The coronavirus was officially declared a pandemic one year ago this month. The news is filled with articles reflecting on the dramatic changes in our lives from last year to this — lost jobs, remote school, canceled events, illness. 

For those in long-term care, this week last year began the pandemic visitor restrictions, and for many East Coasters, it was the point when COVID-19 hit facilities like a tsunami. One week everything was fine and the next it was a catastrophe. 

While the timing of your nursing home’s “tsunami” might be different, it’s likely that there’s an upcoming anniversary on the horizon. The one-year mark of this disaster may bring up disturbing feelings in staff known as an “anniversary reaction.”

The National Center for PTSD (post traumatic stress disorder) describes an anniversary reaction as “an increase in distressing memories of the event … that can range from feeling mildly upset for a day or two to a more extreme reaction in which an individual experiences significant psychiatric or medical symptoms.”

In addition to the date acting as a reminder, other signals can surface — holidays, first anniversaries of painful losses and even news articles. 

For instance, some workers might find triggering this weekend’s scathing New York Times piece on the ineffectiveness of the five-star rating system, “Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public.” While we can all agree that the rating system should be an accurate reflection of the care provided, the tone of the article, which describes the “horrors” of nursing homes, is reminiscent of news coverage long-term care received early in the pandemic, when hospital staff were considered applause-worthy heroes and LTC staff were perceived as thoroughly failing elders, their own heroic efforts disregarded.

Whatever the specific reminders of a painful time, it can be helpful to anticipate that an anniversary reaction might occur. Recognizing the source of feelings or symptoms can make it easier to deal with them.

Organizational response

Organizations can offer various types of support for their teams, especially since this was an on-the-job stressor faced together by team members and they will be experiencing the anniversary simultaneously.

Managers could mention the possibility of an anniversary reaction in meetings and ask staff to be aware and to look out for each other. A copy of this article could be distributed as a way to broach the topic.

The one-year mark might be a moment for your facility to memorialize those who were lost during the pandemic, something we didn’t have time for while grappling with the emergency. 

A ceremony, a moment of silence or the unveiling of a memorial are all possible ways to recognize the loss, depending on the norms and wishes of your organization. The recognition could be followed by an expression of appreciation of the efforts of staff, with perhaps flowers sent to nursing stations, a special song played on the overhead system or some other tribute.

Residents, too, can benefit from acknowledging those who died during the pandemic. Many of them lost peers at the facility or are aware that had the timing of their admission been different, they might not have survived COVID-19. A memorial to those that passed reassures them that their own eventual demise will be recognized.  

Individual coping

This week is my “tsunami week,” and I found myself having Big Feelings this weekend about things that warranted “big feelings” or maybe even just “feelings.” I used the tools of journaling, meditation, prayer, discussion with a trusted friend and redirection towards a positive activity (cooking) to reestablish my equilibrium.

I arrived at work and barely made it to my office before encountering the Big Feelings of other staff members about issues that on the surface weren’t pandemic-related. 

I suspect that almost everyone in the field is grappling with unresolved grief over the impact of COVID-19 in nursing homes.

Thankfully, one year later, the vast majority of residents have been vaccinated and the doors of facilities are once again open to visitors. 

My “tsunami week” might be difficult emotionally, but I followed my own advice, decided against the temporary numbing of a warm beverage filled with caffeine and sugar, and instead bought a flowering plant for my office as a remembrance of those we lost. Appropriately, I chose a peace lily.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her at