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Grief In the Time of A Pandemic: How Do We Cope?

Deborah Schwing, part of Blue Shield of California's network of palliative and hospice care providers talks about loss and grief in a time of isolation

With the U.S. now under shelter-in-place orders, we find ourselves face to face with sudden limitations and unexpected, cumulative losses. How do we cope in our day-to-day lives with the barrage of news tallying the number of deaths by the thousands? How can we make sense of knowing more and more people who have died in the world, our communities and in our families?

A few weeks ago, a colleague’s elderly father was receiving hospice care from us at a local residential care center. As is common with the terminal stages of his disease, his appetite and his strength incrementally waned over a few months. On March 25, he developed a high fever. The nursing director of the facility requested a coronavirus test. The next day, our hospice nurse administered it. Over the next few days, my colleague’s bed-bound father became weaker, which didn’t seem too out of the ordinary.

Deborah Schwing photo 4.21.2020_sq
Deborah Schwing, a licensed marriage and family therapist and professional clinical counselor, is Bereavement Services Manager and Interim Social Work Manager at Hospice by the Bay in Larkspur, Calif.

Not knowing the results of the test, however, the center’s evening caregivers decided to err on the side of protecting themselves from the coronavirus. The center was required at the time to a minimum supply of basic protective equipment, so they improvised their own PPE for the times they had to turn him. They donned gloves and surgical masks and then creatively fashioned for themselves makeshift gowns from clear garbage bags, poking their arms and heads through slits in the plastic. Another bag, cinched at the waist, functioned as a skirt.

Our hospice nurses encouraged his daughter to wear a mask and gloves at all times while visiting him—just in case. Two days after the Covid-19 test, he died. Two days later, the test results came back positive. The news was shocking to his bereft daughter. In the 14 days of self-quarantine that followed, she found her grief displaced by abject fear that she too may contract the disease. Thanks to the foresight of the residential health care center and to our hospice nurses, the protections she undertook during her visits to her father in his final days paid off.

After her bereavement leave, she is now back to work. Her grief simmers just below the surface tinged with the ever-present reminders of how he died in the midst of this pandemic we are still in.

The great human glue that bonds us together

Loss and limitations are challenging. It takes strength and resolve to resist spending the day in bed or binge watching our favorite shows. But loss and limitation can also inspire us. Suddenly, we have extra time to play a board game with our child or finally sort out that pesky sock drawer.

If you’ve experienced profound loss such as the death of a loved one, as my colleague has, you know that grief has a way of lurking just under the surface—masked as feeling tired, irritable, angry, fearful or unshakably anxious. Grief is a tender, vulnerable feeling that when acknowledged and coaxed out into the light of day, can be like a gentle rain that melts the heart, clearing the way for a wider range of positive human emotions to blossom.

This is especially true when we are grieving in the midst of a stressful time of transition. Weeping, crying and sobbing can be an invitation to an expanding heart full of love, excitement, hope, possibility and joy. Grief can be the great cleanser, the great transformer and the great human glue that bonds us together.

Ways to cope

Getting though these times requires compassion and sturdy tools. While there are many things we don’t have control over—the spread of the coronavirus, how long we’ll be sheltered-in-place or even how long we’ll be out of work or working from home—we do have control over some things. Many can choose what time to wake up in the morning, whether to bother taking a shower, how often to listen to the news or when to reach out and offer a kind word.

During this time of limitation, loss and transition, these are my go-to tools each day. I call them my “B-fours”—to be used before I devolve into saying or doing something I’ll regret.

  • Boundaries—honoring my human limits. Maintaining a schedule, working when I’m working, and resting when I’m resting. Listening with my full attention to my kids when they complain. Saying “yes” where I can and humbly saying “no” when I can’t.
  • Body—noticing my body’s response to stress. Recognizing physical and mental fatigue as a normal reaction to change. Taking slow deep breaths of courage and long exhales of compassion. I do my best to walk daily, eat healthy and drink more water and less coffee.
  • Balance—caring for loved ones and caring for myself. I resist falling into the trap of doing everything myself. Instead, when I’m out of balance I ask for help; an extended deadline, a later dinner time or deferring folding that growing pile of laundry. Oh, and I’ve found that compassionately lowering my expectations of myself and of others is a golden-ticket way to maintain balance. My mantra is, “we are all doing the best we can at this monumentally stressful time.”
  • Beyond—pulling back the lens to view this pandemic as a moment in time of our lifetime. I’m on the lookout for moments of meaning in this unprecedented pause to our usual daily routines. I imagine myself in the future looking back on “the pandemic of 2020” and asking myself: “Am I proud of what I did and how I contributed to the well-being of my loved ones, my co-workers or my community?” I let the answer to that question guide me to right action today. I also rely on meditation, a positive outlook, appreciating creative efforts and high doses of laughter as invaluable tools for clearing out the space between the heavy weight of limitations and buoyant hope of possibility.

As we proceed in our new-normal-for-now, may we each acknowledge the gratitude for what we have in the enormity of these challenging times—as we find practical tools that bring out the best in all of us; individually and in our shared humanity.

Deborah Schwing, a licensed marriage and family therapist and professional clinical counselor, is Bereavement Services Manager and Interim Social Work Manager at Hospice by the Bay in Larkspur, Calif., part of the Blue Shield of California network.