caregiving – watercress words by Dr Aletha

Even physicians feel stressed and uneasy about the COVID-19 pandemic, maybe more so than others. After all, we’re supposed to be the ones with the answers to our patients’ questions and have the means to help them. And unfortunately this is a time when we have little of both and it’s frustrating.

One of my collagues read an article about dealing with this stress, and to decrease our stress from having one more piece of information to read he briefly outlined it in an email and added his own thoughts. I liked it so well I asked him if I could feature it here and he graciously consented. And like he did, I have added a few of my thoughts and some references, as well as a link to the original article from CNNhealth.

Limit the frequency of your updates, including social media

With one of my patients who I was having to talk off of a ledge twice weekly, I suggested allowing herself one news check-in for 30 minutes each morning. This worked for her. Choose a frequency and a time that works for you. But why stop there? Consider a social media sabbatical . Truly. Give it a week and see how you feel. Taking the apps off your phone or tablet helps keep you accountable.

CDC-Coronavirus Disease 2019

diagram of the human brain. — The major parts of the brain, including the pineal gland, cerebellum, spinal cord, brain stem, pituitary gland, and cerebrum are labeled. photo courtesy of Source: National Cancer Institute Creator: Alan Hoofring (Illustrator)

Name your fears

Recognize that we all have a negativity bias hard-wired into our brains. It’s a leftover evolutionary tool that helped keep our caveman and hunter-gatherer ancestors alive.

In addition to constantly scanning our environment for threats, it also does a good job of overestimating the likelihood that something tragic will befall us, and underestimates our capacity and resources to cope. We’re not crazy or neurotic, we’re just wired that way.

Conversely, if you minimize or ignore the threat of the pandemic, ask yourself if you should take it more seriously. If your reactions don’t match those of others in your community, your fear may have driven you to denial.

Think outside yourself:

If/when you are feeling overly worried and anxious, and your thinking feels contracted and hopeless, turn your thoughts to how you can help someone else. This may be a child or other family member, a group of society that is at risk or marginalized at this time, or some of the groups at higher risk due to their occupations, age, or medical conditions.

Science is unequivocal that when our thoughts turn to serving others, symptoms of worry, anxiety and depression lessen, and we feel better about ourselves. And this does not have to be anything big, simply shifting to focus off of ourselves and onto someone else helps.

a smiling woman working on a laptop computer — Physicians and counsellors are available virtually, by phone or video visits.

Seek support, but do it wisely:

Don’t hesitate to ask for help if you need it. And that goes for us caregivers too. We are not, and should not think of ourselves, as impervious to the various stressors, the disrupted routines and all of the uncertainty that is prevalent in the world right now. Ask someone you can trust to be objective and rational, and not feed your worries or concerns.

a basket filled with fruits and vegetables

a simple bed, window shade down, small lamp on a side table

close up of walking down a road in sports shoes

Pay attention to your basic needs

Don’t get so wrapped up in thinking about the coronavirus that you forget the essential, healthy practices that keep you physically well.

Getting adequate sleep
Keeping up with proper nutrition
Getting outside as much as possible
Engaging in regular physical activity

Practicing mindfulness, meditation, yoga, and spiritual disciplines will help center you in routines and awareness, and keep your mind from wandering into the dark and sometimes irrational unknown.

a women with hands clasped in prayer with a Bible

a man reading to two young girls, sitting in a woman's lap

Don’t chastise yourself for worrying.

Again, this is part of our normal evolutionary programming. And to help kids when they are scared, don’t just tell them everything is going to be alright.

Let them know you hear their concerns and that you understand where they are coming from. And THEN give them evidence and reasoning for the opposite side of the worry equation.

Acknowledge their fears, and validate them… And then do the same for yourself.

This post was adapted from this article on CNNhealth

How to keep coronavirus fears from affecting your mental health

Thanks to my guest writer-Dane Treat, M.D.

Dr. Treat graduated from the University of Oklahoma medical school, although a couple of decades later than I did. He completed residency at Good Samaritan Family Practice in Phoenix, where he lives and practices now. He also completed a Sports Medicine fellowship. He is a student of Mindfulness-based Stress Reduction. He wisely married a Mayo Clinic trained gastroenterologist, and they are the proud parents of a daughter.

near Phoenix, at Scottsdale Arizona, The Boulders Resort; photo by Dr. Aletha

exploring the HEART of dealing with COVID-19

If you are depressed and thinking about or planning suicide, please stop and call this number now-988

988lifeline.org

Dr Aletha

Besides attending church on Sundays, I routinely read the local Sunday newspaper. I never miss the comics, Ask Amy advice column, restaurant reviews, and the obituaries. Sometimes I find an obit of someone I know or know of. But even if I don’t, I usually read one or two.

Sometimes the person’s life is so remarkable I’m surprised I’d never heard of them. Sometimes it’s so intriguing I wish I had known them. That is the case with a recent one, particularly because it was written by the deceased man himself.

I’m sharing this obituary with you with names deleted to protect privacy and some sections paraphrased. I think you will agree this is a man worth knowing.

David B.

“The reason obituaries are so dull to read is that they are so dull to write and that’s precisely why I’m writing my own: To save my family the drudgery in an otherwise stressful time. Following the standard format of obits I’ll start with I was born in 1948. I enjoyed being an only child until my two sisters came along. After that I learned to be an only child with two sisters.

I have to stop here and mention that when my kidneys failed in my forties, my youngest sister unselfishly agreed to transplant one of hers. When it came time much later for another transplant my older sister conveniently developed cancer rendering her ineligible. Fortunately our son jumped at the chance and eagerly agreed to step up for which I was profoundly grateful.”

After high school he “moved on to blast my way through a five year architectural degree in only seven years.” He co-founded an architectural firm which grew into one of the ten largest firms in the U.S. for several years.

“I’m kind of proud of that.”

Following retirement he served as Vice-President of the national board of the American Kidney Fund as well as President of the local chapter. He was President of the state chapter of an architects institute and served on the boards of local arts commissions.

“There is some other stuff but these are the highlights.”

He admitted that the best thing he did was marrying his wife.

“I loved her dearly. She was my lover, partner, confidant and best friend. If not for her, I would have been writing this many years earlier.”

Together they had two wonderful daughters. One is a physcian and the other “spends most of her time helping keep women out of prison”. About his son he pined , “He has yet to have any kids which is regrettable because the gene pool would be greatly improved by his contribution.”

“I guess all that’s left is to say goodbye to the many friends I’ve made over the last seven decades. I’ve kept up with some but lost track of many. Suffice to say that if I wasn’t dead, I’d miss them all.”

Not surprisingly, he requested that in lieu of flowers friends consider donations to two local non-profits-a soup kitchen/food bank and an organization that helps children of incarcerated parents.

assemble a "when I die" file — a screenshot from the book

How to prepare for the end

I suspect that David prepared for death in other ways besides writing his obituary. He probably wrote a will, arranged burial or cremation, and closed his social media accounts. He likely had a living will or health care proxy. He sounds like a man who navigated his life well and managed his death equally well.

Planning for death seems straight forward but there are numerous details that most of us will miss without help. That’s why I reviewed and recommend a book that walks us through the process.

The book consists of 5 sections that mimic the progression from life to illness to death. Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is. The sections are

PLANNING AHEAD
DEALING WITH ILLNESS
HELP ALONG THE WAY
WHEN DEATH IS CLOSE
AFTER

Chapter titles offer discussion about issues such as

Yes, There’s Paperwork.
Can I Afford to Die?
I’m Sick
Love, Sex, and Relationships
Hospital Hacks
Care for the Caregiver
It’s Your Body and Your Funeral
Grief
How to write a Eulogy and an Obituary
Celebrating a Life

REmember me-collections and keepsakes — I think David’s family has many precious memories of his life.

We should all read this book

As much as I hope you don’t need it right now, unfortunately you do need it right now. So whatever stage of living, or dying, you or a loved one may be in, you will find something helpful here.