As professional Care Managers (Aging Life Care Professionals), when we take on clients we are 100% committed to them, their wellness, helping them to reach their goals, being there for them and their families through all their difficult times. It is not uncommon that we help our clients through the end of their lives, ensuring they have care and comfort, coordinating hospice care and supporting their families. It is an honor to do this work and we are accustomed to our clients passing. It is part of the work we do. Each of us deals with the loss of our clients differently. My process is to go to every funeral. I sit in the back and listen to all the wonderful stories about my clients in their younger years when I did not know them. I celebrate them, and then I tuck them away in my heart. This allows me to move forward and to be fully present for all my clients. This process of sharing rituals with my client’s families, whatever their faith may be, gives time and space to think about the individual and provides me with closure. This process has worked well for me over my decades of work with an older population.
In comes COVID-19. We are living through unprecedented times. I learn of my client’s fever. They are in a nursing home, and the nursing home is on lockdown. I cannot be there to orchestrate care and comfort, and suddenly they are gone. There is nothing I can do except to provide emotional support to the families. This is not typical. There is no ritual and there is no funeral but we continue on, doing what we can. I wake up at 5 am each day, lying in bed and wondering if I have done enough to get everyone ready for this pandemic. Is the plan in place good enough? Are the caregivers following the protocols for sanitizing? Will my client in an assisted living facility on lockdown continue to decline without structure and supports? What else should I be doing and fighting for?
There is no precedent for providing Care Management services under these circumstances. I have always been skilled in powering through difficult times. I am fully functional and my mood is as even as it always is. I have a positive attitude. But I have realized over the past few weeks, as this pandemic continues to rage through the nursing homes and assisted living communities where some of my clients reside, that deep in my heart the sadness is lurking and more difficult to ignore and push down. It is not uncommon that many of us who care for others do not do the best job caring for ourselves. So, I believe it’s time to make some changes and start practicing what I preach. Care Managers, health care workers of all types are very much at risk for burnout, depression and health problems. I plan to continue my good health. Here are some of the ways I have found to do so:
1) Let yourself grieve
These are not just “clients”. They are people who I knew, respected, laughed with, who trusted me and let me into their lives. They each had amazing stories and histories. I have started a memory book for each client I have lost. I’ve written in a journal the things I knew about them, their stories, their accomplishments etc. I reached out to each client’s family weeks after their passing to check in and reminisce with them. I have made donations to causes that mattered to them in their memory. I honor them, and allow myself to feel the sadness.
2) Peer groups
Every profession has some type of required peer supervision and case review, but I am incredibly fortunate to have a local peer group of other solo and small group practitioners. Before COVID-19 we met monthly for peer supervision and case conferencing. We cover for each other’s vacations. We know and trust each other’s high level of practice. Since COVID-19, we meet via Zoom weekly and offer support. There is no monetary value you could place on having this group of intelligent, caring and excellent practitioners in your life. We share resources, ideas, we laugh, we applaud success and more than ever, it is a place where we can honestly say how we are really doing. Find a peer group that lifts you up and allows you to give.
3) Healthy routines and habits
It’s so simple to say we should eat healthy, practice good sleep hygiene and exercise, but it’s often hard to do if you have not already been in that habit before COVID-19. It is hard to change habits when you are under a great deal of stress. I will tell myself I don’t have time for a walk; too much to do! I stay up late and get up early and feel tired. The to-do list grows, it’s difficult trying to take care of our clients through remote video calls, and I miss seeing them face to face. On top of all that, I’m trying to figure out how to properly manage the CARES Act programs, and other business challenges the pandemic has brought. How can I do it all?! I’ve started walking in nature again, which makes a world of difference in my frame of mind and shakes out some of the stiffness I feel from being on my computer all day or in my office instead of being out with my clients.
4) Seek help if you need it
We are the authors of this advice. We, as expert practitioners know that we can talk to professional therapists, and see specialists if needed. But just as a reminder, be mindful of the signs and symptoms of how stress and the pain around you is affecting you. Regenerate in the ways that feed you. Last week I was filled with gratitude when my young adult daughter set up an on-line yoga class for us. She put on calming music and lit a candle to set the mood. I could not lie on the floor and breathe. I could not focus well but my heart felt the love and caring of my family. When I surround myself with them and stay connected with people who matter in my life, I feel regenerated.
My new mantra is: “One step at a time.”
“One step at a time”. Reach out to your supports, whoever they are, and talk to them about what you are experiencing. As experts in this field we do our best and may not have all the answers in this monumental time of uncertainty. Accept that truth and breathe. Together, we will figure it out and no matter what, stand by one another and the clients and families we continue to serve.
About the Author: Joan Harris, LSW, MBA, CMC, Founder and Managing Partner of Symphony Care Management, LLC , a full-service Care Management and Life Planning Company. Respected by her peers, she served as 2018 President of the Aging Life Care Association New England Chapter. She continues to be involved in leadership serving on the Executive Board as Past President. This blog post also appears in the Symphony Blog.