Showing posts with label Grief. Show all posts
Showing posts with label Grief. Show all posts
Thursday, April 16, 2020
Three Wishes for post- COVID-19 health care - article
John A. Hovanesian, MD, FACS, focuses his blog on new technologies and innovations and how ophthalmic practices can best incorporate them to benefit patients. BLOG: Three wishes for post-COVID-19 health care April 14, 2020 So many frustrating unknowns surround us in this health care crisis. Whether we are a doctor or a staff member, an industry employee or a researcher, at this writing we have no real idea how much our loved ones might suffer, when we will return to work and how government subsidies will help us support our families and our employees. But like those who lived through the Great Depression, we are quickly learning lessons in resilience that will color the rest of our lives. Without knowing the rest of this story, I do know what I wish for in the post-COVID-19 world: COVID-19 is impacting health care professionals’ information needs COVID-19: Limited health care access further divides ‘haves’ from ‘have-nots’ AHA updates CPR guidelines to address patients with COVID-19 Leaner, more efficient practices and drug/device makers and a quick economic recovery. Buoyed by patients with pent-up demand for our services combined with workforce streamlining from natural attrition, we will all perform with the bare necessities. We will work harder and longer. This summer, if we are back to work by then, will bring few vacations, but in the wake of the worst financial impact of our professional lives, practices and suppliers of drugs and devices will spring back quickly to health. And to think just a few months ago we were worried about reductions in reimbursement. Those will still be a challenge, but we have overcome so much more. Virtual care will be here to stay. By the time this issue of Ocular Surgery News reaches mailboxes, most of our colleagues will have tried telemedicine to perform some level of service for patients. Most of us who have already tried have become quite pleased with how much good doctoring can be done, even without our diagnostic instruments. The world will know that patients deserve to see our faces and hear our reassuring voices without leaving home. Elimination of COVID-19 will not eliminate the viability of virtual care but enhance its possibilities. Smart industry players will bring us better tools that integrate better with our EHR systems, automate billing and allow solid documentation of services performed. We will all learn the meaning of quality time. Having our schedules cleared is now giving us more time with loved ones, more time with pets, more time for exercise and more time for personal reflection. We will become closer to family and friends who are farther away. We will understand that a full schedule does not mean a full life and that we don’t need to be “the richest guy in the graveyard.” Travel will still be exciting, but so will be looking out the window, enjoying a warm drink. We will be able to laugh at adversity we can’t control and help neighbors through the difficulties that we can. We will return to work with the right priorities, a clearer sense of purpose and a kinder approach to our patients and staff, whom we will appreciate more than ever. The outcome of many of these wishes we can’t control, but the measure of our wisdom may lie in how we use this time to shape the quality of our future. We can be simply reactive, reading and getting absorbed in the news, or we can be proactive, using our downtime to recalibrate our life compass. Whatever your wishes for the post-COVID-19 world, I hope you too are doing what you can to make them come true.
Wednesday, April 15, 2020
Thursday, April 9, 2020
Grief is the Response to loss of something meaningful - from the Centre for Complicated Grief
From the following article:
https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/
"Grief is the response to loss of something meaningful Grief is the natural response to losing a loved one. Most people don’t need grief therapists, even when the loss is sudden and unexpected and very, very sad. People have natural ways of adapting to attachment loss, usually with the support of friends and relatives, and everyone does it in their own way. You can think of healing after loss as analogous to healing after a physical wound. The loss, like the injury, triggers a pain response which can be very strong. Injuries also activate a healing process. Loss does too. However, a wound complication, like an infection, can interfere with healing. So, too, maladaptive thoughts, dysfunctional behaviors or inadequate emotion regulation can interfere with adaptation to loss.
CG is not less likely after loss of a rewarding relationship Mental health training does not usually include learning about the syndrome of complicated grief. However, trainees often are taught that grief is complicated if there was an ambivalent relationship to the person who died. This is a misconception. Adapting to a loss is more difficult if a person can imagine how things could have been different. People might do this because the relationship was conflictual. However, this is uncommon. Most people with complicated grief have had an especially strong and rewarding relationship to the person who died.
Key definitions
Grief is the response to loss that contains thoughts, behaviors, emotions and physiological changed; if the loss is permanent, so too is the grief, but its form evolves and changes as a person adapts to the loss
Acute grief occurs in the early period after a loss and often dominates the life of a bereaved person; strong feelings of yearning, longing and sorrow are typical as are insistent thoughts and memories of the person who died. Other painful emotions, including anxiety, anger, remorse, guilt or shame are also common. Activities are often focused on doing or not doing things to try to deal with the loss.
Integrated grief is the lasting form of grief in which loss-related thoughts, feelings and behaviors are integrated into a bereaved person’s ongoing functioning; grief has a place in the person’s life without dominating.
Complicated grief is a persistent form of intense grief in which maladaptive thoughts and dysfunctional behaviors are present along with continued yearning, longing and sadness and/or preoccupation with thoughts and memories of the person who died. Grief continues to dominate life and the future seems bleak and empty. Irrational thoughts that the deceased person might reappear are common and the bereaved person feels lost and alone.
Adapting to loss entails accepting the reality of the death, including its finality, consequences and changed relationship to the person who died; adapting means seeing the future as holding possibilities for a life with purpose and meaning, joy and satisfaction.
Examples of Grief “Complications”
Maladaptive thoughts are typically counterfactual, grief-focused or catastrophizing; its natural to second guess a loved one’s death, especially if it was sudden, unexpected or untimely; most people worry about whether they are grieving in “the right way” and many dread the future in a world without their deceased loved one. People with complicated grief ruminate over these kinds of thoughts.
Dysfunctional behaviors are typically related to avoiding reminders of the loss and/or escaping from the painful reality. A bereaved person may try to feel close to the person who died through sensory stimulation and day dreaming about being with them – looking at pictures, listening to their voice, smelling their clothes, trying to recall what it was like to be together. Bereaved people are often inclined to avoid places, people or activities that hold reminders of the person who died. These behaviors are problematic when they become the only way of managing painful emotions.
Inadequate emotion regulation is another common problem for people with complicated grief. Acute grief is typically highly emotional. Most people have a range of ways to regulate these emotions. They balance the pain with periods of respite, giving themselves permission to set the grief aside for a time. People with complicated grief have trouble doing this; instead, they often focus on things that increase emotional activation. Regular routines including adequate sleep, nourishing meals, adequate exercise and social contacts may be disrupted, making emotions more difficult to manage."
https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/
https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/
"Grief is the response to loss of something meaningful Grief is the natural response to losing a loved one. Most people don’t need grief therapists, even when the loss is sudden and unexpected and very, very sad. People have natural ways of adapting to attachment loss, usually with the support of friends and relatives, and everyone does it in their own way. You can think of healing after loss as analogous to healing after a physical wound. The loss, like the injury, triggers a pain response which can be very strong. Injuries also activate a healing process. Loss does too. However, a wound complication, like an infection, can interfere with healing. So, too, maladaptive thoughts, dysfunctional behaviors or inadequate emotion regulation can interfere with adaptation to loss.
CG is not less likely after loss of a rewarding relationship Mental health training does not usually include learning about the syndrome of complicated grief. However, trainees often are taught that grief is complicated if there was an ambivalent relationship to the person who died. This is a misconception. Adapting to a loss is more difficult if a person can imagine how things could have been different. People might do this because the relationship was conflictual. However, this is uncommon. Most people with complicated grief have had an especially strong and rewarding relationship to the person who died.
Key definitions
Grief is the response to loss that contains thoughts, behaviors, emotions and physiological changed; if the loss is permanent, so too is the grief, but its form evolves and changes as a person adapts to the loss
Acute grief occurs in the early period after a loss and often dominates the life of a bereaved person; strong feelings of yearning, longing and sorrow are typical as are insistent thoughts and memories of the person who died. Other painful emotions, including anxiety, anger, remorse, guilt or shame are also common. Activities are often focused on doing or not doing things to try to deal with the loss.
Integrated grief is the lasting form of grief in which loss-related thoughts, feelings and behaviors are integrated into a bereaved person’s ongoing functioning; grief has a place in the person’s life without dominating.
Complicated grief is a persistent form of intense grief in which maladaptive thoughts and dysfunctional behaviors are present along with continued yearning, longing and sadness and/or preoccupation with thoughts and memories of the person who died. Grief continues to dominate life and the future seems bleak and empty. Irrational thoughts that the deceased person might reappear are common and the bereaved person feels lost and alone.
Adapting to loss entails accepting the reality of the death, including its finality, consequences and changed relationship to the person who died; adapting means seeing the future as holding possibilities for a life with purpose and meaning, joy and satisfaction.
Examples of Grief “Complications”
Maladaptive thoughts are typically counterfactual, grief-focused or catastrophizing; its natural to second guess a loved one’s death, especially if it was sudden, unexpected or untimely; most people worry about whether they are grieving in “the right way” and many dread the future in a world without their deceased loved one. People with complicated grief ruminate over these kinds of thoughts.
Dysfunctional behaviors are typically related to avoiding reminders of the loss and/or escaping from the painful reality. A bereaved person may try to feel close to the person who died through sensory stimulation and day dreaming about being with them – looking at pictures, listening to their voice, smelling their clothes, trying to recall what it was like to be together. Bereaved people are often inclined to avoid places, people or activities that hold reminders of the person who died. These behaviors are problematic when they become the only way of managing painful emotions.
Inadequate emotion regulation is another common problem for people with complicated grief. Acute grief is typically highly emotional. Most people have a range of ways to regulate these emotions. They balance the pain with periods of respite, giving themselves permission to set the grief aside for a time. People with complicated grief have trouble doing this; instead, they often focus on things that increase emotional activation. Regular routines including adequate sleep, nourishing meals, adequate exercise and social contacts may be disrupted, making emotions more difficult to manage."
https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/
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