Nearly a year into the COVID-19 pandemic, almost 500,000 American families know firsthand the grief of losing a loved one, many in conditions that restrict bedside goodbyes. These circumstances—piled on top of the many unknowns of COVID-19—layer enormous pain, guilt, and grief on top of the already-traumatic process of saying goodbye to someone we love.

“We expect that we’re going to be able to communicate with our loved ones, to be there in times of tragedy,” says clinical psychologist Therese Rando, founder and director of the Institute for the Study and Treatment of Loss in Rhode Island.

The experience of being with someone in their dying moments deeply impacts the way people process trauma, Rando says. What does it mean to