Planning for death during a pandemic

By Dr. Ramy Salah

As a palliative care doctor, it is my job to sit with patients and imagine death, the distant reality that we would rather ignore. After warning a heavy conversation is forthcoming, I ask, “Have you thought about how you would want your care to look like if time were short?” The responses to questions about end-of-life care are as varied as they are familiar. “Keep me comfortable.” “I don’t want to be a burden to my children.” “If I can’t recognize my wife, let me go Doc.” Through statements like these, I learn which treatments are most appropriate for my patients on a personal level. It is my goal, after all, to make sure the care that my patients receive matches the care that they would want.

Palliative care focuses on quality of life for patients dealing with serious illness. Therefore, these conversations have become second nature to me. As precise as a surgeon is with her scalpel, I tactfully employ a combination of words and silence to explore my patients’ thoughts about transitions from health to illness, from home to hospital, from life to death. I temper my approach delicately over several visits — as the maxim reads, “Death, like the sun, cannot be looked at steadily.” This is possible with conditions such as cancer or dementia, where life expectancy can be months or even years. During the time of COVID-19, however, we may not have that sort of time.

In the last month, we have been inundated with medical information — I, for one, have tried to decipher more graphs than I would have cared to in a lifetime. From presidential press conferences to cable news to twitter feeds, we eagerly listen for the evidence to make sense of the pandemic. What are the latest numbers of cases and deaths? Which experimental treatments among the antimalarials, antivirals, antibiotics and antibodies seem promising? What are the ethical considerations on rationing ventilators in a national shortage? I am elated that medical professionals have become the loudest voices in the media, however there hasn’t been encouragement for discussions like the ones I have with my patients.

Advance care planning, or better read as “planning for your care in advance,” is generally thought of as a good idea. Though 82% of people say that documenting their wishes regarding end-of-life care is important, only 27% have completed advance directives. My patients are also reluctant to talk about death, but I have seen how much harder it is to have these discussions when they’re critically ill. I say, “In a health crisis you have to process your emotions before making medical decisions. Or you can make those decisions now before things get too emotional.” Studies show that the latter makes for a much smoother process for the patient, their loved ones and their care teams.

So, where do you start? There are three steps in advance care planning:

1). Reflection: Ask yourself — What makes life worth living? What quality of life would be unacceptable for me? There is no shortage of resources to help begin the process, including PREPARE, Go Wish, and The Conversation Project.

2). Conversation: This is the hardest step in the process, and the most crucial. This exercise is useless if you do not share your values and beliefs with those who will be involved in your care if you get sick. This includes your loved ones and your doctors.

3). Documentation: I urge readers to become familiar with two documents: 1). The Advance Directive (AD); and 2). The Physician Orders for Life-Sustaining Treatment (POLST) form. The AD names a durable power of attorney who will make decisions on your behalf if you are unable. It will also direct those involved in your care how to treat you if time were short. The pink POLST form mainly addresses resuscitation — if you were found pulseless, would you want medical personnel to carry out CPR or allow a natural death? I argue that everyone should have an AD, regardless of age or health status. Everyone with a serious medical condition, especially if they reside in a nursing home, should complete a POLST with their doctor.

In the age of coronavirus, I’m sure you, like me, have vacillated between hope and fear. Maybe you shrugged it off as unfounded mass hysteria one day and envisioned doomsday scenarios the next. Regardless, you must translate your energy into positive action. As grateful as I am to you for staying home, practicing good hand hygiene and donating protective equipment to hospitals, I urge you to begin the tough conversations and advance care planning with your loved ones. After all, it’s always too early until it’s too late.

Complete Article HERE!

Anticipatory Grief Is Real,

And It’s Okay to Feel it During the Coronavirus Crisis

By

I keep having nightmares about going to Target. In these dreams, I walk through the aisles of one of my favorite places, enjoying a Saturday shop. Suddenly, as people brush by me or stand close in line, I realize my grave mistake: I’ve ventured out into a pandemic, and I’m surrounded by potentially infected people. Panic sets in. Anger at myself for somehow forgetting this new reality. Then I wake up feeling sad. I know I can’t go to Target, and I miss it. Once I can go back, will I be afraid, like in my dreams?

This is one of many minor things I mourn about our new way of life. As COVID-19 sickens thousands across the country and the world, the future we’ve all depended on is no longer a foregone conclusion, and it’s really, really sad.

Harvard Business Review named grief as the “discomfort” so many of us are experiencing, and that’s exactly true. I’ve cried for days on end, thinking about the things I thought I’d be doing. Worse, I cry when I imagine people in the near future I had neatly mapped out getting snatched away by an unrelenting illness. I grieve for those who are sick and dying, but I also grieve for my loss of autonomy, trips I’ve canceled, lost hours in the sun, and for the ideas I had about my future life that seem less tangible by the day.

I know I’m not alone. College and high school graduations won’t happen this year, leaving young people who are looking forward to a new chapter of their lives floundering. Many will miss out on prom, a pivotal coming-of-age moment for some. The going-away parties, weddings, birthdays — they’re all canceled.

Right now it seems trivial to mourn the absence of your college graduation ceremony or a school dance because of the coronavirus pandemic, particularly as dead bodies overwhelm hospital morgues. It is kind of trivial. And it’s true that it’s better to miss a milestone if it means saving lives.

But as our lives are torn apart, rendered unrecognizable by social isolation and coronavirus cancellations, it’s only human to mourn the life you thought you’d have.

“Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday,” David Kessler, grief expert and author, told Harvard Business Review. “Anticipatory grief is also more broadly imagined futures. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. We are grieving on a micro and a macro level.”

It can also feel confusing because grieving a lost shopping trip, or even something bigger like a graduation, feels selfish. How can I feel bad for myself when I still have my life and, so far, my health? Ashley Ertel, LCSW, BCD with Talkspace, says ranking grief isn’t helpful.

“You may even be feeling guilty for being sad about missing out when other people are facing sickness and death,” she tells Teen Vogue. “I hope to encourage you by saying that grief comes in all shapes and sizes, and it is normal to feel all sorts of emotions when your reality does not match up with your expectations. Each of our emotional experiences is valid. We don’t compare our levels of joy, and we need to stay away from comparing our feelings of sadness. Sad is sad.”

Sad is, in fact, sad. Of course, no one would compare the grief of missing prom to that of losing a loved one, or even having and recovering from COVID-19. Everyone knows it’s not the same. Still, we feel sad, especially when the celebrations and rituals that “provide special meaning [in] our lives” are taken away, as Ertel puts it. Rather than push our feelings of grief and sadness away, Ertel recommends we allow ourselves to feel it. Acknowledge and honor your feelings, she says; then try to live in the current moment.

In this moment, I feel sad that I can’t go to my favorite restaurant on Fridays like I normally do. I feel sad that I might have to cancel my bachelorette party. I feel sad that this was supposed to be a happy, busy time in my life and it’s now marked by death and daily feelings of despair.

I also feel sad that people are sick. I worry about myself, my friends, and my family. I feel sad that people are dying, and I feel sad for their families. I feel sad that, when this is all over, we won’t know what’s normal and won’t feel familiar with the world around us. I feel sad that, more than ever, I don’t know what the future holds.

But I also feel excited for the dinner I’ll eat tonight. I feel thankful for my comfortable couch and my two adorable cats. I feel like I should brush my teeth. I feel grateful I have food in my fridge and a secure place to weather this storm. I also occasionally feel thankful for this big slowdown, for the canceled plans and postponed events. The mundane joys and discomforts of life are still here, amid all of this. Now, more than ever, I am reminded that there are things to be hopeful for, like the future trips to Target I know I’ll take. And I have hope that they will be happy, like they were before.

Until then, I think I’ll be sad — and that’s okay.

Complete Article HERE!

It’s Time to Talk About Death

The coronavirus pandemic highlights how much we need to have conversations about end-of-life care.

By Sunita Puri, M.D.

Joseph, a man in his 70s, has been on a ventilator for two weeks. His heart, lungs and kidneys are failing. Though I know these facts about his physiology, I will never see him up close. I can only glance at him through clear glass doors, the ventilator and dialysis machine obscuring his face. The coronavirus has limited the number of physicians who can enter his room.

I cannot sit with Joseph’s wife and children to ask what sort of medical care he would want. I cannot read their body language, lean in toward them or offer a tissue as they cry. Now, because of the coronavirus, most hospitals don’t allow families to visit.

Instead, I met Joseph’s wife and children on a Zoom conference call.

“I want to apologize to you for being a face on a screen,” I began. “I wish we could talk about this in person.”

They nodded together, their eyebrows furrowed.

“I wish that I had better news to share,” I said. “Unfortunately, despite our very best efforts to support Joseph’s heart, lungs and kidneys, his body is showing us that he is getting sicker.” I watched, disembodied from a distance, as they hugged each other and cried.

His wife told me that Joseph had never talked with her about what he would want in this sort of situation. “I don’t know what he would say,” she said. “We didn’t think this would ever happen.”

Americans are not good at talking about death. But we need to be prepared for when, not if, illness will strike. The coronavirus is accelerating this need.

In Italy, doctors have had to make excruciating decisions about which patients receive ventilators, which are in short supply. In the United States, we are already facing shortages of life-sustaining therapies; doctors will need to make these same difficult decisions.

Our collective silence about death, suffering and mortality places a tremendous burden on the people we love, and on the doctors and nurses navigating these conversations. We should not be discussing our loved one’s wishes for the first time when they are in an I.C.U. bed, voiceless and pinned in place by machines and tubes.

Talking about death is ultimately talking about life — about who and what matters to us, and how we can live well even when we are dying. Rather than being motivated by fear and anxiety, we can open these discussions from a place of care and concern.

Here’s how I opened a conversation about death with my own parents earlier this month: “Mama, Daddy, seeing a lot of people getting really sick with the coronavirus made me think of both of you. None of us knows what’s around the corner, and I want to be sure I know what you would want for yourselves when you get really sick,” I told them. “I want to be your voice so that I can make decisions for you, not for myself.”

“If I needed a ventilator for a short time, or dialysis, that would be OK, but I would only want treatments that would help me stay independent,” my mother replied.

My father nodded in agreement. “My main hope is to be with all of you. If I will lose my ability to be myself, if my mind will never be clear, please just let God take me,” my father told me, stirring his tea.

Though it is a daunting task, talking about death offers opportunities for grace and connection with our loved ones. Last summer, I watched as a patient’s brother told her for the first time how much he loved her, just before she told him she was choosing hospice instead of a clinical trial. In the fall, I walked the wife of a patient into her husband’s hospital room, where they renewed their wedding vows amid cake, balloons and glittery confetti.

“This was what she always wanted,” he told me when we discussed what was most important to him. “I put it off for so long, but I have to do it before I die.”

Working in the hospital with patients suffering from the coronavirus made me ask myself the questions I hope you will ask yourselves and the people you love:

  • What is most important to me in my life? (My family and pets, and the ability to write and doctor).
  • What makes my life meaningful? (My work; dancing; being outdoors; being with my loved ones).
  • What sort of quality of life would be unacceptable to me? (Being permanently bed-bound or neurologically devastated; indignity and suffering; depending on others for personal care).
  • Who is best positioned to speak on my behalf? (My brother).
  • Who would I not want involved in decision making? (Family living abroad).
  • Would I want to undergo C.P.R. should my heart stop? (Only if the issue leading to the cardiac arrest is reversible. If my heart stopped even when I was being sustained on life support machines or dying from an incurable disease, then I’d prefer to die peacefully rather than with C.P.R.).
  • What would bring me comfort if I were hospitalized? (Pictures of my family; music I love playing in my room; prayer).

This is by no means an exhaustive list of questions. The Conversation Project offers many more, as well as guidance on how and when to begin these conversations. The Serious Illness Conversation Guide gives health care providers a road map of when and how to start asking patients about dying. Both resources offer the compassionate, incisive — and often unfamiliar — language required for us to ask the right questions and empower our loved ones to share specific, honest answers.

Confronting our fears about death — having a conversation about it in frank terms — can be alternately terrifying and tender. Yet knowing how to honor our loved ones’ wishes when they can’t speak for themselves is one of the bravest and most loving things we can do.

Complete Article HERE!

Physician Aid in Dying Used Mostly by White Patients

By Roxanne Nelson, RN, BSN

In the United States, medical aid in dying (MAID) is used mostly by white patients, even after states with more racially and ethnically diverse populations legalized the practice.

Pondering why this is the case were speakers here at the National Clinicians Conference on Medical Aid in Dying (NCCMAID) 2020 during a session on ethnic and cultural considerations in aid in dying.

Factors such as culture and religious beliefs may play a role in preventing some individuals from considering this option, but a 2019 survey from the California Health Care Foundation found that there was support for MAID among African Americans.

“When asked if race and ethnicity prevented you from getting the services and healthcare you needed, 43% of black respondents said yes, that it has happened to them,” said Thalia DeWolf, RN, CHPN, clinical coordinator, Bay Area End of Life Options, Berkeley, California.

“But when asked if they would support the right to die when terminally ill, 70% of blacks and 82% of whites said yes,” said DeWolf.

“This is surprising, since it is almost at the level of the general population, and given the unequal access to medical care and unequal outcomes, they still believe that medical aid in dying should be legal,” she continued.

“We don’t bring this up to suggest complacency, but it brings up some interesting conversation to be had,” she added.

A recent study found that in Oregon and Washington, the two states where the practice has been legal for the longest period, most patients were non-Hispanic white individuals with some level of college education (JAMA Netw Open. 2019;2:e198648.)

In 2016, MAID became legal in California, a state with a much larger and far more diverse population compared to Oregon and Washington. Even so, about 88% of people who use California’s physician-assisted death law are white, according to 2018 data from the California Department of Public Health.

Speaking to Patients

There is an overall lack of participation by black patients in all programs related to end-of-life care, noted Tracey Bush, MSW, LCSW, regional practice leader, End of Life Option Act Program, Kaiser Permanente, Southern California.

“This includes aid in dying, and we consider this lack to be a healthcare disparity,” she said.

“We would be remiss to look at the disparities and participation in these programs without thinking about the disparities in the rest of our healthcare system,” she explained. “We need to think about where the line can be drawn between education, empowerment, and recruitment,” she explained.

From a programmatic perspective, she pointed out, information, pamphlets, and staffing are designed in a way that couches the MAID decision as individualistic, but not all patients have this point of view.

“My argument is that this population doesn’t really view medical decision making in that manner,” she said. “So are we designing our materials and having conversations in a way that really speaks to these patients?”

She also emphasized the need for a diverse care team across the board with regard to ideas, perspectives, cultural beliefs, gender, and ethnicity.

Complete Article HERE!

Deciding who lives and who dies

By Dr. Morhaf Al Achkar

I could soon be the physician following a policy that determines who would be denied medical care. At the same time, I could be one of those forbidden care if I needed it.

Medical leaders in Washington state quietly debated a plan to decide who gets care when hospitals fill up. Not many details are out, but the arguments echo a similar discussion in Italy, where an intensive-care unit protocol withheld life-saving care from certain people. The rejected were those older than 80 or who had a Charlson comorbidity index of 5 or more. With my diagnosis of stage IV lung cancer, I score a 6!

When I read the news, I was morally troubled, enraged and mortified.

I am in the same boat as many colleagues who have health issues or are older and could be asked to return from retirement or work accommodation to help out. Are we asking individuals to risk their lives, but will refuse them treatment if they get sick?

I am not familiar with empirical, objective evidence to support setting a threshold for who should or should not receive care as a way to improve outcomes for a community. Research to answer such an empirical question would have been unethical to start with. Using such a strategy also misuses predictive tools.

Age or the Charlson comorbidity index can help give an estimate of prognosis. But they cannot tell us how an individual person would fare in response to treatment for COVID-19. And if we want to decide who receives care, how can we forget about functional status, quality of life, and the person’s values and preferences?

Besides, the risk of eroding people’s trust is intolerable. The last thing we want is for people to lose confidence that they will be treated fairly just because of their health conditions or age. Do we intend to make such policies available to the public, or do we keep them secret so only people with privilege will know about them?

This is not the story we want to leave for history. And who said that an order from a health authority takes the moral burden off your shoulders? Have we forgiven the doctors in Nazi Germany who experimented with vulnerable patients? We humans carry moral responsibility for our actions. If anything, blindly following an unjust order doubles the burden. Worse than doing what is unjust is not standing up to advocate for the vulnerable. What will be remembered is that we pacified our consciences with a piece of paper we called a “policy.”

We can do better.

Restricting people from accessing care is not the only strategy. We can continue to shift resources to optimize the work. For example, a generalist can lighten the load for the specialist. A well-trained practitioner can supervise a less-trained one. Since the epidemic is not hitting every U.S. city with the same intensity, sick people can be moved around.

If we think we cannot save everyone, let’s invite people to have conversations about death and dying. Patients and their primary-care doctors should discuss advanced directives. The patient can sign a do not resuscitate order. People could even embrace death with dignity if they live in a state that allows it.

I can make the choice to not live and forfeit my right to care. But that right cannot be taken from me. Age or health conditions cannot alter a person’s entitlement.

We can trust doctors’ abilities to make the right moral decision, and we can give them the authority and support in so doing. In today’s hyper-complex context, medical doctors should be competent to manage, case-by-case and situation-by-situation.

Yes, it will be a difficult time. When a decision has to be made between two lives, we regret having to make the decision, and we express our deep sadness. We should not make such unfortunate decisions a norm, and we should not write a policy to make it OK. It is not OK, and it will never be.

The healthcare system has a terrible track record of failing various marginalized groups. But we do have a good track record of providing exceptional care to people. Let’s take the opportunity to do it right this time and not miss our chance, because if the public perceives a failure on our part, their trust will take decades to regain.

Complete Article HERE!

Why You Should Request an Extra Layer of Support When Living with a Serious Illness

By Andrew Esch, MD

Did you know that most large hospitals in the U.S. have a specialized medical team that uniquely cares for people living with serious illnesses? If you or a loved one has any type of cancer, heart or kidney disease, dementia/Alzheimer’s disease, or any other serious illness, you should know about this extra layer of medical support. It’s called palliative care and focuses on relieving symptoms and stress that so often come with these kinds of illnesses.

The goal of palliative care (pronounced pal-lee-uh-tiv) is to improve quality of life for both the patient and the family. Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Experts in Symptom Management, Care Coordination and More

Your palliative care team has expert training in managing symptoms and treatment side effects. Palliative care teams help patients and families in many ways, like avoiding unwanted and unnecessary trips to the hospital.

In addition, they will make sure you have the support you need to make informed decisions about your care. Having a serious illness often means having many doctors. Your palliative care team will make sure that you, your family, and your doctors are all on the same page. They will take the time to get to know you, help you plan goals for your treatment, and coordinate with your other doctors to match your treatment options to your goals.

Palliative Care is Available in Many Settings and Most Hospitals

As of 2019, more than 70% of hospitals (with 50 or more beds) in the U.S. have a palliative care team to help people living with a serious illness. And when people receive palliative care during hospital stays, they spend fewer days in the intensive care unit, have less pain, and are happier with the care that they receive. They may also be less likely to end up back in the hospital. Palliative care is also becoming more available outside of the hospital, in clinics and at home.

What This Means for You

If you or a family member are living with a serious illness, ask your doctor for a palliative care referral as early as possible. To find out which hospitals or clinics provide palliative care where you live, search this Palliative Care Provider Directory.

To learn more about palliative care, visit GetPalliativeCare.org, an online resource with clear, comprehensive palliative care information for people living with a serious illness. The site is provided by the Center to Advance Palliative Care (CAPC).

Complete Article HERE!

Offering Sympathy From a Distance in the Time of Coronavirus

When a friend is grieving a loss, here are ways to provide support

By Margie Zable Fisher

When my good friend, Nikki, told me a few days ago that her father had just passed away from natural causes, my first reaction was to offer sympathy. Then I asked, “What are the funeral arrangements?”

Her answer: “I’m not sure. We will have a memorial service, but we don’t know when. This pandemic is kind of getting in the way.”

Well, yes, it is.

Nikki and I are part of a group of friends who met playing tennis over 20 years ago. We’ve celebrated and helped each other over the years, through marriages, births, divorces and deaths.

But after Nikki’s response, I was stumped. How was I going to support her through the grieving process, when there was no memorial and when we were all supposed to be practicing “social distancing?” I reached out to experts to get some ideas.

The New Rules of Gathering

David Kessler, a Los Angeles-based authority on grief and founder of Grief.com, is in a similar situation. Someone he knows recently died. “This is a strange new world of grief,” he says. “If we can’t gather for a funeral, mourning gets very complicated.”

In the blink of an eye, the world’s burial rituals — which have traditionally helped people through the grieving process — have changed. Italy has banned traditional funeral services. Countries around the world (including the U.S.) have suggested limits on the amount of people attending services.

People over 60 may have the toughest time attending funerals of family members or friends. The U.S. Centers for Disease Control and Prevention (CDC) has recommended that those at a serious risk of COVID-19 avoid gatherings of 10 or more, and older people are at highest risk. Some funeral directors, including Virginia Kerr Zoller, co-owner of Kerr Brothers Funeral Homes in Lexington, Ky., are already suggesting that people’s older relatives stay home, according to a recent article in the Lexington Herald-Leader.

James Olson, funeral director of Olson Funeral Home and Cremation Service in Sheboygan, Wis., and a spokesperson for the National Funeral Directors Association, notes that Wisconsin’s governor declared that no gathering be larger than 10 people. This seems to be the most common suggestion around the country. But, as Olson notes, this could change daily or even hourly.

Matt Levinson, president of Sol Levinson and Bros. Funeral Home, serving the Jewish community in Baltimore, says they are still conducting burials quickly (as commanded by Jewish law), but are recommending that only the immediate family of 10 people or less attend. The funeral home is also offering the option to conduct the memorial service at a later date.

Levinson and his team are offering comfort the best way they can during this time — by alleviating some of the worry of gathering.

“Funeral arrangements are made over the phone, chairs are continually sanitized and spaced farther apart at the cemetery, and gloves are used for people who want to use a shovel to place earth in the grave,” he says.

Levinson also notes that he is working hard to keep his staff healthy. He has them working in shifts, not only to protect them from infection, but also to give them time off to handle the daily demands of this crisis.

One thing that hasn’t changed: informing friends and family about a recent death through phone calls, texts, newspaper obituaries and in Facebook posts. What’s missing are funeral arrangements, and details about gatherings such as shivas, where, in the Jewish tradition, loved ones and friends get together at a home for a week after the burial to support the family of the deceased.

Phone Calls Are Important

So if we can’t mourn together in person, how do we offer comfort?

“We aren’t able to hug, and physically connect, so we need to rely on using our words,” says Kendall Kridner-Protzmann, a pastor of congregational care at St. Andrew United Methodist Church in Highlands Ranch, Colo.

Kridner-Protzmann suggests calling mourners frequently. “Reach out through phone calls, and leave a message if necessary. Even just saying ‘This is really hard,’ is very healing.”

“When you can’t be physically present with a grieving loved one, you can still offer your emotional presence,” says Kelila Johnson, founder of Communing with Grief in Seattle. “There is solace in sitting quietly with someone, even if it’s over the phone or a video call. Often what grievers need most is to know that they don’t have to speak but that they are safe to speak, if they wish.”

Kessler suggests that in the first week after someone has passed, check in with loved ones multiple times. “If the person is in tears for an hour, you probably need to call daily,” he says. “If the mourner says that things are okay, you can probably check back in a couple of days.” He also strongly recommends calling instead of texting, and using FaceTime or Skype, to create a visual connection.

Technology Can Help

When you can’t gather in person, technology offers opportunities to comfort:

  • As mentioned, video calls are a great way to deepen your connection beyond audio.
  • Live streaming, which has been available for long-distance loved ones to view funeral services for many years, is now a necessity.
  • Social media is also helpful. “I’m usually not a big fan of Facebook,” says my friend Nikki. “My sister suggested we announce my dad’s passing on it, and I was floored by the comments we received.” Not only did Nikki receive hundreds of condolences, but she also heard from people from her childhood who shared stories about her father. “It was the greatest thing to hear from so many people. It really made me feel better,” she says.

Other Ways to Show You Care — In Person

I also learned four creative ways to get out and about to support those who are grieving.

Visit the grave. Just because you weren’t able to go to the burial, that doesn’t mean that you can’t go to the cemetery. “Any time after the burial, and while cemeteries are still open, you can go to the gravesite on your own, or at a distance from others, and pay your respects,” says Olson. Letting loved ones know you did this can offer comfort.

Bring food. “When you go food shopping, buy a bag of fruit for your friend, and drop it off,” says Kessler. “You don’t even need to go in the house.” Does your friend have a favorite restaurant? Order takeout, and deliver it.

Walk together — at a distance. Exercise is important to our mental and physical help at any time, but especially when grieving. “If you live nearby, offer to go for a walk with your friend,” suggests Dave Wyner, psychotherapist and certified grief counseling specialist in Louisville, Colo. “Make sure to follow health experts’ advice on keeping your distance. It might feel a little weird to walk that far apart from each other, but it can still feel incredibly supportive to the person grieving. It really comes down to helping them know they’re not alone with their pain.”

Volunteer. Obituaries often list charities you can donate to in someone’s honor. “Why not volunteer for that charity, by helping them out in person?” suggests Olson. He gives an example of The Humane Society. Instead of donating money (or in addition to it), you could offer to walk dogs, in the name of the deceased, he says. This is needed all the time, but now, it may be especially helpful.

How I’m Helping My Friend

Now that I’ve learned how to provide solace and love to those grieving during the pandemic, I’m planning to reach out to Nikki more often by phone. I will give her space to talk and I will listen.

I’m also going to offer to take a walk or a bike ride together (at a distance, of course). And I’m going to ask her what type of meal she and her family would like me to deliver.

The bottom line: We’re all struggling during this health crisis, but people mourning the deaths of their loved ones really need our support. While you may not be able to offer comfort through traditional grieving rituals, I hope these suggestions can help in a time when it is so needed.

Complete Article HERE!