“Two Empty Seats at the Table, No One Will Fill Them”: Sequential Family Losses Due to COVID-19

Authors

DOI:

https://doi.org/10.5020/23590777.rs.v25i2.e15506

Keywords:

bereavement, death, family, COVID-19

Abstract

A particular feature of the COVID-19 pandemic was the occurrence of sequential losses of family members. Although the deaths of significant others are not necessarily destructive events, experiencing them in rapid succession (i.e., the death of two or more family members within a relatively short period) may hinder adaptive coping strategies and be associated with complicated grief. Therefore, the aim of this qualitative, cross-sectional multiple case study was to investigate the process of sequential family losses due to COVID-19. Data were collected through individual interviews with four women residing in different regions of Brazil, each of whom had lost two family members to COVID-19. An inductive thematic analysis was conducted, resulting in three themes: the context of multiple deaths; farewell rituals and funeral ceremonies; and grief processes related to sequential losses. The context of multiple deaths involved simultaneous infection among family members, concurrent hospitalizations, and sequential deaths, which generated emotional overload, loneliness, and the need for rapid family reorganization. Changes to, or the impossibility of, carrying out farewell rituals and funeral ceremonies were associated with feelings of frustration, guilt, and distress, but also led to adaptation through the use of technologies and posthumous tributes. Regarding grief processes related to sequential losses, the multiplicity of pandemic-related stressors, together with weakened social support, appeared to intensify suffering. The findings of this study may contribute to understanding different contexts marked by multiple deaths within socio-affective networks, such as other public health emergencies and disasters.

Downloads

Download data is not yet available.

Translations of this article

Author Biographies

Alice Monte Negro de Paiva, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil

Holds a Bachelor’s and a Master’s degree in Psychology, and is a specialist in a Multidisciplinary Approach to Chemical Dependency from the Federal University of Rio Grande (FURG). Also holds a specialization in Individual, Couple, and Family Systemic Therapy from the Center for Family and Individual Studies (CEFI/POA). Has research interests in topics related to the mental health of individuals and families, as well as loss, grief, and resilience.

Tyele Goulart Peres dos Santos, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil

Ph.D. in Health Sciences and Master’s in Public Health from the Federal University of Rio Grande (FURG), including a sandwich period at the College of Education and Human Sciences (University of Nebraska–Lincoln, United States). Has complementary training in Public Health through the Harvard-Brazil Collaborative Public Health Field Course, developed by Harvard T.H. Chan School of Public Health and the Federal University of Ceará. Holds a Bachelor’s degree in Psychology from Faculdade Anhanguera and a specialization in Cognitive-Behavioral Therapy from Faculdade Dom Bosco. Conducts research on mental health and stressful events, especially related to loss, grief, trauma, and resilience.

Lucyanna Cardozo de Souza Correa Pereira, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil

Undergraduate student in Psychology at the Federal University of Rio Grande (FURG). Scientific Initiation scholarship holder in the project PLRCOVID: “Loss, Grief, and Resilience in the COVID-19 Pandemic: A Qualitative Study.” Has an interest in topics related to stressful events (emergencies and disasters) and their implications for the mental health of individuals and families, focusing on loss, grief processes, and resilience.

Letícia Macedo Gabarra, Polydoro Ernani de São Thiago University Hospital, Florianópolis, Santa Catarina, Brazil

Holds a Master’s and Ph.D. in Psychology from the Federal University of Santa Catarina (UFSC). Graduated in Psychology and specialized in Hospital Psychology from São Paulo State University (UNESP). Tutor in the Multiprofessional Residency in Health at HU-UFSC, with an emphasis on High Complexity Care. Psychologist at the University Hospital Polydoro Ernani de São Thiago. Has experience in Psychology, with an emphasis on Health and Hospital Psychology.

Daniela Barsotti Santos, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil

Completed a postdoctoral fellowship at the University of São Paulo (USP). Holds a Master’s degree in Psychology and a Ph.D. in Nursing from USP, including a sandwich period at the Centre de Recherche en Épidémiologie et Santé des Populations in France. Graduated in Psychology from São Paulo State University (UNESP). Associate Professor at the Institute of Human Sciences and Information at the Federal University of Rio Grande (FURG). Coordinator of the research group VIVAZ – Interfaces in Psychology and Health. Member of Working Group 63 – Psychology, Politics, and Sexualities of the National Association for Research and Graduate Studies in Psychology (ANPEPP). Has experience in Psychology, with an emphasis on Social Psychology, Public Health, and Health Psychology, working mainly on the following topics: sexuality, gender, health-disease process, and health promotion.

Beatriz Schmidt, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil

Completed postdoctoral studies in Psychology at Ohio State University (OSU, United States) and at the Federal University of Rio Grande do Sul (UFRGS). Holds a Ph.D. in Psychology from UFRGS, including a sandwich period in the Human Development and Family Science Program (OSU). Psychologist, Specialist in Family Health, and Master’s in Psychology from the Federal University of Santa Catarina (UFSC). Professor in the Psychology undergraduate program and in the Graduate Program in Psychology at the Federal University of Rio Grande (FURG). Conducts research on human development and family relationships in health contexts, with an emphasis on predictable and unpredictable stressful events across the life cycle.

References

Aguiar, A., Pinto, M., & Duarte, R. (2022). A qualitative study on the impact of death during COVID-19: Thoughts and feelings of portuguese bereaved adults. PLoS ONE, 17(4), 1-11. https://doi.org/10.1371/journal.pone.0265284

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806

Buckley, A., Dodd, A., & Guerin, S. (2024). Grief and bereavement in the time of COVID-19: A thematic analysis exploring psychotherapists’ observations of clients’ experiences. Counselling Psychology Quarterly, 37(1), 93–111. https://doi.org/10.1080/09515070.2023.2186834

Canuto, R. M. S., Ferreira, A. C. L., Novaes, L. F., & Salles, R. J. (2023). O processo de luto em familiares de vítimas da Covid-19. Estudos e Pesquisas em Psicologia, 23(2), 746–765. https://doi.org/10.12957/epp.2023.77710

Corona, A. G. D. L., Chin, J., No, P., & Tom, J. (2022). The virulence of grief in the pandemic: Bereavement overload during COVID. The American Journal of Hospice & Palliative Care, 39(10), 1244–1249. https://doi.org/10.1177/10499091211057094

Crepaldi, M. A., Schmidt, B., Noal, D. S., Bolze, S. D. A., & Gabarra, L. M. (2020). Terminalidade, morte e luto na pandemia de COVID-19: Demandas psicológicas emergentes e implicações práticas. Estudos de Psicologia, 37, 1-12. https://doi.org/10.1590/1982-0275202037e200090

Eyetsemitan, F. E. (2022). The deceased-focused approach to grief: An alternative model. Springer Cham. https://doi.org/10.1007/978-3-030-98245-4

Faghani, S., Ahmadi, F., & Mohammadi, E. (2023). Perceptions of family caregivers in the caring for COVID-19 patient: Self-sacrificing management, fear, and loneliness to protect the patient – a qualitative content analysis. Health & Social Care in the Community, 2023(1), 1–9. https://doi.org/10.1155/2023/7868392

Ghezeljeh, T. N., Rezaei, M., Shahrestanaki, S. K., & Milani, A. S. (2023). Exploring family caregiver challenges in caring for patients with COVID-19 in intensive care units. Frontiers in Public Health, 11, 1-17. https://doi.org/10.3389/fpubh.2023.1057396

Hanauer, C., Telaar, B., Al-Dawaf, N., Rosner, R., & Doering, B. K. (2023). “Feeling disconnected” – risk factors for PGD and themes in grief counselling during the COVID-19 pandemic. A mixed-method study. European Journal of Psychotraumatology, 14(1), 1-11. https://doi.org/10.1080/20008066.2023.2183006

Harrop, E., Mirra, R. M., Goss, S., Longo, M., Byrne, A., Farnell, D. J. J., Seddon, K., Penny, A., Machin, L., Sivell, S., & Selman, L. E. (2023). Prolonged grief during and beyond the pandemic: Factors associated with levels of grief in a four time-point longitudinal survey of people bereaved in the first year of the COVID-19 pandemic. Frontiers in Public Health, 11, 1-29. https://doi.org/10.3389/fpubh.2023.1215881

Lordello, S. R., Coelho, A. C. F., & Pinho, A. R. I. (2023). Processos grupais no luto por covid-19: Um olhar sobre o desenvolvimento humano. Revista Subjetividades, 23(2), 1-11. https://doi.org/10.5020/23590777.rs.v23i2.e12948

Ministério da Saúde. (2025). Painel coronavírus. https://covid.saude.gov.br/

Mitima-Verloop, H. B., Mooren, T. T. M., & Boelen, P. A. (2021). Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions. Death Studies, 45(9), 735–745. https://doi.org/10.1080/07481187.2019.1686090

Paiva, A. M. N. (2023). O processo de luto no contexto de perdas de múltiplos familiares por COVID-19. [Dissertação de Mestrado]. Universidade Federal do Rio Grande.

Phuthegelo, M. K., & Faimau, G. (2023). Family narratives of loss and grief during the COVID-19 pandemic in Botswana. Mortality, 29, 1–16. https://doi.org/10.1080/13576275.2023.2248020

Qian, W., Tang, R., Jiao, K., Xu, X., Zou, X., & Wang, J. (2022). Growing in suffering: The curvilinear relationship between prolonged grief and post-traumatic growth of recently bereaved individual during the COVID-19 pandemic. OMEGA - Journal of Death and Dying, 91(2), 709-727. https://doi.org/10.1177/00302228221141937

Resolução nº 510, de 7 de abril de 2016. (2016, 7 de abril). Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais cujos procedimentos metodológicos envolvam a utilização de dados diretamente obtidos com os participantes ou de informações identificáveis ou que possam acarretar riscos maiores do que os existentes na vida cotidiana. Ministério da Saúde. https://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/legislacao/resolucoes/2016/resolucao-no-510.pdf/view

Schmidt, B., Silva, I. M., Sehn, A. S., Aires, M. C., & Paiva, A. M. N. (2022). Perda, luto e resiliência na pandemia de COVID-19: Implicações para a prática com famílias. Revista Pensando Famílias, 26(1), 3–17. https://pensandofamilias.domusterapia.com.br/index.php/files/article/view/4

Sehn, A. S., Schmidt, B., Lopes, R. C. S., & Piccinini, C. A. (2022). Artigos originais que relatam estudos de caso. In M. I. C. Sampaio, A. A. Z. P. Sabadini, & S. H. Koller (Orgs.), Produção científica: Um guia prático (Cap. 5, pp. 101–129). Universidade de São Paulo. https://doi.org/10.11606/9786587596280

Selman, L. E., Chamberlain, C., Sowden, R., Chao, D., Selman, D., Taubert, M., & Braude, P. (2021). Sadness, despair and anger when a patient dies alone from COVID-19: A thematic content analysis of Twitter data from bereaved family members and friends. Palliative Medicine, 35(7), 1267–1276. https://doi.org/10.1177/02692163211017026

Sola, P. P. B., Souza, C., Rodrigues, E. C. G., Santos, M. A., & Oliveira-Cardoso, É. A. (2023). Luto familiar durante a pandemia da COVID-19: Uma metassíntese de estudos qualitativos. Cadernos de Saúde Pública, 39(2), 1-21. https://doi.org/10.1590/0102-311XEN058022

Stake, R. E. (2006). Multiple case study analysis. Guilford Press.

Stroebe, M., & Schut, H. (2021). Bereavement in times of COVID-19: A review and theoretical framework. OMEGA - Journal of Death and Dying, 82(3), 500–522. https://doi.org/10.1177/0030222820966928

Tobin, M., Lambert, S., & McCarthy, J. (2020). Grief, tragic death, and multiple loss in the lives of irish traveller community health workers. OMEGA - Journal of Death and Dying, 81(1), 130–154. https://doi.org/10.1177/0030222818762969

Thacker, N. E., & Duran, A. (2022). Operationalizing intersectionality as a framework in qualitative grief research. Death Studies, 46(5), 1128–1138. https://doi.org/10.1080/07481187.2020.1795749

Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer Publishing Company.

World Health Organization. (2025). WHO COVID-19 dashboard. https://data.who.int/dashboards/covid19/deaths

Downloads

Published

2025-09-13

How to Cite

Paiva, A. M. N. de, Santos, T. G. P. dos, Pereira, L. C. de S. C., Gabarra, L. M., Santos, D. B., & Schmidt, B. (2025). “Two Empty Seats at the Table, No One Will Fill Them”: Sequential Family Losses Due to COVID-19. Revista Subjetividades, 25(2), 1–15. https://doi.org/10.5020/23590777.rs.v25i2.e15506

Issue

Vol. 25 No. 2 (2025)

Section

Research Report

License

Copyright (c) 2025 Alice Monte Negro de Paiva, Tyele Goulart Peres dos Santos, Lucyanna Cardozo de Souza Correa Pereira, Letícia Macedo Gabarra, Daniela Barsotti Santos, Beatriz Schmidt

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Para autores: Cada manuscrito deverá ser acompanhado de uma “Carta de submissão” assinada, onde os autores deverão declarar que o trabalho é original e inédito, se responsabilizarão pelos aspectos éticos do trabalho, assim como por sua autoria, assegurando que o material não está tramitando ou foi enviado a outro periódico ou qualquer outro tipo de publicação.

Quando da aprovação do texto, os autores mantêm os direitos autorais do trabalho e concedem à Revista Subjetividades o direito de primeira publicação do trabalho sob uma licença Creative Commons de Atribuição (CC BY NC), a qual permite que o trabalho seja compartilhado e adaptado com o reconhecimento da autoria e publicação inicial na Revista Subjetividades.

Os autores têm a possibilidade de firmar acordos contratuais adicionais e separados para a distribuição não exclusiva da versão publicada na Revista Subjetividades (por exemplo, publicá-la em um repositório institucional ou publicá-la em um livro), com o reconhecimento de sua publicação inicial na Revista Subjetividades.

Os autores concedem, ainda, à Revista Subjetividades uma licença não exclusiva para usar o trabalho da seguinte maneira: (1) vender e/ou distribuir o trabalho em cópias impressas ou em formato eletrônico; (2) distribuir partes ou o trabalho como um todo com o objetivo de promover a revista por meio da internet e outras mídias digitais e; (3) gravar e reproduzir o trabalho em qualquer formato, incluindo mídia digital.

Para leitores: Todo o conteúdo da Revista Subjetividades está registrado sob uma licença Creative Commons Atribuição (CC BY NC) que permite compartilhar (copiar e redistribuir o material em qualquer suporte ou formato) e adaptar (remixar, transformar e criar a partir do material para qualquer fim) seu conteúdo, desde que seja reconhecida a autoria do trabalho e que esse foi originalmente publicado na Revista Subjetividades.

Crossref
Scopus
Google Scholar
Europe PMC