more time and be very close and personal with them”. Though there were great demands on the funeral profession due to the pandemic FDs had an awareness of being appreciated for “the extra effort you would put in to try make their loved ones’ funeral a decent send-off, despite the rules that were in place”. Engagement with the public at a time of such global distress gave rise to a role reassessment for FDs, where they realised “that [they] were not just doing a job but providing a worthwhile service to the bereaved and the wider community”. One comment suggests that there may be a lasting legacy of this in society at large as, post-pandemic, “families in general seem more relaxed now, and maybe not as demanding […] and appreciate what we now have again”. Some FDs also experienced a new sense of competence when engaging with bereaved people during the pandemic, noting that “it was good to be able to explain why restrictions were necessary and to show families that you had the ability to answer any questions they may have had”.

Sources of Discomfort for Funeral Directors

Simultaneously, with this sense of being undervalued, the FDs reported unease both with having to conduct funerals within social distancing restrictions and having the responsibility of communicating and enforcing these restrictions to the bereaved families. This comment from one FD brings into sharp focus the pressures under which they worked:

“We went to hospital morgues and handed in an empty coffin. We were not allowed access to the mortuary. We were handed back a sealed coffin which contained a person in a body bag (sometimes two bags) - no dressing, washing or preparation of the remains, no sense of the dignity which we all took for granted. I will never forget the wife of the deceased asking me if I could put her mind at ease by confirming her husband was in the coffin. Obviously, I did not see him being placed and I could not open the sealed coffin. All I could give her was a name tag in a sealed bag that I asked the attendant to remove on arrival to hospital”.

Communicating the restrictions regarding numbers of attendees at a funeral was difficult for the FDs also. They noted that the limited numbers meant that closer friends were not able to be there to support, as family members were included first, regardless of closeness to deceased. Communication of the guidelines to older relatives was particularly challenging for the FDs as “they were being asked to break with the traditions of a lifetime”. Some pressure of having to be consistent in their enforcement was also in evidence. For example, one participant reported, “Some families pushed it too far, at times, and tried to ignore the guidelines, which was very hard for the Funeral Director who had to try and rein it all in. If you deviated, the next family was very quick to say – well, you allowed the other people do it!!” Even though they had the responsibility for their enforcement, the FDs had to clarify that the guidelines were driven by Government and not by the funeral directors themselves.

The Comfort and Limitations of Technology

They reported an acceleration in the use of technology to live stream funerals, acknowledging its benefits in allowing sentiment to still be conveyed and enabling people to be connected, though physically separated. They also thought it would play an important and increasing role at funerals, post-pandemic, citing advantages such as accessibility and affordability and the availability of an online condolence book, “The facility in most churches (not all) to offer an online viewing of the funeral service was, and still remains helpful-it’s here to stay, together with the online condolence book”. Though the benefits of being able to have facetime with a person or speak with them via Zoom were acknowledged, it was also noted that “having funeral arrangements made remotely (e.g. by telephone) and not face to face” was difficult for some FDs. It is fair to say that in general they took a balanced view of the use of technology as illustrated by the following contribution, “The benefit of streaming services for those who would previously have felt pressure to travel for a funeral - streaming is very beneficial, once it’s optional and not THE only way to attend”.

The Impact of Changing Ritual

Overall, the findings from open-ended questions suggest that the FDs see the landscape of Irish funerals permanently altered, as a result of the COVID-19 experience. Though they fully recognised that the imposed restrictions caused hardship to some, they also noted benefits in that “Funerals became simpler, more private events - maybe not a bad thing for some families. That said the ‘full circus’ has largely returned”. Many told them that the funeral with only ten people was deeply personal for the core family and that it was sometimes a relief not to have to deal with the general public and post-funeral hospitality. As one FD commented “Some families preferred the more intimate nature of a COVID funeral and the presence of close family and friends was deemed to be far more important than large crowds, albeit well meaning, calling to the house/funeral home. This was reflected across all age groups”.

Opposing views on the importance of the Irish wake were put forward. On the one hand it was seen as an essential component, emphasising “the extraordinary dedication of the embalming profession to do all they could for the deceased and by extension the families of the deceased”. On the other hand, it was noted that “Families sometimes benefit from being given space in the days after a death. Sometimes they can feel overwhelmed by large crowds for wakes etc. […] and not as much is expected from the public since the pandemic”. Though it was recognised that the privacy afforded by restricted numbers at funerals “was appreciated by families who preferred an intimate grieving occasion”, these same restrictions sometimes impeded the way FDs were able to give comfort to bereaved people. In some cases, this inability to engage as they would usually do, was found to be impactful on FDs, especially when working with families “who had very little community or even extended family support due to restrictions”.

Duty of Care to Staff

The requirements imposed on funerals by COVID-19 served to highlight that staff care was an important consideration for the FDs. Technology was regarded as being important for the wellbeing of the FDs in the context of a pandemic, “Personal safety is paramount as you can’t do your work if you get ill. Technology can lessen personal contact without impacting on a good service”. As one respondent put it “Our duty of care to clients is only surpassed by our duty of care to our staff”. Dealing with COVID-19 brought a heightened awareness of the ongoing need to ensure the personal health and safety of funeral staff, “In future, it is important to have an infectious case protocol in place for transporting and caring for the deceased. COVID is only one of many infectious diseases which we deal with, on a daily basis, and the protocol should be same for all”. The need, in future, for FDs to be vaccinated straight away in the event of another pandemic, to have immediate access to proper PPE and to have procedures in place, with staff fully briefed on these procedures, was also stressed, to maximise their safety.

Discussion

The aims of this study were (i) to explore the experiences and perceptions of staff in funeral service providers of providing funeral services during COVID-19, and (ii) to consider the implications of this experience for future practice supporting bereaved families. Three research questions were addressed in meeting these aims, and the findings are synthesised here.

What is the perception of funeral service providers of the impact of COVID-19

On them and their work? What is the level of confidence among funeral service providers in meeting the needs of bereavement individuals/families following the death of a family member during COVID-19?

There is clear evidence across the findings that funeral staff completing the survey perceived moderate to small negative impacts on them and their work during COVID-19. They reported that they individually, and their organisations worked to an effective level during this period, with moderate scores for both the overall impact of COVID-19 and the individual impact, as assessed by the scales included in the survey. This is perhaps linked to the moderate to higher levels of confidence participants reported feeling during this period. In contrast, the qualitative results highlight a feeling among participants that they were under-recognised at a systemic and policy level. However, alongside this under-recognition was their sense of being more appreciated by the public for the support they were able to provide. This echoes the findings of Mitima-Verloop et al. where those bereaved regarded the funeral service as positive, “because it was the best way possible at that time” (2022, p.6). Several participants specifically mentioned the lack of recognition of staff in the funeral sector as first responders.

What factors supported and challenged the work of funeral service providers during COVID-19?

The aforementioned lack of recognition presented a challenge, especially as it was coupled with lack of access to appropriate PPE. Moreover, having the responsibility of implementing and indeed enforcing restrictions, not of their making, added a layer of complexity to the funeral directors’ role. These restrictions fundamentally changed the public’s experience of death and the rituals surrounding it. However, in line with other findings (Burrell & Selman, 2022) funeral directors in this study demonstrated great resilience, an ability to adapt to the restrictions and to respond creatively to the needs of the bereaved in difficult circumstances. In adapting their procedures, there is clear evidence of learning about new rituals and processes that may have positive impacts for bereaved individuals and families. They noted that in many cases the restrictions on numbers attending afforded relief to the bereaved and resulted in the funeral being a more intimate experience. This resonates with the findings of a New Zealand study which reported that the pandemic provided licence to reimagine funeral practices and rituals and was experienced by many as a blessing (Long et al., 2022). Similarly, a study by Buckley et al. (2023), exploring the experiences of counsellors and psychotherapists of supporting people who were bereaved during COVID-19, reported that the restrictions afforded protection from others to the chief mourners and relieved them of the social pressures usually associated with funerals in Ireland. During the pandemic the use of technology was invaluable to funeral directors. It allowed them to make funeral arrangements remotely, to live-stream funeral services and to provide virtual books of condolence, all of which enhanced their ability to support the bereaved in difficult circumstances.