SANTA CRUZ — Employees of the Santa Cruz County Coroner’s Office, the Dominican Hospital morgue, funeral homes and after-life organizing services know grief’s weight well.
But now, as they walk people through sacred rituals online who couldn’t hold the hands of their loved ones who contracted COVID-19 and died, establishment employees contribute to the chain of events that cause the phantom pains of absent human touch.
They feel those pains themselves. But in a selfless act, the act of laying one to rest is continued.
In the ICU bed
Santa Cruz County nurses have been doing their best to make the final hours an individual is succumbing to COVID-19 peaceful and loving. At Dominican Hospital, bedside staff coordinate audio calls and video visits using patients’ electronic devices and “virtual visit” units — an iPad stacked on top of a mobile structure used for FaceTime calls. This way, though family members are not allowed in the room, they can still see and hear their relatives.
“For patients at end of life, our nurses are with them in their final moments and will connect loved ones virtually, allowing them to say final words, pray and play music for the patient,” said Dominican Hospital President Dr. Nanette Mickiewicz.
The pandemic has presented an unprecedented circumstance where medical professionals, by extension, act like relatives.
“It’s just an unimaginable situation,” said Dignity Health spokeswoman Claire Henry. “I can’t express the depth of my admiration for these nurses who are essentially functioning as surrogate families for these patients at end-of-life.”
When that person is gone, nursing leadership has to change gears and reach out to the family to offer support and resources for after-life planning. This includes mortuary information, Mickiewicz explained.
“We feel blessed to help patients and loved ones find connection in what is an extremely difficult and unprecedented time,” she said.
In the morgue
When a patient dies of the novel coronavirus and a primary doctor is there to sign off on the death, the communicable disease case is reported to the Santa Cruz County Coroner’s Office, explained Santa Cruz County Sheriff’s Office spokeswoman Ashley Keehn. When a primary doctor is unable to sign off on the death, or when it is suspected foul play such as if a confirmed crime is involved, an investigation is open and the body is transported to county facilities.
“A vast majority are signed off by the decedent’s doctor,” Keehn said.
While the county facilities have never totally filled up because the agency has a modern facility with large rooms, hospitals face more of an issue with storage of the deceased, according to Santa Cruz Memorial funeral home owner Randy Krassow.
Funeral homes have, on occasion, been called to receive bodies before paperwork has been filed with the state to establish the death certificate and wishes for future arrangements. It’s a mad dash to get in contact with the next of kin and get release forms signed, he said.
“It’s been touch-and-go a couple of times just this last week,” Krassow said when the county’s death count reached 120.
Santa Cruz Memorial has a special freezer unit for bodies that lost their battles with the virus and works to help families who are already under duress understand why there are kinks in the process. Nearly all of the families in the county elect to cremate their loved ones, Krassow said with the experience of having handled 30 to 35 coronavirus victims so far. But obtaining a death certificate and a permit, done electronically, is complicated when requests are rejected, delayed or the system that processes all deaths in the county — the Electronic Death Registration System — crashes completely.
“You desperately want to keep things personal, you want to be personal with them about their mother but the system is dealing with thousands of deaths and thousands of families,” Krassow said. “Funeral homes are dealing with tens or sometimes 20 people at a time, juggling all these things, things we have no control over… Most people have been really very understanding.”
In their final resting place
Krassow and his staff came up with an online arrangements portal before it was necessary — when the only coronavirus deaths they’d handled were an individual in Watsonville and another individual who died out of the county. But now they’re using it all the time; at least six deceased were awaiting arrival at their final resting places at the time of interview.
While organizing arrangements online may seem organized, it’s the hardest part. Losing the ability to sit across the table from family members experiencing the first stages of grief means counselors aren’t getting the direct feedback that sustains them.
In 2020, Santa Cruz Memorial did an additional 50 death arrangements. By mid-January this year, staff had already made 20 arrangements. Even when they make trips to the latest store to stock vital personal protective equipment, employees are working longer and harder without being able to see the faces of even their coworkers.
“Folks don’t become funeral counselors to make money, it’s because you have empathy and sympathy and you like to help people,” Krassow said.
Most of all, Krassow said he believes individuals who have lost their family members or friends are missing out on key components of a funeral or celebration of life.
“The most interesting things about services are the hugs that happen before and after a service and seeing how much it can impact the immediate family who experienced the death,” he said. “Frankly, the hug is far more comforting than the words.”
While some families have chosen to use Santa Cruz Memorial’s outdoor services with a maximum of 10 people at its peak capacity, many have chosen to delay the services or have them at home. Others have decided to utilize ash-scattering services such as Seas Spirit Memorial; at least 25% of customers elect to take advantage of the service’s new hybrid model where a few people are on the boat and others are nearby on the Santa Cruz Wharf, owner Raina Stoops explained. But there are many more unattended ash scatterings than there once were.
“The COVID ashes are not being handled any differently,” Stoops said, including that at least a dozen people who have died due to COVID-19 since the fall have had their ashes scattered by Seas Spirit Memorial. “We just have patience and let (the families know what we are doing). The crematoriums are pretty busy, so we’ve been working with them to pick up cremains.”
The virus deaths have not hit the Seas Spirit staff any harder than other deaths, Stoops said.
“I deal with death so much, and everyone has a story to tell,” she said. “Someone who gets hit by a car or who dies from cancer or COVID or just died in their sleep… all those deaths are equally important.”