Articles Worth Reading

[MartyT]

Coronavirus and Finding Ways to Cope with Anxiety and Loss by Gloria Horsley

Today, I hosted a Facebook Live session with my daughter, Heidi, to discuss the impact of the coronavirus.  Tambre Leighn, an Open To Hope author, certified coach, Funder of Well Beyond Ordinary, and behavioral change expert, also joined us.

CONTRACTING THE CORONAVIRUS
Our session started with the news that my daughter, Heidi, took a coronavirus test this weekend and learned last night that she has tested positive. After starting to develop symptoms last week, she took action and got tested. Now, she is self-quarantining for the next 14 days, using protective gear and self-isolation to protect her husband and children.

Now that she has been diagnosed, Heidi has experienced a wide range of emotions — from anxiety to relief that she has a diagnosis to self-judgment about wishing she had known before getting on a plane or being anywhere in public. Heidi also feels anxious about causing any harm to her loved ones and even strangers she has come in contact with the last week or so.

However, it’s also been an important step for Heidi to share this information with us. It’s not meant to alarm or cause anxiety. Instead, Heidi feels it’s important to use her own experience to raise awareness of the importance of physical distancing and being aware of how our actions and decisions can impact others.

DEALING WITH RISING ANXIETY
This leads us to today’s guest and discussion about the impact of the coronavirus and the level of anxiety that it is creating. There is a lot of anxiety about the unknown, including what is the outcome of all of this. We also want to know how long will it go on and whether we and our loved ones will get the coronavirus and how bad it will be.

It’s understandable given the enormous impact and rate of change that we see happening around the world. While the information is good to know, it can also make us feel overwhelmed and contribute to the anxiety. Instead of answers, it only furthers the sense of the unknown since nothing has happened like this in our lifetime.

When we become anxious, it’s our mindset that focuses on the things we can’t control. In this case, there are many aspects of what is happening that we can’t control.

WHAT WE CAN DO
However, we can also choose to focus on those circumstances we can control. We can help ourselves, our loved ones, and our community by following all the mandates that the city, state, and federal governments have put into practice.

Another thing we can do is look at what triggers the anxiety in each of us. For some, it might be the media while others may have grief and loss in their lives that have amplified their anxiety.

Once we identify the trigger, we can then work on shifting our perspective and taking some action to move away from that trigger. If it was the media, then reduce how much time you spend reading and watching news stories about it. Do something that gives you a sense of purpose — whether that’s exercise,  a hobby, or something similar to what Heidi is doing by participating in this Facebook Live session.

RESILIENCE AND INNER STRENGTH
We have to know that we have the strength and resilience to overcome this situation. Believing that can help minimize the anxiety, which otherwise could adversely impact the physical strength of our immune system. And, we all need that immunity right now to physically fight this virus.

Then, there is our resilience. This is the capacity that we have to recover from situations and move forward. Many of us have had past situations that provide evidence of our resilience. If we have suffered loss and grief in the past and been able to carry on with our lives, then we are resilient.

PHYSICAL DISTANCE, NOT SOCIAL DISCONNECTION
Now, more than ever, we need each other. How we give ourselves the time and attention we need may have changed to a virtual channel. But, it is just as important and beneficial that we reach out to others — our friends, family, neighbors, and colleagues — and let them know we are here and thinking of them.

In the process, we will also have been proactive in controlling certain circumstances. We are choosing to physically distance ourselves to stay healthy and keep others safe, too. But, we are not socially disconnecting.

AN ACTION PLAN
Throughout this situation, it can help to create a personal action plan for yourself. It should fit your values, circumstances, and what matters to you. With this action plan, you have a purpose and focus that shifts your perspective away from the thoughts that make you anxious. You’ll able to keep your mindset on the actions you need to help yourself and those around you get through this situation.

[kayc]

Thank you for this.  I was exposed to C-Diff 9 days ago and that scares me even worse than the Coronavirus.  This would be a terrible time to contract it and I am concerned about my puppy should I get hospitalized.  The person who was supposed to care for him if anything happened now can't because her dog attacked him when he was sleeping.

This was a timely message.  

[MartyT]

This from our friends at AfterTalk:

Coronavirus, Medicare, and Telemedicine: Everything You Need to Know

by Danielle Kunkle Roberts on April 23, 2020

 

Editor’s Note: We are grateful to Boomer Benefits for this and past articles by Danielle K. Roberts. Since many of our readers are either seniors or those counseling seniors, we thought this excellent summary of the pandemic and medicare was worth sharing with all of you. A link to the Boomer Benefits site is at the end of the article. Be Safe!

LL and LB

Coronavirus, Medicare, and Telemedicine: Everything You Need to Know
by Danielle K. Roberts

If you’re like most of us, the global coronavirus pandemic has you feeling a little unsettled and concerned. Our daily routines are disrupted, we’re avoiding family, friends, and community social circles, and feel a frisson of fear every time we sneeze or cough. Even a simple thing like grocery shopping has become a worrisome ordeal.

We’re living in uncharted territory. Seniors, who are especially vulnerable to the effects of the virus, are caught between a rock and a hard place. It’s important to follow the CDC guidelines and stay home to protect yourself, but what happens if you don’t feel well and need medical care?

The good news is that Medicare is responding to the coronavirus crisis and making it easier than ever to get the care you need, even if you can’t—or shouldn’t—leave your house. With expanded coverage for telemedicine, Medicare is making sure seniors can get necessary healthcare without the risk of exposure to COVID-19.

Here’s what you need to know about coronavirus, Medicare, and telemedicine.

Medicare will now cover your telemedicine appointment. Recent changes have been made to provide better access to patients from their homes.

What is coronavirus?
Coronaviruses have been around a long time; some are harmless to humans and some cause disease. In some cases, the disease is mild—similar to a slight cold. In other cases, the disease can be severe. Both the SARS and MERS epidemics were caused by a coronavirus.

In 2019, a new strain of coronavirus appeared in Wuhan, a city in China. This new virus, called COVID-19, can cause severe respiratory

symptoms and pneumonia. The disease is spread among humans through droplets from coughs and sneezes. There is currently no vaccine for this strain of coronavirus.

Symptoms of coronavirus can develop any time up to 14 days after exposure. The virus attacks the respiratory system; symptoms include fever, cough, and shortness of breath. In rare cases, it can cause respiratory failure, kidney failure, and even death.

 Danielle Roberts of boomerbenefits.com joins ABC News 10 to answers viewer questions about telemedicine and health insurance during the coronavirus (COVID-19) outbreak. 

CLICK HERE TO GO TO THE PAGE WITH THE VIDEO

Who is at risk for coronavirus?
Anyone can get coronavirus, but certain people are more at risk for dangerous complications from the disease. According to the CDC, these people are especially vulnerable to COVID-19:

Coronavirus is also known as COVID-19

• Seniors
• People with asthma
• People with diabetes
• People with heart or lung disease
• People with HIV
• Pregnant women

You can lower your risk for coronavirus and slow the spread of disease by following the CDC recommendations:

1. Avoid unnecessary travel, especially on airplanes and cruise ships.
2. Clean and disinfect your home, paying special attention to doorknobs, light switches, toilets, faucets, sinks, and cell phones.
3. Avoid touching surfaces in public places—elevator buttons, handrails, and door handles—and avoid places where people gather.
4. Wash your hands often with soap and warm water, rubbing them together for at least 20 seconds. If soap and water aren’t available, use a hand sanitizer containing at least 60% alcohol.
5. Try not to touch your face, especially your eyes, nose, and mouth, since the virus enters the body through mucous membranes.
6. Maintain a distance of 6 feet or more between yourself and other people.

Special recommendations for seniors
Seniors are in a difficult spot. They are at higher risk because of their age and also because many have underlying conditions such as hypertension or heart disease. Not only are they more likely to contract coronavirus, but they are also more likely to have severe symptoms.

You can better protect yourself by following the CDC recommendations for high-risk individuals:

• Obtain a three-month supply of your daily medications. You may need to call your doctor or pharmacist to get a prescription for an extended supply of doses.
• Stock up on over-the-counter medications to treat fever (aspirin, Tylenol, ibuprofen). Don’t forget supplies such as thermometers, facial tissues, and hand sanitizer. If you have underlying conditions, additional supplies such as a blood pressure cuff and pulse oximeter may be useful for telemedicine monitoring.
• Fill your pantry with household staples and groceries to last several weeks.
• Build a network of family, friends, and community support services who can deliver meals, medications, and supplies if your stock runs low.

Keep a record of your temperature each day. This will be helpful for your doctor if you do begin to develop symptoms.

Recording your temperature every day is a good way to stay on top of potential problems; fever is one of the first signs of the disease. If you start to feel ill, you’ll have a temperature log to share with your healthcare provider to help her make an accurate diagnosis.

Isolation isn’t fun; it can be lonely and boring to be cooped up at home. But resist the urge to ask your children and grandchildren to visit, even if no one is showing signs of illness. With a 14-day incubation period, people can spread the virus before they show symptoms. Take advantage of technology like FaceTime to stay in touch with loved ones.

If you’re in good health, don’t feel like you’re stuck indoors. If the weather is nice, take a walk around the neighborhood—maintaining a safe distance from others, of course. Sit in the sun and listen to music or read a good book. A little fresh air works wonders when you’re self-quarantined.

What should I do if I feel sick?
With all the potential complications from coronavirus, it’s understandable if your first response is to go to the ER or urgent care when you feel sick. But heading to the hospital is quite possibly the worst thing you can do.

Hospitals are full of sick people, especially in the middle of a pandemic. If you don’t have COVID-19 before you get to the ER, you might pick it up once you get there. And if you do have coronavirus, it will take some time to diagnose it, which means you could be infecting others while you wait for your results.

If you have any symptoms of COVID-19, call your primary care physician or county health department right away. Depending on your situation, they may direct you to a drive-through testing site or conduct a telehealth visit to diagnose your condition. Home testing kits are coming on the market, which means you may soon be able to test for coronavirus without leaving your house.

If your symptoms aren’t related to coronavirus, it’s still best to call your doctor before seeking treatment outside the home. Many conditions can be managed with telemedicine and you’ll avoid unnecessary risk of exposure if you’re able to remain in place.

For medical emergencies—chest pain, difficulty breathing, symptoms of stroke, or serious falls, for example—don’t waste time calling your doctor. Dial 911 right away.

What is telemedicine?
People often use the terms telemedicine and telehealth interchangeably; they’re related, but there are a few differences. Telemedicine is a range of technologies used by healthcare professionals to diagnose and treat illness and disease from a remote location. Telehealth, on the other hand, is focused on remote health monitoring and health maintenance.

Telemedicine is used by healthcare professionals to diagnose and treat illness and disease from a remote location.

If you have a cough and runny nose, and you have a video call with your doctor to diagnose your illness and prescribe an antibiotic, that’s telemedicine. If you’re discharged home after a heart attack and your doctor uses remote monitoring equipment and telephone check-ins to keep an eye on your heart rate and blood pressure, that’s telehealth.

Telemedicine uses communication technology to simulate an office visit. You and your doctor can see and talk to one another in real-time over a secure connection. Your doctor can prescribe medications and order lab tests and x-rays through telemedicine just as he could with a face-to-face visit.

Most telemedicine platforms don’t require any special equipment. You simply download an app on your smartphone or computer. You don’t pay per-minute connection charges, although you may have data charges depending on your cell phone plan.

How does Medicare cover telemedicine for coronavirus?
Original Medicare has covered telemedicine in certain situations for several years. However, the benefit was limited to people in rural areas and required them to travel to a local clinic or hospital to video conference with a doctor. In 2019, Medicare expanded the telehealth benefit to cover virtual check-ins for patients who had established relationships with a provider and were under ongoing care for a particular condition.

Early in March, President Trump issued an emergency declaration allowing the Centers for Medicare and Medicaid Services to waive restrictions for telemedicine and telehealth services. Under the new rules, Medicare beneficiaries can receive a wide range of health services right in their homes. These include:

• Medicare telemedicine visits: Medicare will cover telemedicine encounters for any office visit, hospital visit, or other health service that typically takes place in person. Health professionals such as doctors, nurse practitioners, social workers, dieticians, psychologists, and medical therapists can now evaluate, diagnose, and treat Medicare beneficiaries using telemedicine video technology. The requirement for an established provider-patient relationship will not be enforced during this public health emergency. This means you can call any doctor or hospital offering telemedicine whether you’ve previously been seen there or not.
• Medicare virtual check-ins: Medicare will pay for telephone and/or text check-ins with established patients. For people with chronic conditions, these virtual check-ins mean they can get frequent monitoring and advice to help them stay healthy without leaving home.
• Medicare e-visits: E-visits take place through a patient portal and don’t involve any face-to-face or voice contact between the patient and provider. These are usually non-emergency issues, such as a medication refill request. E-visits require an established patient-provider relationship.

In the past, if Medicare covered these services, they were subject to the standard Part B deductible and coinsurance amounts. President Trump’s emergency declaration authorizes providers to waive the Part B coinsurance or copayments for telemedicine services, as long as they do so uniformly. In other words, a doctor can’t waive the coinsurance for one patient and collect it from another.

If you have a Medicare Advantage plan, you may have telemedicine benefits beyond those authorized by Part B. Call your plan’s member services department for details.

How does Medicare cover coronavirus testing and treatment?
Medicare covers coronavirus testing at 100%. You do not have to meet your deductible before testing is free. Medicare Advantage plans are also encouraged to waive any cost-sharing for coronavirus testing to make sure every senior gets testing when it’s necessary.

All medically necessary treatment for coronavirus is covered by Medicare. In addition, Medicare will pay for inpatient stays even if you are medically able to be discharged but need to remain in the hospital for quarantine purposes.

Other Medicare benefits for coronavirus

If you’re covered by a Medicare Advantage plan, you may have access to expanded benefits that may be helpful during the public health emergency. For example, some Medicare Advantage plans pay for meal and grocery delivery. Others cover home health aides who can help you clean and disinfect your home. If you need to fill a prescription and your pharmacy doesn’t deliver, your plan may also pay for a private ride service to and from the pharmacy so you can avoid public transportation.

Many Medicare Advantage plans also have benefits for over-the-counter medications and devices. Your plan may pay for your stockpile of Tylenol, hand sanitizer, and a home blood pressure cuff or pulse oximeter to help your doctor monitor your health over telemedicine visits. Check your plan brochure for details.

The bottom line about Medicare and coronavirus
We’re living through unprecedented times and it’s normal to feel like things are spinning out of control. The good news is that you can reduce or eliminate your risk of coronavirus if you follow the CDC’s recommendations and stay at home until the crisis is ended.

Many grocery stores are offering delivery so that you don’t have to leave your home.

Medicare is there to support you in all your health needs during this time. By expanding benefits for telemedicine, you can avoid a trip to the doctor and potential exposure to the virus. Don’t be afraid to call your doctor and request a telemedicine encounter—you’re lowering the risk of infection for yourself and others. And you’ll get the same quality of care you’d get in the office.

If you need medication, ask your pharmacy to deliver it and any other health supplies you may need. If they can’t, call your Medicare plan to see which pharmacies in your network offer home delivery. Your plan’s mail order pharmacy is another option to avoid unnecessary trips.

The team at Boomer Benefits is committed to helping you with your Medicare options in this time.

Take advantage of businesses offering extra services to help keep you safe. Many grocery stores are offering doorstep delivery; don’t risk getting sick because you’ve run out of eggs or coffee. Services such as Instacart and Amazon Prime can bring virtually anything you need right to your door. You can even get takeout from your favorite local restaurants delivered to your house.

Remember, staying home doesn’t mean ignoring your healthcare. Phone your doctor if you feel sick or have questions about your health. Eat a healthy diet and get plenty of rest to keep your immune system at its best. Use your time at home to learn something new or re-engage with a neglected hobby. Call your friends and family regularly to keep your spirits up and encourage one another to stick with the program until the CDC says it’s OK to return to normal life.

We’ll all get through this together. The experts at Boomer Benefits are here when you need Medicare advice and our offices will remain open by phone to offer help when you need it.

“We are in the business of helping people understand Medicare, in simple, plain terms that everyone can understand. We believe that it’s important that you first understand Medicare itself.  You can’t understand your supplement options until you first get a handle on your basic Medicare benefits. Fortunately, we’ve mastered how to make it simple.”

CLICK HERE FOR THE BOOMER BENEFITS WEBSITE

[MartyT]

‘Your Papa Is Right Here’

After my husband died, an old friend asked me what he could offer me, beyond words. I thought of something that our young sons could treasure.

By  Marc Sorensen Leandro

Every inch of me needed a break,  so my mom took the boys to a playground down the road. It was young for them but there was a fence, so as they scooted or swung, you at least knew they wouldn’t dart into the street. And it was the one kid-friendly place I’d discovered in Berkeley, during a week devoured  by unpacking, anticipation, and parenting by avoidance. 

Once they drove off, I was alone for the first time in our new house. I cried a tangled mixture of exhaustion and grief, leaving me with a plugged nose, bloodshot eyes, and a dull pain in my chest any time I took a deep breath. With the boys’ screeching and scampering temporarily quieted, in this place Lin had never been and never would be, a door opened and out came the sads. 

I walked up to my new bedroom and pulled open a curtain covering a closet stacked four or five high with boxes, and fixed my eyes on a leather valise wedged into a corner. It was a slightly ratty, box-shaped thing with a stitched handle, on either side of which was a tarnished metal clasp that you twist to release. It was Lin’s, and it was old, from long before we met, and had been a mute companion from Brooklyn to Rhode Island to Los Angeles, where Lin got off, and then to Berkeley with me and the boys. I’d noticed it before, imagining that some night when the kids were asleep, Lin would describe in granular detail what his life was like when the contents of the case were used, and useful. He’d tell me who he was then, and how it was different or worse or better than now. 

I dragged the case out, found a stack of notebook inside, and grabbed one at random. Written on the inside cover was Lin’s name and the date, early into his freshman year at the University of Oregon. Even though it was 20 years old, the pages were so clean and well-preserved that I felt like an archivist who should be wearing special gloves. I flipped to the middle, and tucked into a manila divider on a loose-leaf sheet, found a poem in Lin’s unmistakable script. I knew that he had written poetry, but he probably felt it wasn’t good enough to share. Or maybe he thought that he’d get around to sharing it, someday. 

I want to lie down in the sun
and bask in the glow of the water.
I want my soul to leave my
body through my eyes and ears
and let my doubts drip out
the ends of my hair. I am
a ceremonial headdress
floating down the Milky Way
in a bamboo canoe. Spirits
glow inside me, and my fingers
and toes are twenty lighthouses,
beckoning the kindred. Pain
huddles in the doorway. Fear
has lost its fins. I breathe in
the sky and exhale the water.
I pretend they aren’t watching.
The river and I create dances
together, and when we get tired,
we sleep in each other’s arms.
A deep sleep that lets me forget
the struggles and free my
hands of scars. Forget paper
and pen and their tragic
electricity. Forget this mortal
coil with the rattle at the
end. I want to make contact
and know that it’s a miracle. A
miracle without a pen that is not
bound in paper. I want history
inside. I want to leave all this
vertical behind. I want to lie down
in the water and bask in the sun.
-Lin Sorensen, 1995

The room slowed. Lin was 19 when he put this down, with 22 years left to live. Somehow, the words grasped his fate, and in the aftermath, in our new unintended home in Berkeley, I was astounded and unsettled and comforted all at once.

I called Lin’s dad to tell him what I’d found. He was struck too, and what’s more, said he was taking a class on Milky Way photography the following weekend. The next day, I slipped the poem onto the clipboard Lin and I used to log the boys’ milk intake when they were tiny, and walked to UC Berkeley, where my librarian friend photographed it with a special camera on a pure white background. I made an oversized print of that image, and after Lin’s dad captured a haunting celestial portrait, I blew that up too and placed both in identical frames which I hung at the foot of our bed, of my bed. Two mattes, two glass sheets, and two photos, into one whole. Now, as I go to sleep or when I wake up, I’ll take them in and smile, or stare, and sometimes I press my outstretched fingers to the poem and make contact. 

My job now is to curate into existence things that Max and Otis can see and touch and be around — everyday things that will burrow deep into their child’s minds and spur questions that in time might become answers. 

On the day Lin died, there was a party at our house in L.A. That’s the only word for it. His dad flew in, as he had countless times when Lin was sick, and with my parents and five or six friends, we danced and drank and held each other into the night, with the same stunned disbelief across all our faces, lit at times by smiles that beamed Lin’s sweetness. 

After the others left and the boys were long asleep, it was just me and my dad, who 12 hours before sat with Lin and me at the very end. So much of me was freshly carved out as we stood there saying goodnight, and then Lin’s hand was on my left shoulder, steadying me, comforting me. I cried out in shock, then formed some words to explain to my dad what had happened. He and I shared one last hug for the day, and I continued to my room, shutting the door behind me.

The Klonopin was kicking in when my phone dinged. “Can you talk?” read a text message from an old friend back East who must have heard. Can I talk? Thirty seconds later, we were on the phone. He’d been into the whiskey and we cried together, and the only words I remember at first were, so unfair so unfair, I know I know… I know. Before we hung up, he told me how much he loved Lin, and that he wished there was something he could do beyond words. With my heart all filled up and just hours into freefall, and I came up with something.

I moved from Rhode Island to San Francisco in the mid-1990s,  around the time this same friend took up woodworking. At a going-away party, he gave me one of his first creations, a compact cherrywood box, inlaid with a brushed stainless steel top. When you open the brass-hinged lid, a small circle cut-out of the metal from the other side reveals itself. At 24, it was the finest thing I’d ever owned, and it became a repository for all my prized ephemera. I moved at least 10 times in the two decades that followed, and I always packed the box with care, tenderly wrapping it in towel after towel, and placing it in a backpack I kept by my side, while lesser belongings clattered around in the back of the U-Haul. 

“What about recreating the box? The same but bigger, as a reliquary for all things Lin, for the boys to have one day?” He said yes right then, and six months later, just before Lin’s memorial, it arrived. Larger and even more beautiful than its predecessor, it was identical in design with two differences: the word Lin, carved by hand inside, and the inlaid stainless steel top buffed to a brilliant mirror finish that would ward off a vampire. When the boys are old enough, inside they’ll discover among other things,  some of Lin’s writing, a bundle of kitchen-counter notes he and I left each other in the early Brooklyn days, a printed dinner menu from our wedding, condolence cards, his eyeglasses, his wedding ring, and a vial of sand from the last time we were together at the beach as a family.

Objects are big with me, now, like an energetic tether that connects me to Lin. And our boys, they’re at an age where things dig deep grooves. Not long ago, I wrote myself a note that I titled Cornerstones of Continuity/Remembrance. The framed photographs are No. 3 on that list, and the boys have already started asking about their backstory. And the wooden box and its contents are No. 5. My job now is to curate into existence things that Max and Otis can see and touch and be around — everyday things that will burrow deep into their child’s minds and spur questions that in time might become answers. 

These are delicate days, and my wish — more than anything I’ve ever wished except that Lin would live — is that our boys won’t spend years fumbling into sharp, dark cul-de-sacs in an effort to find him. I want to make him known. I want continuity, like when they were 4½ and he was still alive, but also like he’s putting them to bed and taking them to soccer practice and sitting in the front row of their high school graduation with tears welling up in his eyes. I’ll fail in this goal, because he is not here, and because the boys must quest their quests. But I can light the road, and I can draw maps, with guardrails and markers, affixed with neon arrows that flash brightly and say to them, “Your Papa is right here.” 

The boys arrived back from the playground with their batteries depleted and their edges smoothed. They found me puffy-eyed, sprawled on the carpet in my room surrounded by Papa’s notebooks, and climbed onto me, nuzzling and giggling and generally being the puppies that they are. The pendulum of my heart swings unpredictably between gratitude and despair every day still, two years after our world blew up. And sometimes, I’m dead sure that I can’t do this. But then, the silliness and warmth and light that shone on us for so brief a time presses through and I think, maybe I can.

Marc Sorensen Leandro is a writer and private chef who now lives in the San Francisco Bay Area with his boys, Max and Otis. He was a contributor to Huffington Post, and his work has been featured in Out Magazine and American Circus, among others. Find him on Instagram at @marcbenjamin1.

[kayc]

Marty, thank you for always sharing articles, this is one of the things that sets this forum apart from others...your invaluable help.  I don't know how I missed the one on COVID before, but glad I saw it now, along with the more recent one.

[MartyT]

[Kieron]

1 hour ago, MartyT said:

The pendulum of my heart swings unpredictably between gratitude and despair every day still, two years after our world blew up.

Oh, wow...  that is simply profound, and exactly how I feel these days.

[kayc]

Many ask, "Do I need counseling?"  Here's what "What's Your Grief" has to say on the subject:

Demystifying Grief Counseling: Five FAQs

What is grief counseling?

First, we want to clarify what we mean by ‘grief counseling’. When we use the terms ‘grief counseling’, we’re using it to mean any type of one-on-one, couples, or family therapy, provided by a licensed counselor, to someone(s) who experienced a significant loss. Ideally, the counselor will have experience and expertise related to grief and bereavement, though their backgrounds will vary. 

The impetus for seeking therapy is challenges related to coping with loss and adjusting to life in its wake. Though, a person may find they address a wide range of issues throughout their counseling journey, whether they set out to do so or not.

---

Do I need grief counseling?

The question many people start with – and thus the most common question we hear – is something along the lines of “Do I need grief counseling?” or “How do I know I should go to grief counseling?”

I’m afraid our answer isn’t the most satisfying for people who want black-and-white guidelines, but I also think it’s the simplest. What we say is – if you are even slightly open to counseling – it never hurts to give it a try. 

People often think there’s a threshold of severity they should surpass before seeking counseling. Just as a person might wait until a fever spikes to a specific temperature before calling the doctor, they believe their grief has to hit a certain intensity before calling a counselor.

However, therapeutic experiences can be helpful to anyone, even people who are feeling pretty ‘okay’ in their life.  For example, counseling can help a person explore their experiences in a supportive, confidential, and non-judgmental environment. Also, counselors can provide psychoeducation and help clients identify coping tools and resources for dealing with a wide range of stressors. 

We know this may seem overly simplistic, logistically speaking. There are barriers related to access and cost that we’ll address a little in the next few FAQs. But generally speaking, in terms of whether you should try it or not, if doing so doesn’t place undue strain on your wallet or your time – then we say go for it. 

For our friends who want a little more concrete advice on this topic, try these articles:

• What is “Normal” in Grief? 
• When Grief Goes from Just Plain Miserable to Problematic
• “Normal” vs Not-so-“Normal” Grief
  
  https://whatsyourgrief.com/do-i-need-grief-counseling/

[MartyT]

The Ephemeral Nature of Normal

 

Posted: July 28, 2020 

Author: Belleruth Naparstek

Here’s a question for you, now that we’re a little halfway through this mishigas of a year: what does “normal” even mean anymore?

I won’t quote dictionaries at you; you know better than anyone else what normal looks like for you. As humans, we’re simple creatures of habit. We get into routines, we set our own boundaries, we develop preferences and nurture them. We create our normal, settle in and get comfortable — and then along comes a pandemic to throw everything into the air like so many juggling balls.

And it does feel like that sometimes, doesn’t it? Your job situation changes (working from home, losing hours, being let go), there’s nowhere to take the kids all summer, your loved ones are all at each other’s throats, no one knows what schools will be doing next year but they’re asking you to decide what to do right now… this is a real cluster, and here we are trying to balance it all, when the easier thing to do would be to let it hit the floor.

You feel like you’re not keeping up the way you used to, you’re frustrated with your seeming inability to get things done, the world feels like it’s had a sepia filter dropped over it, you’re losing track of time, and the calendar looks like a jumble of numbers and squares… and that hazy mess of confusion just happens to be the sneakiest way depression gets the drop on you.

It’s not the symptom we usually focus on when we talk about depression. We’re used to seeing pervasive self-hatred and dislike, fatigue and an empty tank of energy, disturbed sleep habits, isolation, and the midnight munchies (because making a midday meal feels like climbing Mount Everest). Above all, there’s the constant weight of sadness, and the creeping diminishment from being soaked in feelings of hopelessness and helplessness that sneak up on you, becoming a true blue cognitive distortion that colors your thinking.

But when you’re experiencing a significant loss of focus and concentration, the disruption to your thought patterns can easily become just as intrusive. When you can’t remember details or make clear decisions and “normal” changes every time the sun comes up, it’s hard to feel like you’re in control of anything around you.  Read on here >>>

[MartyT]

If there’s one good thng about grief, it's this...

by Danny Katz

If there’s anything good about grief, which there isn’t, but if there was (there isn’t), it would be this: you lose a lot of weight. Oh yeah, you just burn off the calories because your gut is a seething churning pit of despair – it’s really effective.

 

We’re grieving the loss of a much-adored loved one and I have to say, we’ve never looked trimmer. I caught sight of myself in the bathroom mirror and thought, “Whoahhh Danny, your body is a trim, hunky masterpiece of sculptural musculature! Sure your face is a gaunt, haggard bladder of misery with sad, saggy bloodhound jowls ... but the bod? Whoahhh, ripped!”

If there’s another good thing about grief, which there isn’t, but if there was (there definitely isn’t), it would be this: friends are really nice to you.

Yeah, they drop round gifts of flowers and pot-plants – our house turned into a Royal Botanic Garden, a tiny indoor one, fragrantly scented with roses and burnt toast.

Some friends even drop round cakes and chocolates, and we can eat everything because we’re on the Gut-Churning Seething-Despair All-Grief Diet (“I lost five kilos in seven days after gorging on an entire Maltesers Cheesecake! I cannot un-recommend the All-Grief Diet enough!!!!” D. Katz, Melbourne. #LookingFabulous #ApartFromBloodhoundJowls).

If there’s one final good thing about grief, which there isn’t, but if there was (believe me, there isn’t), it would be this: grief puts everything into perspective.

Yeah, you realise that petty problems are unimportant, that love is all-important, and that no matter how much you’re suffering, there’s always someone else who’s suffering worse than you, which is bizarrely reassuring.

Though following this line of logic, in a world with a finite human population, there must be one person who’s right at the bottom of the hardship heap. Someone who wakes up in the morning and thinks, “Well, life is terrible, but at least I know someone else is suffering worse than ... oh ... wait. No, I’m it. Bugger.”

The Person Who Suffers Worse Than Anyone Else On The Planet must be doing it tough. They’d be grieving for loved ones, they’d be living in a war-zone, they’d be stricken with poverty, they’d be bombarded with cryptocurrency spam-emails even though they’ve already unsubscribed twice.

The Person Who Suffers Worse Than Anyone Else On The Planet would be racked with illness, they’d be out of work, they’d be dealing with a broken relationship, they’d be regretting ripping off a hangnail they knew they shouldn’t rip off and now it stings every time they dunk their finger in orange juice (which they know they shouldn’t be doing either).

The Person Who Suffers Worse Than Anyone Else On The Planet is a great hero: they make everyone else feel better about their crappy circumstances.

And at least they can console themselves by thinking: “Well, at least I’m not one of those foie gras ducks who spend their brief lives getting force-fed corn through a tube jammed down their throat until their livers become horribly distended then they’re slaughtered so the liver can be mashed into a French pâté that may one day be used in a Masterchef invention test, served in an ice-cream cone with a roast quince chutney, which all three judges will say is completely inedible. Being born just to become an ingredient in a failed Masterchef invention test: no suffering is worse than that. That’s the bottom."

Hangnails, cheesecake, distended livers: these are the thoughts going through my grieving brain. And I know in time our grief will lessen, the cakes will stop coming, the kilos will stack back on, and friends will go back to treating me with the indifference I deserve. Very much looking forward to it.

Danny Katz is a Melbourne humourist.

[MartyT]

By Peggy Haymes 

Some days there is just too much too-muchness.

It may be a reflection of your own life and how things are going, whether it's the never-ending demands of caregiving or the unforgiving pressure of finances or the bad news about the people whom you love that just seems to keep coming.

It feels like too much.

Or it may just be the side effect of living in this world these days. As I've shared with some of you, the other week I had a doctor visit. After taking my vitals, the nurse did her obligatory screening. "In the last few weeks, have you felt down, helpless, hopeless, or depressed.?"

I thought for a moment. Covid surging again. Afghanistan. The west on fire and Ida pummeling the east.

"No more than is appropriate," I answered.

As Alexander learned on his no good, terrible, very bad day (a classic children's book), some days are like that.

Some times are like that.

Which means that taking care of ourselves, which is never optional, becomes even more essential. Self-care has become a bit of a buzzword, often translated into "get a massage and a pedicure."

Which may not be possible for some people.

Which may not be helpful for some people.

At its very heart, self-care is about stepping away and taking a breath. For some of you, that may mean a handful of days away where you can unplug. For some of you, it may mean taking an afternoon -- or even an hour -- just for yourself. For some of you, it may mean saying no when you usually say yes.

In my blog this week, I've shared a video about why sometimes stepping away from the world is the best thing you can do for this world, and some simple ways to do just that.. You can find it at https://www.heartcallings.com/blog/breath

Peace,

Peggy Haymes
 

Heart Callings, 2806 Reynolda Road, #207, Winston-Salem, NC 27106, United States

[MartyT]

How your brain copes with grief, and why it takes time to heal
December 20, 20212:55 PM ET
BERLY MCCOY

Grief is tied to all sorts of different brain functions, says researcher and author Mary-Frances O'Connor. That can range from being able to recall memories to taking the perspective of another person, to even things like regulating our heart rate and the experience of pain and suffering.

Holidays are never quite the same after someone we love dies. Even small aspects of a birthday or a Christmas celebration — an empty seat at the dinner table, one less gift to buy or make — can serve as jarring reminders of how our lives have been forever changed. Although these realizations are hard to face, clinical psychologist Mary-Frances O'Connor says we shouldn't avoid them or try to hide our feelings.

"Grief is a universal experience," she notes, "and when we can connect, it is better."

O'Connor, an associate professor of psychology at the University of Arizona, studies what happens in our brains when we experience grief. She says grieving is a form of learning — one that teaches us how to be in the world without someone we love in it. "The background is running all the time for people who are grieving, thinking about new habits and how they interact now."

Adjusting to the fact that we'll never again spend time with our loved ones can be painful. It takes time — and involves changes in the brain. "What we see in science is, if you have a grief experience and you have support so that you have a little bit of time to learn, and confidence from the people around you, that you will in fact adapt."

O'Connor's upcoming book, The Grieving Brain, explores what scientists know about how our minds grapple with the loss of a loved one.

Interview highlights
On the grieving process

When we have the experience of being in a relationship, the sense of who we are is bound up with that other person. The word sibling, the word spouse implies two people. And so when the other person is gone, we suddenly have to learn a totally new set of rules to operate in the world. The "we" is as important as the "you" and "me," and the brain, interestingly, really does encode it that way. So when people say "I feel like I've lost part of myself," that is for a good reason. The brain also feels that way, as it were, and codes the "we" as much as the "you" and the "I."

On the difference between grief and grieving

Grief is that emotional state that just knocks you off your feet and comes over you like a wave. Grieving necessarily has a time component to it. Grieving is what happens as we adapt to the fact that our loved one is gone, that we're carrying the absence of them with us. And the reason that this distinction makes sense is, grief is a natural response to loss — so we'll feel grief forever. A woman who lost her mother as a young person is going to experience that grief on her wedding day because it's a new moment where she's having a response to loss.

But "grieving" means that our relationship to that grief changes over time. So the first time, maybe even the first 100 times, you're knocked off your feet with grief, it feels terrible and awful and unfamiliar. But maybe the 101st time, you think to yourself, "I hate this, I don't want this to be true. But I do recognize it, and I do know that I will get through the wave."

On the emotions involved in grieving

The range of emotions that someone experiences when they're grieving is as long a list as the range of emotions we have in any relationship. Commonly there's panic, there's anxiety, there's sadness, there's yearning. But what we sometimes forget is that there's also difficulty concentrating and confusion about what happens next.

I am often struck by the intensity of the emotions. Grief is like someone turned up the volume dial all of a sudden. The emotion that I think often interferes with our relationships and friendships when we're grieving is anger, because the anger feels so intense. You have someone blow up at a dinner party and you think, "What's happening with them?" And then to try and remember, "Oh, they're grieving and everything is amped up a little bit."

On what is happening in our brains

We have neuroimaging studies basically of grief, of the momentary reaction where you have that emotional yearning experience. There are less than a handful of studies looking at more than one moment in the same person across time — so looking at their grieving trajectory. What we know right now in these early days of the neurobiology of grief is really coming from snapshots.

Having said that, one of the things that we know is that grief is tied to all sorts of different brain functions we have, from being able to recall memories to taking the perspective of another person, to even things like regulating our heart rate and the experience of pain and suffering. So lots of different parts of the brain are orchestrating this experience that we have when we feel grief.

On prolonged grief

When you're knocked over by that wave of grief, you want to know, "When will this end?" From a research perspective, there is a very small proportion of people who might have what we now call prolonged grief disorder, something we start looking for after six months or a year [after a death or loss]. ... And what we are seeing, [in such cases], is that this person has not been able to function day to day the way that they wish that they could. They're not getting out the door to work or getting dinner on the table for their kids or they're not able to, say, listen to music because it's just too upsetting. So these types of concerns ... suggest it would be helpful to intervene and get them back on the healing trajectory where they will still feel grief, but they will adapt to it differently.

The older term that we were using for a long time was "complicated grief." And although prolonged grief disorder is the term we've settled on, there's a reason that I like the term complicated — because it makes you think of complications.

As an example, one of those is the grief-related rumination that people sometimes experience. The better term for that that people will recognize is the "would've, should've, could've" thoughts. And they just roll through your head over and over again. The problem with these thoughts — we sometimes call "counterfactuals" — is that they all end in this virtual scenario where the person doesn't die. And that's just not reality. And so, by spinning in these thoughts, not only is there no answer — there are an infinite number of possibilities with no actual answer of what would have happened — but it also isn't necessarily helping us to adapt to the painful reality that they did die. And so our virtual version is not really helping us to learn how to be in the world now.

It's less than 10% of people who experience prolonged grief disorder. And what that means is 90% of people experience difficult grief and suffering, but don't have a disorder after losing a loved one. I think it's so important to remember that ... because we don't want to hide grief away ... in a psychiatrist's office or a counselor's office, except in indications where that would be helpful to get people back on track.

On how to support grieving people in your life

I think when you care for someone who is going through this terrible process of losing someone, it really is more about listening to them and seeing where they're at in their learning than it is about trying to make them feel better. The point is not to cheer them up. The point is to be with them and let them know that you will be with them and that you can imagine a future for them where they're not constantly being knocked over by the waves of grief.

On losing people to the pandemic

One of the topics I think is not much in the national conversation is that so many of the deaths of our loved ones happened in hospitals, emergency rooms and ICUs — and we weren't there to see it. And that is for a very good reason, because we were trying to stop the spread of COVID. So having family members in hospitals did not make sense.

But it means that people are without these memories of watching their loved one become more ill and watching those changes that happen in their body that prepare our mind for the possibility that they might die. To go through that process without those memories makes it much harder to learn what has happened. So many people feel it hasn't really sunk in yet that they're gone.

What I don't hear very often is the fact that with COVID, the loved ones that are left behind made the sacrifice of not being with their loved ones in the hospital in order to stop the spread. And that sacrifice needs to be recognized, I think. In part to help people heal, so that it's understood why they're having such a difficult time. And to elevate the understanding that they did something for the greater good — and they gave up something while they did it.

[kayc]

On 12/21/2021 at 9:10 AM, MartyT said:

the loved ones that are left behind made the sacrifice of not being with their loved ones in the hospital in order to stop the spread. And that sacrifice needs to be recognize

I couldn't agree more!  And it's a decision that was taken from them, leaving them often feeling guilty for not being there, something that is beyond their control.  I know because I went through that when my husband died, long before Covid, when the nurse kicked me out of the ward and locked the door behind me...I wasn't disruptive, I was out of their way, it was ME who had alerted them to his heart attack!  Yet I was deprived of being with him when he went through the biggest transition of his life.  We were always there for each other, always!  Until then.  

It's so important to not take on guilt of things beyond our control.  It's something we have to work through as it comes unbidden and it takes effort and often a process to let go of it.   That's where coming here helps, reading the articles, it seeps in little by little.  It also helps to know we are not alone in this.

 

[kayc]

What Does It Mean to Integrate Grief?

GENERAL / GENERAL : LITSA

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Not too terribly long ago I was working with a bereaved dad. I was the second grief therapist he’d seen; the first was shortly after the loss, years before. He explained that his earlier grief therapy wasn’t helpful, saying with frustration, “she kept telling me I needed to ‘integrate my grief’ but I had absolutely no idea what that meant or how to do it“. The griever in me could deeply relate to his annoyance. And the grief therapist in me understood exactly what that therapist was trying to say.

Avoiding jargon can be tough. In almost all specialized fields, there is an unofficial language. Once you’re fluent, it can be hard to remember that others aren’t. Mental health is no exception. We throw around acronyms. Therapists use phrases that are part of the mental health lexicon, forgetting that they require clarification and context. We spend a lot of time explaining grief types, terms, and concepts because they aren’t common knowledge. And we want you to have a general understanding of the glossary of grief, because sometimes that jargon is describing something useful. Like integrating grief.

First a little background on how we think about grief

Over the years many writers and researchers have looked for ways to understand the trajectory of grief. That’s a tricky project, because grief tends to look different for everyone. There are no predictable, linear stages. There’s no set timeline. There are no universal emotions or experiences. In the old days (and my that I mean before the 1990s) society and professionals alike viewed grief as something we need to get over and leave in the past to make room for a new life moving forward.

In the 90s, clinicians and researcher put forth the Dual Process Model of Grief and Continuing Bonds theory, which both upended those ideas. They made space for grief to be ongoing, not something we work at and then recover from. It offered an understanding of ongoing relationships with people who’ve died as normal, not a problem. Of course, none of that helps to explain what it means to integrate grief. But it is important context.

Before we can get to integrated grief, we’ve got to get through early, acute grief.

When someone dies or you experience another type of devastating loss, your life often feels like it has split into two parts – before and after. In the early days and weeks following a loss, grief is completely consuming. You look back almost obsessively on the world that existed before, the way life was ‘supposed’ to be. You’re filled with total disbelief, doubt, and fear about whether you will ever be able to live in this shattered, “after loss” world. The pain is unrelenting and the future often looks like an empty abyss.

Coping in the early days of grief

Reminders of the person can feel exclusively painful in the early days. And yet often people feel desperate to hold on to the physical reminders because it feels like all you have left. You want to preserve everything they touched, their smell, the sound of their voice, even when sometimes those things are overwhelming reminders of their absence. You might go over and over moments with them in your mind, trying to etch the memories permanently in place. You spend so much time in the past to avoid looking around at a present and a future in which your loved one is missing.

The grief feelings can be terrifying. It’s common to worry that you’ll get crushed by the constant deluge of grief emotions. To cope with the intensity of these emotions, people fight back against grief. You might find yourself avoiding anything that brings up the pain. Rather than clinging to every hint of your loved one, you may be doing the exact opposite. To manage your emotions you may be avoiding those reminders, trying not to think about the loss, avoiding places and things that might turn you into a grief-puddle.

And it might look different from day to day, week to week, all the while thinking, when will this end?? When will I finally find ‘acceptance’ and ‘move on’??

Unimaginable as it is, we somehow survive acute grief

Hard as it is to believe, somehow we survive the early days after a loss – one day at a time. Sometimes one breath at a time. The pain remains intense, but our brains slowly but surely start to make sense of a world in which our loved one is missing. The Dual Process Model of bereavement, one of our favorite grief theories, explores the ways we find time to tend to loss-oriented stressors (our memories and connections to our loved one and the pain of our loss) and also the restoration-oriented stressors (the practical daily tasks of rebuilding a day to day life after loss). We do not work on our grief and suddenly find the other side, reaching ‘acceptance’ and ‘moving on’. Instead we’re continually coping within domains, loss and restoration, oscillating between them in an ongoing way.

As we slowly resume routines, we start figuring out how to live a life that feels meaningful and balanced without our loved one. For many people, two things become clear: they want to eventually thrive in the world again, and they also want to bring their loved one’s memory with them. The ways of coping during early grief often don’t serve those goals. Clinging furiously to every reminder and staying lost in the past and in the pain doesn’t allow for a meaningful present. But trying desperately to avoid emotional reminders or numbing difficult feelings, and ignoring the past doesn’t allow for a connection to our loved one’s memory in the present. They create a compartmentalized world in which we’re either consumed by grieving or denying our grief and our loved one’s memory. Neither is sustainable.

So, finally — what does it mean to integrate grief??

At some point in grief, most people realize that grief has changed them. We aren’t going back to ‘normal. In order to stay connected to the memory of our loved ones, cope with the complicated emotions of grief, and to live in a way that has meaning and purpose, we have to invite grief in to stay.

That is integrating grief.

If you’re a regular WYG reader, you might know this as ‘making friends with your grief monster‘.

Integrated grief is grief that exists within your life, as an ongoing part of your life, without overwhelming or dominating your life. I know, at this moment that might feel unfathomable. But as you learn to carry the complex emotions of grief and you change your relationship with grief, slowly the chasm will close between grieving and ‘functioning’. Grief impacts your identity, changing your roles, relationships, and priorities. Integrating grief means letting go of who you were before the loss and embracing the person you are now, a person changed by grief, often in ways both good and bad. As you learn what it means to have a relationship with someone who has died it becomes easier to move forward into a new life, bringing your loved one with you.

What does integrating grief mean to you?

 Defining integrated grief isn’t easy or straightforward. And in practical terms it can look or feel different for different people. We asked our community over on instagram how they thought about integrating grief and here are some of the responses.

• Accepting this daily as part of yourself
• To let yourself really feel it. To let it become part of the fabric of your being
• Make the loss become part of you
• Be able to function with the loss
• Accept the loss as your companion instead of trying to “work through” it.
• Attempting to have your loss live in tandem with your new normal, a familiar part of your new life.
• Owning it. Realizing and working on being sad/grieving AND whatever else needs to be done.
• Make it part of your story
• Stop bumping into the shock of it every moment of the day
• Bring it in. Let it be part of you.
• Growing around your grief. Carrying it and building your life around it.
• To accept the new reality without them but to feel the connection to them.
• Making peace with the truth that your loss becomes part of you and always will be.
• Learning to live with and adapt to the gaping hold in your life instead of staring into it.
• Continuing to keep traditions and little things we shared as I learn to live again.
• Figuring out how to live alongside your grief.
• Learning to carry memories into the day to day.

Integrating grief doesn’t happen over night or with the flip of a switch. It is a slow evolution. Be patient with yourself and get support if you need it.

Can subscribe at WhatsYourGrief.com
https://whatsyourgrief.com/what-does-it-mean-to-integrate-grief/?inf_contact_key=cd8fd9d827fab37c4b9ab007ed27920b680f8914173f9191b1c0223e68310bb1