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Beyond a traumatic loss: The experiences of

mourning alone after parental death during
COVID-19 pandemic

Zahra Asgari, Azam Naghavi & Mohammad Reza Abedi

To cite this article: Zahra Asgari, Azam Naghavi & Mohammad Reza Abedi (2021): Beyond
a traumatic loss: The experiences of mourning alone after parental death during COVID-19
pandemic, Death Studies, DOI: 10.1080/07481187.2021.1931984

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DEATH STUDIES
https://doi.org/10.1080/07481187.2021.1931984

BRIEF REPORT

Beyond a traumatic loss: The experiences of mourning alone after parental

death during COVID-19 pandemic
Zahra Asgari , Azam Naghavi , and Mohammad Reza Abedi
Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran

ABSTRACT
Millions of adolescents around the world lost their loved ones due to the COVID-19 pan-
demic; at the same time, health protocols in many countries do not allow mourners to prac-
tice their familiar rituals around death and dying. This study explored the experience of 15
Iranian adolescents who had lost their parent(s) during the pandemic through a phenom-
enological approach. Two main themes including distress in a shattered life and crisis in crisis
were extracted from the interviews. Findings highlight the importance of immediate and
alternative ways of support for adolescents who lost their parents during the pandemic.

Introduction Mortazavi et al., 2020). Weinstock et al. (2021)

The high and increasing number of deaths by
COVID-19 has led Jackson et al. (2020) to call it a
“tsunami of death” (p. 2). Death, dying and rituals
around them have been profoundly affected by the
COVID-19 pandemic. Many people around the world
lost their chance of saying the last goodbye to their
loved ones as health protocols restricted hospital vis-
its. They also lost the opportunity of receiving usual
social support as the rule of social distancing prohib-
ited having large funeral/burial services or the practice
of some rituals (Stroebe & Schut, 2020). These restric-
tions and prohibitions could affect the emotional well-
being of grieving persons (Aguiar et al., 2020; Falk et
al., 2020) of over 3 million people who had lost their
lives from COVID-19 until May 2021 (World Health
Organization, 2021). Several researchers claimed that
death by COVID-19 can be categorized as a traumatic
loss as it is unexpected and unanticipated for many
people (Masiero et al., 2020; Walsh, 2020).
Adolescents may be more vulnerable during the
COVID-19 pandemic (de Figueiredo et al., 2021; Liu
et al., 2020) and if they lose a loved one, especially a
parent, they may face complicated or prolonged grief
(Falk et al., 2020; Weinstock et al., 2021). Many chil-
dren and adolescents will adapt to loss (Mosher, 2018;
Porter & Claridge 2021); however, several would bene-
fit from professional grief supports (Joaquim et al.,
2021). COVID-19 death’s circumstances may lead to
complicated or prolonged grief (Breen et al., 2021;
claimed that the world may face a “grief pandemic”
(p. 1), and it seems that this may so for adolescents.
Parental loss is considered as one of the most stressful
events in the human life (Ludik & Greeff, 2020) and it
can be a traumatic event for children regardless of the
nature of the death (Bergman et al., 2017; Cohen et
al., 2016). Adolescence is itself a critical period, as
teenagers face several biological and developmental
transitions such as puberty, identity formation, less
capacity for emotion regulation (Weinstock et al.,
2021), and increased emotional bonds with their peers
(Galla et al., 2020; Patel et al., 2021). Also, in contrast
to young children, adolescents have acquired abstract
thinking and know that death is irreversible (Santos et
al., 2021). The unique nature of pandemic deaths,
such as isolation of the patients and the different
methods of funeral/burial rituals, can seriously affect
the survivors’ mental health including children and
adolescents (Aguiar et al., 2020).
Although adolescents may experience some chal-
lenges in coping with parental death (Schoenfelder &
Haine-Schlagel, 2011), they are generally overlooked
in the literature (Mosher, 2018) and in the COVID-19
pandemic (Rapa et al., 2020). We therefore aimed to
explore the unique experience of losing parent(s)
during the COVID-19 pandemic among Iranian
adolescents.

CONTACT Azam Naghavi Az.naghavi@edu.ui.ac.ir Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Azadi sq,
Isfahan, Iran.
ß 2021 Taylor & Francis Group, LLC
2 Z. ASGARI ET AL.

Table 1. Participant demographic characteristics (N ¼ 15).

Months after the loss
Participant No. Gender Age Grade Loss of … Place of death At time of the interview
P1 Female 15 9th Father Hospital 3
P2 Female 18 12th Mother Hospital 4
P3 Female 14 8th Father Home 3
P4 Female 14 8th Father Hospital 4
P5 Female 15 9th Parents Hospital 5
P6 Female 16 10th Parents Hospital 2
P7 Female 17 11th Mother Hospital 5
P8 Female 14 8th Parents Hospital 1
P9 Male 16 10th Mother Home 5
P10 Male 15 9th Father Hospital 4
P11 Male 18 12th Father Hospital 3
P12 Male 17 11th Father Home 4
P13 Male 18 10th Parents Hospital 1
P14 Male 16 10th Mother Hospital 2
P15 Male 17 11th Parents Hospital 4

Materials and methods
A descriptive phenomenological approach was
employed to understand the experience of mourning
and bereavement among Iranian adolescents who lost
their parent(s) due to COVID-19. This method
focuses on the non-judgmental and rich description of
people’s lived experiences (Willig & Rogers, 2017).
Criteria for eligibility to participation were being ado-
lescents (13 to 18 years old) and exposed to the unex-
pected death of parent(s) due to COVID-19.
Setting
The study was conducted in Isfahan, one of the largest
cities in the center of Iran. By May 2021, over 74,000
of deaths by the COVID-19 were reported in this
country (World Health Organization, 2021). Islam is
the religion of most Iranians and like other religions,
it has its own death rites. There is praying with the
body, ritual washing, and the burial. After the burial,
the family and friends get together for seven days of
mourning, and the deceased family offer meals to the
visitors. The first, third, seventh, and the fortieth days
are the most important days after the funeral, and
people try to comfort mourners during this time.
Following the health protocols, Iran also banned hav-
ing such gatherings during the pandemic.
Participants and procedures
Participants were selected thorough purposive and
snowball sampling from schools and the organizations
that support orphan students in Isfahan. The first
author contacted schools and organizations to identify
possible participants then contacted the participants
who agreed to be interviewed. The schools and organ-
izations only provided the information of participants
after their informed consent; however, three partici-
pants refused to participate after their initial verbal
informed consent because of their mental health
issues. They were referred to psychiatrists. Semi-
structured interviews were conducted with 8 girls and
7 boys (14–18 years) who had one or both parents die
from COVID-19. Interviews were conducted by the
first author who is a licensed school counselor and
trained qualitative researcher. All interviews were con-
ducted in Persian language and only the related
quotes to this paper were translated by the third
author who is a bilingual psychologist and qualitative
researcher. The demographic characteristics of partici-
pants are provided in Table 1.
Due to the health protocols and lockdown restric-
tions, data were collected through semi-structured
online video call using WhatsApp or Skype program.
The interviews lasted approximately 60 min and were
recorded with the informed consent of the partici-
pants. The topics covered in the interviews included:
the first encounter with the news, the emotions expe-
rienced, the funeral rituals or alternative ways of
mourning, and plans for the future. Some of the ques-
tions were “How did this happen?”, “Were you with
the deceased parent when s/he passed away?”, “Could
you explain your thoughts and feelings when you
heard the bad news?”, and “Were funeral rituals con-
ducted for your deceased parent?”. The interviews
continued with probes and exploratory questions.
Data analysis
Analysis occurred concurrently with data collection.
We used Colaizzi’s (1978) method to analyze the data
and used MAXQDA software to organize the analysis.
Interviews were transcribed verbatim by the first
author. The first and the third authors read and re-
read the texts line by line and made the initial coding

separately. Then they shared the codes and discussed
about them until agreement. In the next step, we cate-
gorized the codes into sub-themes and themes. Then,
the themes were reviewed, defined, and named. We
used Lincoln and Guba (2013) criteria to ensure trust-
worthiness of the analysis. Therefore, to ensure con-
formability, the second author made an external check
about the quality of the extracted codes and themes.
To ensure the credibility of the study, we produced an
audit trail and a summary of the codes and themes to
all participants. They were asked if the results
reflected their experiences. Participants believed that
we had captured the essence of their thoughts and did
not make suggestions for change.
Ethics
Ethics approval was granted by the University of
Isfahan Ethics Committee (IR.UI.REC.1397.082).
Participants could withdraw from the interview at any
time. None withdrew and some expressed appreciation
about having an opportunity to talk about their
thoughts and feelings. We used pseudonyms to pro-
tect the identities of the participants. The interviewer
finished each interview by making sure the partici-
pant’s emotionally state was acceptable and followed
up with them through text chat. All participants were
offered free counseling sessions or referred to a psych-
iatrist if they needed.
Results
Two main themes were extracted from the interviews:
Distress in a shattered life with two sub-themes and
Crisis in crisis with three sub-themes.
Distress in a shattered life
All participants believed that the loss of parent(s)
shattered their life and created ongoing distress.
Drowned in the ocean of emotions
For some participants, the loss of their parent(s) was
their first encounter with death, and this made the
intensity of the traumatic loss even more. Their main
distressing feelings after the loss and mourning included
prolonged feelings of shock and denial due to unpre-
dictable death, excessive guilt, loneliness, and isolation.
For example, “I still can’t believe that my father passed
away because of a virus, while I could not even hug
him for the last time and say goodbye … No one came
to bury him and we buried my father alone” (P1), “I
DEATH STUDIES 3
feel guilty, I left my father alone in the hospital. It was
very painful for me that no family member was with
my father when he passed away” (P4), and “I saw tears
in her eyes when my mom took her last breaths, and I
could not do anything. It was so painful. I cannot forget
that moment” (P9).
Meaningless life
Some participants stated that they felt life to be mean-
ingless after the parental loss. They expressed confusion
and shared thoughts that nothing mattered to them
anymore in such insecure and unstable world. P8 ques-
tioned, “Why do they have to die suddenly, and why
do I have to mourn alone in this heart-wrenching situ-
ation? Why am I alive now? What do I want from my
life?” and P12 explained, “Life has meaning with the
family members. My dad was the pillar of our life;
without him, everything is collapsed.” P5 stated:
I am the only child. My parents were physicians
caring for Corona patients, and they both died. My
parents were all my hopes in my life. Now, I have
only one aunt who takes care of me. I no longer have
any motivation to be in this extremely scary world.
Crisis in crisis
The unexpected death of parents created a crisis and
the COVID-19 mourning condition added more crisis.
Most of the participants highlighted that lack/low level
of support and empathy from their social networks
had reduced their resilience and led them to do/think
about risky behaviors such as a suicide attempt or
substance/alcohol abuse.
Lack of social support
Almost all participants reported a low level of social
support from their social network in the absence of a
funeral ceremony, and this social isolation made the
traumatic event even more difficult:
Only a few relatives, about four or five persons, came
to our house after the day my father died. My peers
and friends were afraid that they might get infected if
they came in contact with me, so they said their
condolences via online chat. (P3)
I wanted to kiss my mother’s beautiful face for the
last time at the funeral, but I could not do that. I had
not seen her for more than a week because she was
hospitalized in the Corona center. My father, brother
and I were silent during the funeral. Where were our
relatives and friends? They just heard about our pain
but did not have any empathy and consolation with
us at that moment. Seeing my father crouched in
those situations seemed more difficult than becoming
motherless. (P2)
4 Z. ASGARI ET AL.
Some participants expressed anger because they felt
stigmatized when people labeled and kept a distance
with them. A feeling of being stigmatized made the
complexity of the loss worse. P7 recalled: “I heard a
man talking to his wife when he saw my mom’s death
notice on the wall; ‘Hey, this house is a source of
Corona,’ he said” (P7). Another commented:
I do not complain to anyone for not coming to my
parents’ funeral, I fully understand the sensitive situation
of these days. But the heavy look of the neighbors and
their unusual behaviors of keeping physical distance and
the excessive distance of my relatives in these difficult
days make me very sad and angry. (P15)
Risky behaviors
Several participants reported that engaging in behav-
iors such as substance and alcohol use and having sui-
cide ideation after the traumatic loss could alleviate
their pain, although these behaviors could expose
them to more dangers. “These days I think of not
being in the world. I think, how can I free myself
from all these sufferings?” (P15) and “In these dumb
and difficult days, only alcohol and cigarettes can
calm me down. I did not like them at all before, but
now I cannot quit them. They calm me down” (P10).
Academic maladaptation
Most of the participants stated that a substantial
change due to the pandemic was the transition to
online education. They described the change as having
a profound effect on their academic performance,
which was exacerbated by the experience of a sudden
loss of one or both parents. They recounted unfavor-
able effects such as academic failure, online class
absences, lack of communication with classmates, and
reduced engagement in the class activities, and lack of
motivation to succeed. For example, “It was too diffi-
cult to adjust to the new changes at the online school.
I missed most of my classes because I could not toler-
ate the stress of my loss and those classes” (P9), “Now
that I feel the need for more communication, I do not
have a friend to talk to about my feelings.” (P12), and
“With what happened, I have no desire to try and set
a goal to enter the university. I am so depressed with
the suppressed mourning” (P11).
Discussion
The findings indicate that the parental death related to
COVID-19 was considered as a traumatic experience
for the bereaved teenagers. They had to endure the
sudden loss with a high level of stress, loneliness, and
gruesome feelings (LeRoy et al., 2020). Like previous
studies about traumatic loss (Johannesson et al., 2009;
McGee et al., 2018), our participants felt ongoing dis-
tress, and a rush of complex negative emotions such a
mixture of feelings of shock, despair, anger, regret, and
guilt. Moreover, the prohibition of hospital visit led to
unanswered questions about the last words that the
parent(s) would say, the last thought that the parent(s)
would have in their lonely deathbed, and a deep sad-
ness of not being able to say goodbye.
Feelings of meaningless after the traumatic loss is
consistent with the previous studies that found trau-
matic loss may delay or complicate the meaning mak-
ing and identity creation during adolescence (Hamid
& Jahangir, 2020). The low level of self-awareness in
such situations and the suddenness of the trauma may
disrupt the adolescents’ assumptions about themselves
and the world, so they may lose their sense of mean-
ing of life (Malone, 2016; Mortazavi et al., 2020;
Walsh, 2020). Although social support may have a
profound influence on creating meaning for the loss
(Smid, 2020), the necessary health protocols during
the pandemic negatively affected the teenage mourn-
ers. We used the term, “crisis in crisis” to refer to
mourning alone after a traumatic loss, which differen-
tiates the bereavement and mourning during the pan-
demic from other traumatic loss situations.
According to Burrell and Selman (2020), mourners
need to receive physical comfort during the funeral
such as touching, hugging, handshaking, or talking to
each other for consolation. Such behaviors are also
common in the Iranian culture but are prohibited by
health protocols during COVID-19, which could lead
to emotional pain (Johns et al., 2020). The literature
highlights that complicated grief may appear when
people face traumatic loss, mourn in isolation, and are
unable to say goodbye to the deceased (Burrell &
Selman, 2020), and experience excessive negative emo-
tions (Li et al., 2019). Mourning alone was more com-
plicated for adolescents who felt socially stigmatized
by their friends and relatives who were scared that the
deceased family might be the virus carrier, and who
were unable to receive face-to-face peer support due
to online learning. Their maladaptive and risky behav-
iors are consistent with those reported previously
(Ammerman et al., 2021; Liang et al., 2020). Davis et
al. (2012) emphasized the importance of the role of
the family in meaning-making after a traumatic loss
and stated that the meaning making is associated with
a lower level of depression. For our participants, the
whole family was in crisis. Thus, the term “traumatic
loss” might not fully explain the intensity of suffering
of the participants. Instead, we posit their experiences
are “beyond traumatic loss.”

At times of crisis, children and adolescents turned
to parents to learn how to cope with the situation and
how to make a meaning for the crisis, and when death
is involved, their presence in the ritual rites around
death is recommended. Adolescents who lose a parent
during the COVID-19 pandemic, face multiple losses:
the loss of loved ones, the loss of role-model for cop-
ing and meaning-making for the loss, the loss of
opportunities of saying goodbye, the loss of practicing
familiar rituals, and the loss of social support. As the
world was not prepared to answer all aspects of the
pandemic, it seems that the psychological needs of
children and adolescents are overlooked. This study
suggests a need for action to identify and support
bereaved adolescents whose parent(s) died during the
pandemic. Online platforms can be employed to
deliver tele-mental health interventions when social
distancing is applicable (Dores et al., 2020).
We used online interviews with participants, hence
we faced some challenges in analyzing facial expressions,
and achieving more data through observing body lan-
guages during the interviews. However, it is worth men-
tioning that online interviews had positive aspects, as we
could interview adolescents from a larger geographical
area. Furthermore, the study was conducted shortly after
the death of parents; hence, we were not able to deter-
mine longer-term outcomes. Designing longitudinal
studies to determine long-term effects of parental
bereavement during the pandemic seems necessary and
timely. There is also a need to study alternative ways of
supporting bereaved adolescents. Online interventions
may help adolescents to express their feelings and con-
nect with their friends when there are restrictions on
social gatherings. These new methods seem crucial as
many young people spends long hours on social media
(Dong et al., 2020).
Acknowledgments
Authors would like to thank the anonymous participants
for sharing their personal traumatic experiences.
Disclosure statement
No potential conflict of interests was reported by author.
ORCID
Zahra Asgari http://orcid.org/0000-0001-7239-2048
Azam Naghavi http://orcid.org/0000-0003-0559-6192
Mohammad Reza Abedi http://orcid.org/0000-0003-
3162-7044
DEATH STUDIES 5
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