Virtual Grieving

– When Pandemic Death Stares Us In The Face

Virtual grieving of a colleague who dies from coronavirus can be difficult for everyone in the … [+] workplace
by Bryan Robinson

“COVID-19 robbed us of our goodbyes,” says Dr. Joy Miller of Peoria, Illinois, “My friend was suddenly gone without warning. How do I say goodbye? I can’t travel. We aren’t allowed to gather, and I will never see him again. I don’t know what to do. I feel lost and empty, as if my heart is being ripped from my body.”

Grief is a lonely and isolating experience in and of itself. And human contact is essential for healthy and full psychological closure. With added self-distancing during the COVID-19 pandemic, grief can be compounded and prolonged. In the midst of heartbreak, Miller finds the loneliness of grieving compounded by the double whammy of self-distancing. Unable to embrace or be embraced by those who share her loss, she must draw upon her own creativity and resources for comfort.

Miller—founder and CEO of Resliency 2020 and Joy Miller & Associates—isn’t alone. Amidst the COVID-19 pandemic, many colleagues and friends are dying in isolation. And coworkers and families are mourning from afar. Not only are they robbed of their colleagues, they are robbed of their ability to gather and mourn their losses with others, which is leaving an empty, unsatisfying feeling from a lack of full closure. Studies show that during bereavement, having satisfactory grief scaffolding and a support person navigating post-death formalities, plus satisfactory information about the death decreases risks of post traumatic stress disorder (PTSD), depression, and prolonged grief disorder (PGD).

Without appropriate bereavement scaffolding in place, many grievers are at risk of PGD and complicated grief (CG)—a syndrome characterized by preoccupying and disabling symptoms that can persist for decades. Affecting between 10 to 20% of mourners, CG can lead to the difficulty of accepting the death of a loved one, yearning or avoidance, sadness, somatic distress, and social withdrawal.

“In my faith of Judaism, everything is mandated to occur in a specific way,” says Miller. “At a specific time, with a specific prayer. I always knew what to do. Right now, I would normally be at the visitation, making food for the family, standing at the graveside and helping put dirt on the grave until each particle covered my friend completely. I would say Kaddish, and I would mourn, and in eleven months we would return to once again celebrate his life, and place the stone on his grave. But now I can do none of that.”

The pandemic has mandated that mourners of all faiths cannot have their traditions that have helped them heal for generations. Like so many other people in this country and around the world losing their loved ones to COVID-19, mourners must find new ways to grieve and process. Some dying hospital patients are saying their goodbyes to loved ones by FaceTime or other virtual devices. This modality isn’t ideal, but it’s the only option for now to contain the community spread.

“I am faced with death without normality,” says Miller. “This is the new normal for right now. Each of us must find a new way to enter this path, but I am choosing to discover new rituals that help me face my sadness. Ironically, I teach a graduate-level course on grief and loss. It seems to open my heart even deeper as I contemplate the stages of death and dying, joy and pain and healing and peace with my students.”

Although there are no adequate substitutes for human connection during grief, Dr. Miller came up with nine tips to help you grieve your departed colleagues from afar during the new normal:

  1. Go through photos. Miller is a photographer, so sorting through old captured pictures has helped her reminisce about past celebrations, joyful moments, funny stories and the love she shared with her close friend. But you don’t have to be a photographer to create a montage of photographs to help you heal, and you will see how the act of reminiscing about your colleague can bring peace and healing.
  2. Write down your feelings. Writing helps us discover some peace, sort our feelings, and document what we’re not allowed to share at the mortuary, the visitation or the cemetery. It brings closure and helps us find clarity. Journaling your thoughts and feelings down on paper can be a huge unburdening. You might also consider writing a goodbye letter to your departed coworker, saying what you wish you could have said directly and how much he or she changed your life for the better.
  3. Allow yourself to cry. Miller remembers tells her grieving clients that each tear brings you closer to healing. The process is cleansing and tears help us move toward a new reality. Acceptance means realizing that these tears may be present for a long time.
  4. Meditate. Meditation, prayer or contemplation can help you face and release your feelings of loss and bring comfort. If you need guidance in meditating, you can Google “apps for the bereaved” and find many support resources online.
  5. Reach out to others. Social distancing platforms—such as live streaming of funerals—are temporary solutions until mourners can embrace the comfort of each other’s arms. Meanwhile, take advantage of social devices such as FaceTime, Zoom or Skype to share stories with others who are also mourning the departed. Talk about the times that were sacred to you. Discuss how your colleague helped you change your life and the impact he or she had on your growth.
  6. Set up a memorial page. A memorial page on Facebook or other social media allows you to connect with employees who share your loss. Friends and family can post their own tributes and condolences. And reading through the online messages can provide comfort.
  7. Focus on the positives. It is called “anamnesis”—a way to remember the positives in this painful loss. Each person is in our life for a reason, a purpose, and it all has meaning. Ask yourself what this person taught you and what you want to keep from your life together.
  8. Consult a grief counselor. If the grief process is severely interrupted to the point that you could be having prolonged or complicated grief, contact a grief specialist. During the pandemic, therapists are conducting virtual sessions by social media, so it’s possible to get immediate support.
  9. Let there never be the final death. Author David Eagleman said, “There are three deaths. The first is when the body ceases to function. The second is when the body is consigned to the grave. The third is that moment, sometime in the future, when your name is spoken for the last time.” Consider making a vow that there will never be that final death, and speak of your departed colleague often in your head and in your heart.

On September 10, 2020 Dr. Joy Miller co-hosts Resiliency 2020, an international live streaming webinar to support the mental health needs of front line pandemic workers.

Complete Article HERE!

Managing grief different, difficult for seniors

By BECKY RASPE

Grief can be a difficult process for anyone, but seniors tend to be faced with difficulty in healing after a profound loss.

Diane Snyder Cowan, director of Western Reserve Grief Services in Cleveland; Carolyn Lookabill, director of marketing at the Lantern of Chagrin Valley in South Russell; and Erin Matteo, social work manager and bereavement coordinator at Wexner Heritage Village in Columbus, said grief manifests differently for each person.

“Grief is a normal, necessary, natural reaction to loss no matter the age,” Cowan said. “It is unique to each person and grief is not linear. You don’t move through stages or get over it. It’s a total body experience impacting the emotions, cognition, behaviors, spiritual beliefs – basically the heart, mind and body.”

Lookabill added, “We all don’t display grief in the same way. It’s not always tears – it could be difficulty eating or sleeping. There is no normal, and that can be a difficult concept in a communal setting. It’s something other residents might not understand about each other.”

Matteo added experiencing grief following the death of a loved one can be compounded by other losses a senior could be experiencing.

“One thing that is specific to seniors is the loss they experience is not just the loss of a partner or friend, they experience loss of independence, ability to do things they enjoy or sometimes the loss of physical or mental capacity to do things,” she said. “So, the sheer magnitude of things they can experience directly related to their age imposes a lot of different barriers to quality of life. It’s important to understand the degree of their loss and the changes in their lives on top of that.”

Though grief affects people of all ages, it can affect seniors in ways unique to the age group.

“Aging adults often think about their mortality,” Cowan noted. “There are losses that occur as part of the natural aging process. Some aging adults are isolated, especially now during the pandemic. Many experience several losses within a short period.”

Matteo added, “A lot of them have that anticipatory fear, that they might be next or their time is coming too. When a senior loses someone, consider that it is not their first rodeo. They have this understanding that they are getting up there in age and have seen it happen.”

If left unchecked, unresolved grief can negatively impact a senior’s wellbeing.

“For the most part, that person begins to withdraw,” Lookabill said. “They begin to not respond to overt attempts by neighbors and friends to be supportive. They withdraw to the point where they become more isolated and not even get dressed or cook their meals. Their nutrition and language skills can suffer too.”

For a senior struggling with these emotions, it’s important to not invalidate their feelings, Matteo stated.

“When someone in their 80s and 90s loses a partner, that loss is very significant because a lot of those seniors have been married for over 60 years,” she explained. “One of the things people like to say is ‘they were really old’ or ‘they lived a good life.’ When you say those kinds of things, you minimize their grief for the rest of the family to be able to move on and be comfortable.”

Family members should be prepared to approach the situation with an open mind and willingness to listen, the professionals said.

“The family member doesn’t even have to speak,” Lookabill said. “You don’t have to say anything. Your presence is supportive. It’s good to be available, even if you don’t fully understand the situation. They can share the grief that they have in common. It doesn’t have to be a major response, just be there in the moment.”

Cowan said, “If family is available, offering an open heart, love and listening is the first step in supporting a grieving loved one. It’s important to remember that older adults may need more time to become aware of and express their feelings.”

Complete Article HERE!

Celebrating a life well-lived — one year later

“The goal is not a good death. The goal is a good life — all the way to the very end.”

— Atul Gawande, M.D., surgeon, writer and public health leader

By rclark

One year ago on this date, July 11, 2019, my wife, Norma, was freed from the prison of Alzheimer’s disease. So exactly one year later it is appropriate to celebrate Norma Houghton’s life and share with my readers personal reflections on my recovery.

You who have been with me all the way from diagnosis in 2010 to last summers’ final breath know the documented story of a lady who gave an extraordinary gift to sacrifice her privacy to help others. The sadness in over 10 years of seeing her drift away was softened by the concern of many readers, as well as numerous caregivers.

My restoration and renewal following our 57 years of marriage has been facilitated in part by periodic messages this past year from her hospice caregivers from Compassus. A healing journey of recurring memories was predicted by their periodic communication.

Norma’s good works have been recognized with the Norma A. Houghton Staff Award in the Birthing Center of Monadnock Community Hospital and an annual scholarship for a graduating student from one of our three local high schools choosing higher education in nursing.

As past co-chair of the Western New Hampshire Walk to End Alzheimer’s, I have been given the satisfying task of using my wife’s story as a monthly “mission moment” to cheer on the current walk committee through the challenges of planning a major event during the pandemic.

So her legacy lives on and, though grief has come to my life, spiritual growth and a new life have also emerged as predicted and aided by Compassus. I can now see that hospice is not about dying but helping caregivers and patients live life to the fullest.

When our time on Earth comes near a close, the choice of hospice provides a better quality of life than if aggressive end-of-life medical care were applied. Dr. Gawande’s classic treatise, “Being Mortal,” about “medicine and what matters in the end,” is on point.

You may remember an early column about full body donation for medical education. I expect next week to travel to Boston University Medical School to bring Norma’s ashes back to Jaffrey. Plans are being laid at the United Church to develop a memorial garden as a final resting place for beloved members of the church.

If you want to find out more about hospice services, visit the hospice and palliative care organization (www.nhpco.org). It is not true that hospice is only for the final days or hours of life. Hospice is about helping patients and their families have the best possible quality of life as they can when life expectancy is limited.

Usually a patient’s doctor and the hospice medical director work together to offer experience with hospice criteria, guidelines and clinical judgements. Hospice Medicare coverage includes nurses, other caregivers, medicines, supplies and equipment, with little or no cost to patients, families or caregivers.

Clearly for me hospice care provided even more than medical, emotional, social and spiritual support. I find myself surrounded with family and friends who share my loving memories of Norma and continue to offer peace and support as I come to this special date.

Compassus gave me positive relief and strength during a time of extended grief, allowing me to create appropriate remembrances and lasting reminders of a life well lived. Since they suggested a celebration on the anniversary of my loved one’s death, isn’t it a joy that my July column is published as a tribute on this very date!

“Enjoy life. Have fun. Be kind. Have worth. Have friends. Be honest.

“Laugh. Die with dignity. Make the most of it. It’s all we’ve got!”

— Ricky Gervais

Complete Article HERE!

Do Animals Truly Grieve When Other Animals Die?

By Denyse O’Leary
Anthropologist Barbara J. King, author of How Animals Grieve (2014), has written a thought-provoking essay on the difficulties that COVID-19 has created for people coping with the death of a loved one because they are not allowed conventional grieving methods. Although it is titled “Animal Grief Shows We Aren’t Meant to Die Alone,” King’s essay turns out to be appropriately skeptical of ambitious claims about animal grief. She writes,

There is a popular perception that some animals, particularly elephants and crows, participate in their own kinds of funerals. But there’s little solid evidence—at least, so far—for this kind of community ritual. Elephants may occasionally cover a dead companion’s body with leaves or branches, but the meaning and intent of this action remains unclear. A 2012 paper includes the words “scrub-jay funerals” in the title, but the “funerals” were actually noisy gatherings of birds around scrub-jay skins and feathers laid out by researchers in an experiment. The birds’ response to what they saw indicates acute social assessment of their surroundings, to be sure, but it’s a stretch to consider that behavior a death ritual.

Barbara J. King, “Animal Grief Shows We Aren’t Meant to Die Alone” at Sapiens (April 22, 2020)

That said, she cites a number of instances of animals showing apparent grief at the death of a companion:

At the Farm Sanctuary in New York state, after years of close companionship, a duck named Harper withdrew socially and refused to form new bonds after the death of his duck friend Kohl in 2010.

Barbara J. King, “Animal Grief Shows We Aren’t Meant to Die Alone” at Sapiens (April 22, 2020)

But wait; it’s hard for a human to be sure what’s happening here. Harper may simply have lost the ability to form close bonds with other ducks, irrespective of what, if anything, he understands about Kohl’s absence. Again, while much is made of primates grieving over dead companions,

Monkeys and apes don’t act exactly as humans do around dead bodies. Mixed in with compassionate caretaking may be aggressive or even sexual behaviors: They might strike or mount a corpse. Yet human grief, too, can manifest in unusual ways. At a solemn memorial service, a mourner may suddenly laugh in involuntary response to tension.

Barbara J. King, “Animal Grief Shows We Aren’t Meant to Die Alone” at Sapiens (April 22, 2020)

Well, we are beginning to get a clue now. A human being may behave oddly at a funeral but that is because of an awareness of what death means. The monkey is troubled by death but does the monkey understand what death is? Anthropologists like King resist making that distinction:

For much of the 20th century, it was common practice for ethologists to resist acknowledging the profound emotions expressed by these animals. Anthropologists and zoologists who broke with tradition to describe animal grief—and other emotions as well, including joy—found themselves accused of anthropomorphism, the projecting of human capacities onto other species. The tide began to turn, however, as ever-more research in the field and in captivity showed unmistakable evidence of animals feeling deeply what happens to them. More than ever before, researchers now recognize that grief and love don’t belong only to us humans.

Barbara J. King, “Animal Grief Shows We Aren’t Meant to Die Alone” at Sapiens (April 22, 2020)

No, love and grief don’t belong only to us humans. But there is something that does. Consider the story of Hachikō, the Akita dog (right, in 1934) whose human friend, a professor named Hidesaburō Ueno, died of a cerebral hemorrhage while on a train trip in Japan in 1925 and never returned to the station from which Hachikō had seen him go:

Hachiko moved in with a former gardener of the Ueno family. But throughout the rest of his ten-year-long life, he kept going to the Shibuya Train Station every morning and afternoon precisely when the train was due to enter the station. He sat there for hours, patiently waiting in vain for the return of his beloved owner which sadly never came back.

Maria Wulff Hauglann, “The Amazing And True Story Of Hachiko The Dog” at Nerd Nomads

Hachikō has inspired much devotion ever since, along with several films and monuments.

The touching part of the story is not simply Hachikō’s devotion but the fact that the dog could not know that his beloved Hidesaburō had died.

Death, after all, is an abstraction. We can be told that someone has died and, without seeing the person’s body, we know what that means. We also know that all human beings (and all animals) will die sometime. But that is an abstraction too. For humans, mourning is a philosophical as well as an emotional affair. As a result, death raises questions about the meaning of life which Harper, the monkeys, and Hachiko could never ask.

It is these thoughts and questions, not only grief, that have always underlain funerals:

What’s undeniable is that our early Homo sapiens ancestors began to create increasingly elaborate burial rituals. At around 24,000 years ago in what is today Sunghir, Russia, for example, a boy of about 12 years of Animals ranging from elephants to cows, ducks to dogs, may grieve.age and a girl of about 9 were buried together. The research paper describing the remains says they were “head to head, covered by red ocher, and ornamented with extraordinarily rich grave goods.”

Barbara J. King, “Animal Grief Shows We Aren’t Meant to Die Alone” at Sapiens (April 22, 2020)

But then those human beings knew what it meant in the abstract to say that the children had died. The grave goods they provided suggest that the mourners thought the children might need something somewhere. But they surely understand that somewhere to be another dimension of reality. That’s part of what the animal doesn’t have.

So do animals grieve? Yes indeed. Do they grieve the same way humans do? No, because, for better or worse, they can’t. There is no turning back from the gift of reason.

Complete Article HERE!

BIPOC in Death Care

The voices of Black, Indigenous, and People of Color (BIPOC) need to be amplified so we are going to use our newsletter and social media platforms to aid in their sharing. Here are a few resources for us to explore racism, privilege, and bias in death care:

Sayin It Louder: A Conversation About “A Good Death” in a Racist Society.

A conversation among death care professionals Alua Arthur of Going with Grace, Lashanna Williams of A Sacred Passing, Joél Simone Anthony of The Grave Woman, Alicia Forneret, Oceana Sawyer, and Naomi Edmondson.

 

Watch the recording of their discussion by clicking here.

5 Crucial Things A Grieving Partner Needs You To Know

by Susan Johnston

We all process grief differently.

When my dad died, it was hard on me, of course, but also on my boyfriend.

The call came just a few weeks shy of our one-year anniversary. Suddenly, he found himself sitting next to me in the front row of the church and meeting my extended family.

He handled it with sensitivity and maturity, and the experience has brought us even closer.

I’ve had boyfriends in the past who weren’t the consoling kind (“I’ve never heard of Shy-Drager Syndrome — how bad could that be? Are you sure your dad has that?”), so I considered myself lucky to have a boyfriend who could watch me break down in tears and hold me sympathetically without making inappropriate comments or breaking down himself.

In a cruel twist of fate, I got a taste of the other side when a doctor diagnosed his mother with cancer less than a year after I lost my dad.

Being the shoulder is a lot harder than he made it look. There’s not much you can say that will make things better, though you’re tempted to try.

Both of us experienced anticipatory grief (me knowing my dad would never dance at my wedding or hold his grandchildren, him wondering when and how his mother might go).

But we expressed these sentiments differently. I needed to talk or cry at inopportune moments. He approached it from a more practical, scientific perspective.

According to Roberta Temes, a psychotherapist who specializes in grief counseling and the author of Solace: Finding Your way Through Grief and Learning to Live Again, this gender difference is pretty typical.

“Women will talk to girlfriends more,” Temes says. “The community of women is accustomed to talking. The community of men is accustomed to getting on with it.”

So, what do you say to your significant other when they lose (or know they could lose) a close friend or relative? And how do you help them regain their footing after the passing?

Everyone experiences grief differently, but here’s how to support your partner through grief by keeping a few things in mind.

1. Sometimes silence really is golden.

According to Temes, one of the worst things you can say is, “I know just how you feel.” As Temes explains, “Each heartache and heartbreak is unique; you really don’t know any but your own.”

Even if you’ve lost someone you love, you probably don’t know exactly what the loss means to them or how they will process it, so don’t assume that you do.

When in doubt, simply offering a hug and a willing ear can show that you’re there for the person. You don’t always have to say something comforting. 

2. Sometimes we need to talk, even if we’re just repeating ourselves.

“If it’s the beginning of mourning, they need to be left alone,” says Temes. “If a few weeks or months have passed, then they need to talk about the relationship. It is important for them to talk, often repeating the same stories. The more they speak of the moment of death, the sooner it becomes a reality to them.”

Temes suggests asking questions like these to open up the conversation: “How are you doing — is it difficult to sleep? Are you able to get back to work yet? Some people find it difficult to eat when they are mourning. Would you like to come over for dinner one night next week?”

3. Even if you didn’t know the person who died, we need you there.

Whether your partner just lost someone they care about or anticipates losing them, they need your support.

If you’re with someone whose parent is dying, and they ask you to go with them and visit that person, don’t say “no,” “let me think about it,” or “that’s too much of a commitment.” You’re there for your partner, not their relative.

If you don’t care about them enough to say yes, then a serious relationship isn’t for you.

My boyfriend felt a little out-of-place sitting with my immediate family at the funeral when he’d only met my dad twice. But my brother appreciated having him there so he could focus on comforting my mother, and I appreciated him making the effort, too.

4. Healing rituals can help.

“Rituals are terrific,” Temes says. “All religions have rituals. If you’re not religious, it’s still a great idea to establish a ritual, which can range from setting aside a particular time to go through a photo album to lighting a candle and saying your memories.”

5. Grief doesn’t follow deadlines.

“It is a long process,” according to Temes. “Those who are grieving will get back to themselves when they are ready, not when you invite them to a party or demand they pull themselves together.”

A month after my dad died, I thought I was feeling like myself again.

Then I saw a family huddled around their luggage at an airport, and it reminded me of all those vacations my dad loved to plan and how we’d never get to travel with him again. Or, I’d see an older man in a wheelchair and get a flashback to my dad’s last few months.

Grief can come in waves, but as time passes, mine has become more muted and less frequent.

While everyone’s healing process is different, Temes says that if a month or two as passed and your significant other cannot eat, sleep or function at work, or if they become obsessed with the deceased person, it’s time to get concerned.

She suggests you, “tell your partner you are worried about them and so you made an appointment with someone who knows more about bereavement than either of you.”

Complete Article HERE!

‘I Couldn’t Let Her Be Alone’

– A Peaceful Death Amid the COVID Scourge

Patti Breed-Rabitoy had coped with lung and kidney disease for years but remained a vital, bubbly presence in the lives of her husband, Dan Rabitoy, and three grown children.

By JoNel Aleccia

As her mother lay dying in a Southern California hospital in early May, Elishia Breed was home in Oregon, 800 miles away, separated not only by the distance, but also by the cruelty of the coronavirus.

Because of the pandemic, it wasn’t safe to visit her mom, Patti Breed-Rabitoy, who had entered a hospital alone, days earlier, with a high fever and other symptoms that were confirmed to be caused by COVID-19.

Breed-Rabitoy, 69, had suffered from lung and kidney disease for years but remained a vital, bubbly presence in the lives of her husband, Dan Rabitoy, and three grown children. She was a longtime church deacon and youth leader in Reseda, California, a fan of garage sales, bingo games and antique dolls. Then came COVID-19, likely contracted in late April following one of her thrice-weekly dialysis sessions. Now she lay sedated and on a ventilator, her life ebbing, with no family by her side.

“I had seen these things on TV and I would pray for those people and say, ‘I can’t imagine what they’re going through,’” said Breed, 44. “And now I was living it.”

A single mom of two young sons, she was wrenched with guilt at not being with her mother. “You always picture you’re going to be right by your parent’s side,” she said.

Unlike many families of dying COVID patients, Breed and her family were able to find some comfort in her mother’s final hours because of the 3 Wishes Project, a UCLA Health end-of-life program repurposed to meet the demands of the coronavirus crisis. In the U.S., where more than 120,000 people have died of COVID, it’s part of a wider push for palliative care during the pandemic.

At 5 p.m. on May 10, Mother’s Day, before Breed-Rabitoy’s life support was removed, more than a dozen family members from multiple cities and states gathered on a Zoom call to say goodbye. John Denver’s “Rocky Mountain High,” one of her soft-rock ’70s favorites, played on speakers. Online, a chaplain prayed.

Breed-Rabitoy had been deeply sedated for more than a week, since a terrible night when she struggled to breathe and asked doctors to place her on the ventilator. Confusion abounded, Breed said. Could her mom still hear in that state? Two nights in a row, Breed asked nurses to prop a phone near her mom’s ear.

“I prayed with her. I sang her favorite songs. I read her the Bible,” she said.

Finally, a nurse gently explained that her mother was too sick to recover. If they removed the ventilator, it would be to allow her to die.

That’s when hospital staffers described the 3 Wishes program and asked whether the family had any personal requests for her last moments. They decided on the music and the family Zoom call. Dan Rabitoy requested that a nurse hold his wife’s hand as she died.

After it was over, family members received keychains stamped with her fingerprint and a copy of the electrocardiogram of the last beats of her heart.

“I’m grateful to have these keepsakes,” Breed said. “All these things have been healing.”

The project was developed in Canada but co-launched at UCLA Health in 2017 by Dr. Thanh Neville, an intensive care physician who serves as 3 Wishes’ medical director. It aims to make the end of life more dignified and personalized by fulfilling small requests for dying patients and their families in the ICU.

Before COVID-19, the program had granted nearly 1,600 wishes for more than 450 patients, nearly all in person. The deathbed scenarios have varied, from music and aromatherapy at the bedside to meeting a patient’s request for one last mai tai cocktail.

“We’ve done weddings and mariachi bands and opera singers and 20 to 30 family members who could come in and celebrate,” said Neville, 41. “And none of this is possible anymore.”

COVID-19 has “changed everything,” said Neville, a researcher who focuses on improving ICU care for the dying. Also a clinician, she spent weeks this spring tending to seriously ill COVID patients. Since March, her hospital system has seen more than two dozen COVID deaths.

In the beginning, visitors were strictly prohibited. Now, some may come — but many don’t.

“I would still say the majority of COVID patients die without families at their bedside,” Neville said. “There are a lot of reasons why they can’t come in. Some are sick or old or they have small kids. A lot of people don’t want to take that risk and bring it home.”

It has been hard to keep 3 Wishes going during a time when in-person memorials and celebrations are banned and infection control remains the primary focus. Neville even had to change the way the fingerprint keychains were made. Now, they’re treated with germicidal irradiation, the same method that lets health care workers reuse N95 masks.

The 3 Wishes Project is offered when death is imminent: Patients are enrolled after a decision has been made to withdraw life-sustaining technology or if the chance of death is greater than 95%. The program was created to help patients, caregivers and clinicians navigate the dying process in a less clinical, more humane way. Wishes needn’t be limited to three, and they can be articulated by patients, family members or hospital staffers.

The program is based on palliative care tenets that focus on the humanity of the patient amid intensive medical care, said Dr. Rodney Tucker, president of the American Academy of Hospice and Palliative Medicine. Seemingly small acts that honor an individual life help counter the efficiency-driven environment of the ICU, which can be dehumanizing. They’re at the core of care that has been shown to ease both angst for the dying and grief for those who loved them. “It helps the family that’s left behind cope more successfully with the loss,” he said.

Such efforts also remind providers of the humanity of their practice, which can help them cope with the stress of witnessing death daily, especially during something as extraordinary as a pandemic, he said.

A study published by Neville and colleagues last year found that 3 Wishes is a “transferrable, affordable, sustainable program” that benefits patients, families, clinicians and their institutions. They calculated that the mean cost of a single wish, funded by grants and donations, was $5.19.

Genevieve Arriola, 36, has been a critical care nurse for eight years. When the pandemic struck, she found herself juggling medical care and emotional support more than ever. She took care of Breed-Rabitoy for three days straight, all the while communicating with the dying woman’s family.

“This was a very delicate situation for someone who is married to her for over 20 years and a daughter who was miles away in Oregon and couldn’t see her mom,” she said.

She was also the nurse who held Breed-Rabitoy’s hand as she died.

“I pretty much felt honored to be that person,” Arriola said. “I couldn’t let her be alone. If no one can be there, I can.”

Weeks after her mother’s death, Breed is grappling with the loss. The last time she saw her mom was March 16, at a McDonald’s off Interstate 5 near Grants Pass, Oregon.

The pair met for less than 30 minutes before Breed-Rabitoy headed south down the interstate, her long-planned family visit cut short by concerns about COVID. She had just learned that the local dialysis center was closed to outside patients, and she was worried about growing reports of infection and death. “She told me, ‘I feel like this disease is coming after me,’” Breed recalled.

Now, the keepsakes from 3 Wishes are placed where Breed can see them every day.

“It added such a level of love and dignity we weren’t expecting,” she said. “It made the process of losing a loved one to COVID-19 so much more bearable.”

Complete Article HERE!