COVID-19 and Anxiety

Expressing Love from a Distance

I am limited by my mother’s cognitive and memory issues, which are not uncommon among the elderly and may be aggravated by fear and loneliness. Illness or trauma can also limit people’s energy and ability to communicate.

• Send or deliver cards, printed photos, or homemade art (especially from the grandchildren). Frank Benett, a volunteer chaplain in acute and long-term care facilities, knows firsthand of the joy these cards bring “because every time I visit they proudly, happily show me all that their family has sent or dropped off.”  In addition, you and your family will have the joy of expressing your love.
   
• Explore what you could have delivered beside food. Flowers, a plant, or even balloons might brighten things up.
   
• Connect by video. Inquire if there is anyone on staff who can bring a device to your loved one so you can do a video chat.
   
• And most importantly, keep in touch by phone, each day, with the intention to just listen and be kind. To offer love. For some of us that might mean discovering new strategies for communicating (see Talking on the phone to someone with cognitive issues).
   

Talking about COVID-19

In this pandemic, we are all seeing that “there’s not a lot of room between any of us and the very edge.” Those are the words of Kate Bowler, Professor of Divinity and podcaster, who was diagnosed with incurable cancer five years ago, and has thought a lot since then about living with uncertainty.  

As we reach out to our loved ones, this uncertainty and sense of being near the edge may become a somber backdrop. We can try to ignore it, but this may make our loved ones feel even more alone.  Alternatively, we can lean into a courageous conversation that acknowledges their reality.  Here are some tips.

Prepare ourselves. Before we engage, we need to make sure that we are ready to listen—with our full presence. This might mean that we take a few deep breaths or tune into the sensations of our body for a few minutes to collect our minds. It is not helpful to bring our own stress and worry into these conversations.

Acknowledge loss. We listen when they express how uncertainty and loss are impacting them (see the section on dealing with uncertainty for additional points about this). We want to avoid making promises that we or they will be able to control the outcome, but we can assure them that our goal, and that of their care providers, is to ensure love and comfort.

Allow emotions. Learn more about coping with loss.We can acknowledge their emotions. The classic stages of grief identified by Elisabeth Kubler-Ross are denial, anger, bargaining, sadness, and acceptance, and we all experience these in different ways and at different times. Along with this might come anxiety, especially if we are dealing with the loss or potential loss of someone we love. Allow your loved one to express these and other emotions as they arise, without judgment or needing to change them. Avoid trying to put a positive spin on fears and anxieties.

Use affirmative statements. Try one of these simple yet powerful statements to validate their feelings: I hear you. I appreciate how hard this is for you. It makes sense that you are feeling sad, lonely, angry… That sounds really hard. I love you. I'm going to check on you and be with you every step of the way in whatever form I can—on the phone, in spirit, in person whenever that is possible.

Ask how they coped in the past. If the moment seems right, chaplain Frank Bennett suggests that you can prompt your elder to talk about how they made it through adversity in the past. Many of them lived through the depression or other recession or a war: how did they cope? Their stories may demonstrate resilience and provide a lift to them—and you. And it helps us remember that hard times pass; that the pandemic won’t last forever.

What We Can Do For Ourselves

Dealing with Uncertainty

Kate Bowler has thought a lot about living with uncertainty. In her writing in the New York Times, she points out how it is the habit in our American culture to try to replace the real uncertainty of our human lives with a belief about the power of hard work and positive thinking to conquer all—even with something like cancer or the coronavirus.

But this pandemic knocks down our walls of certainty. We see the world with a new vulnerability, as Kate says, “without the Instagrammed filter of breezy certainties and perfectible moments.” Psychologist Claire Bidwell Smith, who writes about the role of anxiety in stages of grief, puts it this way: “Suddenly we must face the fact that there are absolutely no guarantees in life. Everything that once seemed sturdy is now fragile, particularly the people we love.”

We need to recognize that there is a limited amount we can do in the face of all this uncertainty and loss. Of course, we should identify what that limited action is and do it if possible, but then we need to let go of the rest, perhaps over and over again. And we need to recognize our limits and look for resources to support us as we try to cope with uncertainty and anxiety.

Judson Brewer, an MD and neuroscientist has found in his research that even simple in-the-moment mindfulness exercises significantly reduced anxiety. He suggests three simple steps:

1. Pause. This helps keep the thinking parts of your brain active, so you can choose more helpful responses. Brewer notes: “Taking a moment to pause in stressful situations—whether that means you take three deep breaths or simply pay attention to the feeling in not-anxious parts of your body (like your feet or your hands)—helps ground you in calmer emotions.”
2. Notice the impact of your calm. When you realize that calm feels a lot better than anxiety, you can start to create a habit, because our brains learn to perform the action that is most rewarding. The more you practice calm, the more it will become your norm.
3. Take it one day (or one hour) at a time. When you notice that your brain is starting to spin out into future-oriented thinking and worry, remind yourself to pull your lens in. Do what needs to get done today. Tomorrow you can deal with what comes then.

Dealing with Anticipatory Grief

Alan Wolfelt, Director of the Center for Loss and Life Transition, writes that “alongside the physical pandemic, the coronavirus is creating a pandemic of grief, threatening everything we love.” Our hearts and minds are trying to prepare for what we might lose, which is sometimes called “anticipatory grief.”

I can relate directly to this. When my mother said there was a coronavirus case in her building, it felt as though she could die any day—and I would not be able to be with her. I worry that my mother will die alone, without anyone to ease her fear and loneliness.

To help us cope with this distress, Wolfelt recommends that we do many of the same things for ourselves that we do to support our loved ones. We can acknowledge the reality of the pandemic and honor all of our feelings. Naming them and expressing them—in conversations or through journaling—allows them to soften. He suggests four additional strategies.

In short

For our own sake, as well as for our loved ones, we do our best each day to offer practical and emotional comfort.  We call, listen, provide resources and cheer, and above all let them know they are loved. We can and will find ways to make meaningful connections in spite of their isolation, taking care of those we love and ourselves, physically, emotionally, and spiritually.