Death Cafés: Where Communities Affirm Grief

As the United States surpasses 550 000 excess deaths from COVID-19, the impact of these fatalities is especially salient. COVID-related deaths will likely accelerate a years-long trend in declining “working age” life expectancy. ¹ Individuals who are left, particularly racial and ethnic minorities, are shouldering the burden of losing their elders and cultural knowledge bearers, multiple family members, and others suddenly and without closure. Critically, these same communities must grieve during the pandemic, which has cumulatively stripped them of economic sustenance as well as their traditional mourning and burial practices.

The downstream effects of these large-scale disruptions in grieving rituals may be persistent and affect future generations through higher health care costs, mental health burdens, loss of community and family supports, and stunted productivity. ¹ More immediately, bereaved persons may suffer distress arising from survivor’s guilt as well as the effects of prolonged and traumatic grief. ² Creating space for communal expressions of grief is thus central to the public health needs of the present generation.

Accessible structures that can facilitate communities coming together at a localized level are death cafés. Death cafés are free-of-cost gatherings at which locals—often strangers—share their perspectives and questions about mortality. Distinct from therapy or bereavement groups, death cafés encourage wider participation of individuals who are curious and may have no personal experience with death alongside people who see death daily at work. The cafés fit within the death-positive movement that aims to reduce the stigma behind death.

The demand for and interest in these groups have rapidly increased in light of COVID-19, ³ and organizers have accordingly transitioned to virtual gatherings. Death cafés engage people who are diverse across race and ethnicity, gender, age, and experiences with death in group-directed discussions that meet the current needs of individuals in their immediate contexts.

Even young adults are attending death cafés to process the premature deaths of others their age. ⁴ Hospitals and nursing schools have adopted these spaces to prevent burnout and share resources on palliative care as health care workers navigate their own losses while taking on caregiver roles with patients. ⁵ Health care providers experienced unprecedented deaths in a short period of time in the early days of COVID-19. Churches and synagogues, in the face of changes to their traditional funeral services, are also hosting death cafés online for their congregations. Inspired by death cafés, Chinese Americans are holding group discussions in Mandarin about end-of-life care. ⁶

As public health calls for collective meaning-making practices at national and local levels to support resilience after mass losses from COVID-19, ² death cafés may be one such approach. Social critiques of ways in which death is handled by the media, our death determination practices, and the practice of medicine can leave some individuals feeling unresolved grief, and some death café participants feel a responsibility to contextualize their grief within current failings. ⁷ For example, a woman whose disabled grandfather died after being denied medical care asked in one death café why some lives are deemed more dispensable than others.

Death cafés offer an intimately scaled and emotionally tangible approach to collective grief and discourse given the limitations imposed by the COVID-19 pandemic. In turn, they may bring us closer to building equitable and health-promoting institutions and communities that can heal together. Although these gatherings do not replace the urgent gains we must make in addressing inequities in mortality and disparities in grief burdens that already-overburdened communities carry, death cafés can offer a path forward by inviting life-affirming practices that arise from grief.