Dr. El
Dr. El

In my last two columns, I’ve focused on a “big picture” view of eldercare. This week, I’m highlighting a way in which individuals can mend their mental health after an extremely difficult year, particularly for those of us in the field of long-term care.

Chances are that it’s been a tense, stressful, sad time both personally and professionally. One technique that psychotherapists recommend to process and release these feelings is to write about them.

Below, I draw comparisons between April 2020 and April 2021, using narrative to acknowledge both my experiences as an essential worker and the vast improvements in the situation since that time. 

Then: New York City, where I work, was the pandemic epicenter and almost completely shut down. Sirens filled the air at all hours of the day and night. New York nursing homes were mandated to take in residents with COVID-19.

Now: The city is coming back to life. Sirens have been replaced by the honking horns of commuters with late-pandemic irritability. Nursing homes have been mandated not to take in residents with COVID.

Then: The census was shockingly low. The fees for COVID residents were probably what was keeping many facilities afloat.

Now: The census is high again. The national trend of facilities being acquired by for-profit companies is probably what’s keeping many places afloat. 

Then: The residents were bereaved, bereft, traumatized. They desperately needed psychology services.

Now: The residents are more likely to be younger with psychiatric histories or to be older and more physically ill. They need more intensive mental health and physical care than the pre-pandemic cohort. 

Then: There was no such thing as testing for COVID in the nursing home. We worked clueless, frightened and vulnerable.

Now: Swab days are so routine that we’re doing self-serve preparation, picking up our test tubes, bags and forms and standing in our 6-feet apart lines to wait for testing. I still miss the nice swabber who came from the testing company later in the year. She was a kind, familiar, gentle, calming presence in the middle of the storm.

Then: Residents went to the hospital, never to return. Multiple staff members were out for weeks at a time. We walked around in a daze, barely recognizable under our PPE, attending to our charges.

Now: The residents are almost all fully vaccinated. A positive COVID test is a rarity for them and very unlikely for the staff, with most vaccinated or post-COVID and the New York City risk rate slowly declining. 

Then: Residents were isolated in their rooms. Family members were prohibited from visiting. I used my cell phone for tearful video calls with family members who hadn’t seen their loved ones since they left for the hospital with suspected COVID weeks before. In every room I entered, I felt like I was offering a thimbleful of solace, but from the greetings I got, I knew I was their kind, familiar, gentle, calming presence in the storm.

Now: Residents eat in the dining room and have rehab buddies again. Family video calls are a regular service provided by the recreation department. Friends and relatives set up appointments and can visit residents after testing protocols have been passed. I sneak peeks at them in the lobby, curious to see who they are but not wanting to steal a moment of their precious time together. 

Then: Sleep wasn’t really a thing. Saturday was Headache Day. I was a zombie presence at home, physically there but running on fumes.

Now: Sleep is much better. Saturday is errand day. I have energy left for my family after work.

Then: Hospital workers were celebrated while nursing home staff were ignored or disparaged. 

Now: There’s national recognition that the underfunded, piecemeal long-term care “system” desperately needs an overhaul in order to sustainably meet the needs of an aging population. 

This “then and now” exercise helped me recognize how much we’ve been through, how far we’ve come in a year’s time, and what survivors we are. Another writing method I found helpful in recent months was to make a list of good things that happened in 2020 in order to counteract my belief that it was an unredeemable year. 

In addition to the basics of adequate rest, good nutrition and exercise, writing in whatever form — free-flowing narrative, poem, song lyrics, letters to a friend, etc. — can be a way to revise the pandemic narrative and regain equilibrium. We’ll need this equilibrium and our strength to navigate the anticipated changes in the field.

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 EleanorFeldmanBarbera.com.