Over the next few weeks the HSE Psychology services for Galway, Mayo and Roscommon will be streamlining some key information for Boyletoday.com viewers based on the evidence of what works in similar circumstances. Our themes will be around building resilience, coping with cocooning, managing relationships, caring for those with disabilities and other vulnerabilities and sharing supports for those who are ill or bereaved. This week our theme is ‘Caring for Others and Coping with Bereavement during Covid-19 Restrictions’:
Caring for someone who is ill can take a significant emotional toll. This is heightened during Covid-19 as access to usual support systems is reduced due to restrictions. If you are caring for someone who is extremely ill, or if someone you love has died, the pandemic has meant that the support from the wider community is not available in the same way as before and this may be challenging. It may also be difficult to know how to best support children who have lost a loved one.
HSE Psychology colleagues Joanne Byrne, Orla Richardson, Padraig Collins, Diana Jordan, Deirdre Cleary, Gerardin Casey and Malie Coyne have put together information to help the public with caring for someone who is ill, managing loss and grieving, and how best to support bereaved children during this difficult time.
Caring for someone who is extremely ill
The opportunity to care for someone you love who is extremely ill can be a very meaningful experience. In these COVID times, without access to the people who would normally offer help and support to us, the physical and emotional demands that come with providing a high level of care to a loved one can be magnified. It is very normal to feel under strain at a time like this and it is normal to experience a range of both positive and negative feelings. If possible, try not to give yourself a hard time for some of the more difficult feelings you may experience.
It is normal to feel stressed, anxious, or overwhelmed in the face of ongoing uncertainty. Feelings provide us with valuable information and can lead to a positive response (e.g. anxiety about spreading the virus leading to following guidelines about hand washing). However, feelings that become overwhelming may no longer be helpful and may lead you to neglect your own needs. If you find yourself overwhelmed, it is an indicator that you may need to focus some care and attention on yourself.
As the saying goes, you need to “put on your own oxygen mask first before helping others”. When looking after yourself, it is a good idea to think about what has worked well for you in the past. You could also consider these ideas:
· Start with the basics: Our physical health is linked to our psychological health, so it is important to try to get enough rest and sleep, eat healthily, engage in physical activity, and avoid unhelpful coping strategies (e.g. excess alcohol). Start with whatever is manageable, whether that is getting to bed 10-minutes earlier, introducing gentle stretches or going for a short walk.
· Consider your supports: For many people, a regular connection with family and friends plays an important role in keeping emotionally balanced. It can be helpful to link with positive and supportive people in whatever ways are possible at this time – by phone, by email or social media. It is also important to respect your need for quiet, personal time on your own, if this is more helpful to you. Set boundaries, where needed, around any interactions that you find stressful.
Remember, the act of caring for someone who is ill comes with both rewards and challenges. Acknowledge your strengths and struggles. Be compassionate towards yourself and accept that you are doing the best that you can. Seek emotional and practical support if you feel that this would help by contacting services and agencies that are there to help you.
Grieving in exceptional times
A death in your family or in your circle of friends can be hugely difficult. You may feel shocked, upset, angry or frightened. You may find it difficult to process what has happened. Being bereaved can be one of the loneliest experiences you or someone you love will ever go through.
When we are bereaved, closeness and support from those we love may help us to cope. Unfortunately, during this time where remaining physically isolated from others is necessary, the physical distance can add to the grief and to a sense of feeling alone. Many people have concerns about what might happen at a funeral during restrictions. The traditional ways we mark our grief has changed. For the moment, it is not possible to come together and to gather in one location for a large funeral, as a maximum of 10 people from the bereaved household and immediate family are permitted at this phase of the lockdown.
Families might use technology to include a wider group of people. The Irish Hospice Foundation ‘Care & Inform Series’ have practical information around planning a meaningful funeral for your loved one at this time (see https://hospicefoundation.ie/bereavement-2-2/covid19-care-and-inform/).
In the days and weeks following a loss, there are important ways that you can support yourself and others in this situation:
· Look after yourself: Try to stick to a routine if at all possible. Prioritise your own need for rest. Try to get outdoors into nature. Eat regular meals. The structure will help, even if only a little. It may be a good idea to limit consumption of news and social media as when you are feeling sad, regular news can be overwhelming.
· Keep in contact with others if this is helpful to you: Some people find it useful to keep in contact with family and friends, others can find this overwhelming. If you find that people are not responding in a way that is helpful to you (which can be often due to fear or feeling helpless), you may consider contacting a helpline (see services listed at the end of this piece).
· Seek and offer practical help from others: Don’t be afraid to ask others for practical help as most people will be happy to do something useful for you (e.g. ask someone to manage phone calls if you need a break).
Some days may feel very difficult. You may also find you have days when you have more energy and the grief isn’t as consuming. Good and bad days are a normal part of grieving.
How you can help another person
You may have family or friends who have been bereaved and you may wish to support them. It is good to be aware that, at this time of uncertainty and fear, many people may struggle more than usual. Being present with someone you care about in their grief is one of the best gifts you can give them. It can be useful to directly ask someone how you can help them. In general, offering practical and emotional support, and staying in touch when needed, is welcomed.
Supporting Bereaved Children
The loss of a loved one can be a traumatic and confusing experience for children and young people, at any time. The current restrictions have meant that the comfort and support from the wider community is not available in the same way as before which is very difficult for many families. While each child will respond differently to a loss, all children can be supported to understand what has happened and to be helped to process their difficult feelings.
What to look out for: One important factor in how a child experiences loss is their age and stage of development. Although the understanding and emotional response to death can vary greatly among younger children and older adolescents, all children are capable of feeling the loss and can pick up on the grief of the family. Sometimes children show very little noticeable reaction and may process their feelings at a later time. It is not uncommon to notice disturbances in eating, sleeping, behaviour and play, and for children of all ages to experience a range of emotions that may come and go.
How to help:
· Provide honest age-appropriate information: Although this is something families can find challenging, it is important for the child that someone close to them tells them about the person who is going to die or has died. Ask questions about the child’s understanding of what has happened and respond in a gentle way. The instinct can be to use comforting metaphors (e.g., ‘they have gone to sleep’), but using clear and honest language is preferable (e.g., ‘their heart stopped beating and their body isn’t working anymore’). Answer the child’s questions honestly using words that they can understand. Reading a book on loss together, such as those recommended on websites below, can provide a way to make sense of this loss and associated feelings.
· Give your child time to talk to you, at their pace, now and in the future: Reassure them that they are not to blame and that it is okay for them to be upset. Share happy memories of the person who has died and let them know that it is still okay to have fun. Children will take your lead and open expressions of feelings such as ‘I feel sad today and I miss ….’ can help children to see that adults have feelings too and it is okay to express them.
· Help the child to work through their emotions in a non-judgemental way: Parents often face the challenging task of managing their own wide range of reactions to the loss while also trying to help their child to cope. Children’s behaviour often gives an indicator of underlying feelings (e.g., an unexpected angry outburst may actually be your child letting you know they need a hug). Accept their emotions without judgement or blame. Assure your child you’ll do your best to support them.
· Encourage children to engage with usual activities and interests: Because children thrive on predictability, where possible try to stick to regular routines. When restrictions are over, communicate with the school as returning to a familiar environment may bring up feelings your child needs support with.
Remember that there is no perfect way to cope with death and that grief follows a different path for each person. Being available to your children and allowing yourself room to grieve with compassion is the best way to way to support them through this difficult time.
Barnardos: Bereavement helpline service (01 473 2110, Mon – Thurs 10am to 12 pm) or Email: [email protected], or find resources on: https://www.barnardos.ie/resources/bereavement
Hospice Foundation: Care and Inform Hub – Information on matters relating to end-of-life and bereavement care Covid-19: https://hospicefoundation.ie/bereavement-2-2/covid19-care-and-inform/
Irish Childhood Bereavement Network: Supports for Helping Children and Teenagers to Grieve: https://www.childhoodbereavement.ie/
Rainbows: 01 473 4175. Supporting children with Bereavement. Email: [email protected] or https://www.rainbowsireland.ie/
com with David Kessler: an American writer and therapist who has written several books on grieving. He has a live Facebook group available daily at 1pm to help people worldwide during the pandemic.
https://bethany.ie/ Bethany is a voluntary community and parish based service which aims to support bereaved adults through the grieving process. Services are free of charge and confidential.
https://anamcara.ie/ Organisation that supports parents and families after the death of a son or daughter.
https://www.widow.ie/ Support network for people bereaved of a spouse or partner.
https://alittlelifetime.ie/ Foundation to give voice to bereaved parents and their families across Ireland and promote healthy grieving, understanding and hope when a baby dies at any stage of pregnancy.
Dr Susan Delaney has a number of informative video’s on YouTube and discusses grief and coping with loss.
Hospice Foundation: Resources on Supporting Carers: https://hospicefoundation.ie/supporting/supporting-carers/
Care Alliance Ireland: Guiding support for Family Carers:
Family Carers Ireland: Provide a variety of supports and services to family carers: https://familycarers.ie/