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Journey Toward Healing: COVID-19 & the Many Faces of Grief, Douglas C. Smith, MDiv., MA, MS

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Grief comes in many forms and can occur around multiple situations. COVID-19 has certainly illustrated that.

The first grief many experienced connected to COVID-19 was a VICARIOUS GRIEF (an empathic type of grieving; we started grieving because someone else was grieving). As we initially heard about what was happening in Wuhan, China and that nursing home in Kirkland, Washington, “our hearts went out” to the people in those places, grieving along with them in their grief.

We can still experience that VICARIOUS GRIEF as we continue to hear of the many people who have been hit by the pandemic: relatives, friends, neighbors, job losses, financial hardships, severe sicknesses, death. We can also feel VICARIOUS GRIEF in many non-COVID situations: when a friend of ours has had a spouse die; when a child in our neighborhood loses a pet; when a relative goes through a divorce. VICARIOUS GRIEF: we empathically grieve with people because they are grieving.

As COVID-19 spread, the next type of grief many felt was ANTICIPATORY GRIEF (we began to grieve in anticipation of possible future losses that might affect us and our loved ones). As COVID-19 went beyond Wuhan and Kirkland, spreading geographically and impacting more and more people, we began to fear how we and people we knew might be affected. We began to grieve our own or our loved ones’ possible loss of health or loss of jobs or other possible hardships. We had ANTICIPATORY GRIEF. And, even after the pandemic has been around as long as it has, we may still have feelings of ANTICIPATORY GRIEF as new strains of the virus arise. Will I be hit by the Delta variant? Will I be hit by the Omicron variant? Will I be hit by the next variant, whatever it might be labeled?

We can also feel ANTICIPATORY GRIEF in many non-COVID situations:

as people get laid off at our workplace, we might grieve our own possibility of being laid off; as we get a new dog after losing our previous one, we might already start grieving the eventual loss of our current dog; as we get older, we might grieve further loss of health and our eventual death. ANTICIPATORY GRIEF: grieving in anticipation of a possible future loss.

When COVID-19 eventually does strike us directly, in the many ways it can strike us, we experience GENERAL GRIEF (we grieve because we have lost something to which we have been attached). We might lose our social life, and we grieve that loss. We might lose our contact with our faith community, and we grieve that loss. We might lose our health, and we grieve that loss. We might lose our employment, and we grieve that loss. We might lose a loved one or a friend to death, and we grieve that loss. And, as long as the pandemic stays with us, we continue to accumulate those losses: more social restraints, more financial hardships, more deaths.

In non-COVID situations, we can also grieve many different types of losses—not just losses due to death: loss of innocence, loss of self-worth, losses due to substance abuse, losses due to sexual abuse, losses due to discrimination. GENERAL GRIEF: sadness and depression coming from any kind of loss.

We can also experience DISENFRANCHISED GRIEF during COVID. DISENFRANCHISED GRIEF (when I am feeling a deep grief over a loss that others do not take seriously or belittle). This can be experienced during the pandemic when I might take the pandemic earnestly, acknowledging all the great losses that have been occurring as a result of it, but others might say it’s nothing to worry about, it’s not that bad, or it’s just a “hoax” or “fake news.” When people do that, they are disenfranchising our feelings of sadness and depression, telling us that our feelings are somehow not valid or legitimate.

We can experience this DISENFRANCHISED GRIEF in many different non-COVID situations: when people who have never owned pets criticize the intensity of grief we feel when we have lost our pet (“it’s ‘just a pet,’ not a person”); when people minimize the loss of a child in utero (“you need to get over it; you can always have another one”); when people de-emphasize the grief of losing someone who is eighty years old or older (“you shouldn’t be sad: they had a full life”). DISENFRANCHISED GRIEF: having our genuine grief downplayed or belittled.

The final type of grief that many of us have probably felt during COVID is AMBIGUOUS GRIEF.

This is the result of grieving a loss for which there can be no closure or understanding. The classic example of AMBIGUOUS GRIEF during COVID is not being able to physically attend the funeral of a loved one because of restrictions related to the pandemic. But it can also be related to all the other lost opportunities that mark certain rites of passage: not being able to attend a marriage, or baptism or bar mitzvah, or graduation because of travel or gathering restrictions.

That AMBIGUOUS GRIEF can also take the form of an overriding/undefinable loss that defies our ability to put into words: the overarching cloud of loss that is felt throughout our society: reserved children wearing masks at bus stops to muted social gatherings. In non-COVID situations, AMBIGUOUS GRIEF can be seen in grieving someone who has Alzheimer’s who is no longer the person you’ve known throughout your life, or grieving one of your children who has become the victim of drug abuse. AMBIGUOUS GRIEF: grieving a loss for which there can be no closure or understanding, sometimes an overriding/undefinable loss.

COVID has brought to the forefront many forms of grieving, and these various forms of grieving might be with us for a long time, even long after the time in which we can get the physical effects of this pandemic under control. As individuals and as a society, our goals in these trying times must be to learn how to be survivors rather than victims during all of that loss.

The first step in that process has to be in identifying and naming our various forms of grief and loss. Once we identify and name those losses (as I have outlined above), we need to seek appropriate assistance in finding some healing. That healing can begin by simply openly sharing with others our grief. Healing can come through grief literature, healing can come through individual therapists and grief groups. We identify and name the losses. We then share the losses, and healing has begun.

Douglas Smith teaches a Grief Support Services certificate program through Northern Michigan University’s Department of Continuing Studies. He is the author of Caregiving: Hospice-Proven Techniques for Healing Body and Soul as well as seven other books on counseling the dying and the grieving.

Excerpted from the Spring 2022 issue of Health & Happiness U.P. Magazine. Copyright 2022, Empowering Lightworks, LLC. All rights reserved.

Senior Viewpoint: How to Choose a Healthcare Proxy

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It may seem unthinkable to many of us that a day might come when we are unable to speak for ourselves. Yet according to theconversationproject.org, “half of all people over 65 admitted to a hospital need help from someone else.” As the pandemic and unexpected accidents have shown us, even healthy people may suddenly need someone else to speak for them and help make health care decisions.

A healthcare proxy, also known as surrogate decision-maker, power of attorney for healthcare, or healthcare agent, is able to speak with all of your healthcare team members and read your medical records. This person would apply what they know about your health care preferences to make decisions about tests, procedures, and treatments if you became too unwell to make those decisions yourself, such as in the case of stroke, dementia, or being knocked unconscious.

Parents and legal guardians are automatically healthcare proxies for those under eighteen in their care. If you’re over eighteen and don’t want the legal system to choose a healthcare proxy for you, you need to designate one. This is particularly crucial if you have a chronic illness, are diagnosed with a serious disease, or are going on a big trip.

In Michigan, only one person can act as your healthcare proxy, and must be over eighteen. Who would be best for this important role?

Your healthcare proxy might need to make tough, quick decisions on your behalf, including on procedures, treatments, or even life support. Health needs sometimes shift rapidly, so this should be someone who could understand your values and wishes in any situation, and will carry them out even if different from their own preferences.

Your healthcare proxy will also need to ask questions of your doctors and other healthcare helpers to get a clear grasp of your situation. They may also need to advocate strongly on your behalf to get the right care for you-—with health professionals and also with people close to you who may not agree with the proxy’s decisions. Is the person you’re considering comfortable enough to do so?

It’s helpful to also designate a secondary healthcare proxy. This person would act on your behalf if your primary choice became unable or unwilling to take this role. If you named your spouse as your proxy, and later are in proceedings for divorce, legal separation, or annulment, this designation would be suspended, and your secondary choice would become your healthcare proxy.

“Sometimes a spouse, adult child, sibling, or other family member may not be the best choice to follow your wishes. Your proxy doesn’t need to be someone local; the person you choose can act as your proxy and make choices for you over the phone,” explain the experts at theconversationproject.org.

If your proxy is a trusted friend, neighbor, member of your faith community, or other non-family member, family members may have questions.

So be sure to identify your proxy and the reason for this choice to them before a healthcare emergency arises. For example, you might explain that you want them to be able to focus fully on your time together and/or be moral support for you rather than have to deal with health care decisions that could be stressful.

You’ll also need to make sure your potential healthcare proxy understands all of the responsibilities involved (The Conversation Project’s downloadable Guide to Being a Healthcare Proxy can help flesh this out), and is willing to take these on. Listen to their responses, answer any questions they may have, and let them know it’s all right if they decide not to be your proxy.

Once someone has agreed to this, you’ll need to have a detailed talk about your healthcare preferences with them. You can download and work with The Conversation Project’s Conversation Starter Guide to help you prepare.

Name your healthcare proxy and alternate in an advance directive; give your proxy a copy of it, along with names and contact info for your primary care doctor and any other important healthcare team members; and give these healthcare team members your advance directive along with your proxy’s name and contact info.

Lastly, be sure to continue discussing your healthcare preferences with your proxy as your understandings and wishes evolve.

Resources:
https://theconversationproject.org/wp-content/uploads/2020/12/ChooseAProxyGuide.pdf, https://www.dshs.wa.gov/sites/default/files/ALTSA/stakeholders/documents/duals/toolkit/Health%20Care%20Proxy.pdf
https://www.nychealthandhospitals.org/healthtips/ask-our-expert-how-to-choose-your-health-care-proxy/
https://www.michigan.gov/documents/miseniors/Advance_Directives_230752_7.pdf
https://michiganlegalhelp.org/self-help-tools/wills-life-planning/making-health-care-power-of-attorney

Excerpted from the Winter 2021-22 issue of Health & Happiness U.P. Magazine. Copyright 2021, Empowering Lightworks, LLC. All rights reserved.

Bodies in Motion: PRCA-Cooling Cabin Fever & Empowering Kids

Parents, do you ever feel like your kids are climbing the walls, especially in the cold winter months? It’s common to spend more time cooped up inside once the snow starts to fly, though of course there are plenty of fun ways to get outside, such as skiing, snowshoeing, or building a snowman. A new way you could consider getting the kiddos out and moving is trying the sport of ice climbing—yep, an organized way to “climb the walls”!

The Pictured Rocks Climbing Academy, or PRCA for short, is a Michigan non-profit that provides low-cost rock and ice climbing opportunities to Upper Peninsula youth ages 7-18. They are based in Marquette and rock climb in the Marquette area in summer, and ice climb around Munising in the winter. The PRCA was established in 2016 when world-renowned alpinist Conrad Anker noticed no local kids were ice climbing at Pictured Rocks National Lakeshore. At that year’s annual Michigan Ice Festival, money was fundraised to start the PRCA.

Since then, the PRCA has gone full steam ahead with all things climbing! The PRCA prides itself on providing not only climbing opportunities to those who might not otherwise have them, but also fostering community and stewardship for its members. From guided outdoor rock and ice climbing, volunteer opportunities at local events, weekly indoor group climbs during the school year, yoga, attending climbing festivals in the Midwest, and more, the PRCA provides unique experiences to UP youth. No gear or experience is required to climb with the PRCA, and membership costs are low, with scholarships available to those who need one.

For many, climbing is much more than just a sport—it’s a lifelong pursuit that connects them with wild places, a strong community, and opportunities to constantly learn. Climbing pushes you to trust yourself and those around you, constantly learn and adapt, and widen your comfort zone. Climbing also promotes positive mental and physical health, such as improved strength and balance, and higher feelings of self-sufficiency. The PRCA is run by volunteers with years of climbing experience who teach these values and experiences to UP youth. 

With climbing’s rising popularity, thanks to more gyms opening across the country and the sport being featured for the first time in the Olympics, it’s important to understand the mentorship aspect the sport has compared to other outdoor pursuits. Climbing is inherently dangerous, and historically was taught almost strictly through mentorship. These days people can get started climbing in the gym, through online videos, etc. While it’s great to have these more widely accessible resources available, without mentorship it’s possible to have gaps in knowledge and safety. The PRCA helps serve as a bridge for this mentorship gap.

Safety is the number one concern of the PRCA. All guided rock and ice outings are facilitated by Michigan Ice Fest Guides. These guides have taken and passed one or more guiding courses and assessments run by the internationally recognized and accredited American Mountain Guides Association. The PRCA teaches youth many things—climbing movement, gear use, anchor systems, belaying, and more—all adjusted to the age and experience level of the climbers participating. 

So, parents, if your kids are interested in a new way to recreate outside, face fears of heights, be more active in community stewardship, or just want to try something new, check out the Pictured Rocks Climbing Academy. 

To get involved with the PRCA, reach out through their website’s “Contact Us” page. If you’re over eighteen and would like to volunteer, don’t hesitate to reach out as well! 

Website: picturedrocksclimbingacademy.org
Facebook/Instagram: @picturedrocksclimbingacademy

Laura Slavsky (she/her) grew up in Marquette, MI and began climbing in 2014. She has guided ice climbing clinics at Michigan Ice Fest, is a Community Ambassador for the national climbing non-profit Access Fund, and has volunteered with the Pictured Rocks Climbing Academy since 2019.

Excerpted from the Winter 2021-22 issue of Health & Happiness U.P. Magazine. Copyright 2021, Empowering Lightworks, LLC. All rights reserved.

An Alarming Trend in Kids—What Great Lakes Recovery Centers & We Can Do About It

Many call the U.P. “God’s Country,” and see it as a great place to raise kids. Good reasons for this abound, however, our kids have become increasingly endangered by a threat many of us may not easily see—suicide.

The most recent U.P. Community Needs Assessment reports that suicide related calls to Dial Help in the U.P. tripled between 2010 and 2017. The U.P’s suicide rate for 10 to 24 year olds was 14.2 per 100,000 residents, while the average for Michigan was 7.9. And stressors have only increased since then.

As Great Lakes Recovery Centers (GLRC) Foundation Coordinator Amy Poirier explains, “If someone’s having suicidal thoughts, it’s not one thing, one incident behind it. Multiple factors can be involved.”

“I see what’s happening with our kids,” Poirier continues. “They don’t know what life will be like from day to day. It’s hard for kids right now. Every day, kids are seeing their friends being quarantined or needing to be tested. What goes on in the minds of all those kids—is my name, my friend’s name, my teacher’s name going to be on that list? The stress that they’re going through right now is unbelievable. And that’s just COVID, that’s not even counting the everyday life stressors of a teenager.”

Poirier facilitates the West End Suicide Prevention coalition.

She is also very active in the Marquette County Suicide Prevention Alliance, is one of the Marquette County Suicide Prevention Walk coordinators, teaches suicide prevention courses, and works with social media and community outreach.

“We’re trying to break down the stigma around mental health,” describes Poirier. “Between one in 4 or 5 people are suffering from mental illness, yet there’s so much stigma, and no one wants to talk about it. Our goal is to open up the conversation, normalize it, help people realize ‘It’s not just me. There are also a lot of other people out there that are having this problem. We can get help, help one another, and get professional help too.’”

GLRC coordinates several of the U.P.’s Communities That Care evidence-based coalitions that work to reduce kids’ risk factors. Nearly all of these have a suicide prevention work group. The West End Suicide Prevention coalition, a diverse group of people on the west end of Marquette County, developed LIVE, a positive mental health campaign (Love yourself, Include others, Value life, Engage community) which was brought to the entire Upper Peninsula through a grant from the Superior Health Foundation.

GLRC helps coordinate and teach various suicide prevention courses throughout the U.P.

GLRC also works with many U.P. schools to help reduce the stigma around mental health issues, and on any suicide prevention activities the school might want to do. The LIVE Art & Word contest for high schoolers to support suicide awareness and prevention efforts was just completed on Nov. 15th. Seven cash prizes will be awarded, including a $500 grand prize. You can vote for your favorite visual art, word, and song entries at West End Suicide Prevention’s Facebook page.

GLRC also opened Child & Adolescent Psychiatric Services in Ispheming a couple of years ago to help address the unmet psychiatric needs of kids with mild to moderate mental health issues who don’t necessarily qualify for community mental health services. This includes Trauma Development Assessment to look at where a child’s development is at due to trauma they may have experienced, psychiatric evaluation, medication management, parent education, different types of therapies, and psychiatric consultations.

However, with an issue as pressing as children’s suicide prevention, support is needed across the community. Whether you’re a parent, grandparent, work with children, or not, below are some ways you can help.

Take part in a suicide prevention gatekeeper training course, such as:

Mental Health First Aid – An evidence-based, free eight-hour course for adults only. Instructors from GLRC and other agencies teach you a five-step process to help someone who’s having a crisis, whether it involves suicide, anxiety, depression, psychosis, eating disorders, or substance abuse. You can sign-up at GLRC.org/mhfa. Once enough people register, a course is organized.

QPR (Question Persuade Refer) – A one-hour course that can also be presented to adolescents (as young as 12) and adults. This course is often taught in schools. Parents can ask if their school has this program.

ASIST Training – Applied Suicide Intervention Skills Training for anyone in the community. No prior training is required. DIAL HELP, a U.P. center that provides crisis support 24/7 by phone, text or chat, will hold the next one Nov. 18th and 19th in Hancock. Contact Krissy Martens at kmartens@dialhelp.org to register.

Promote the LIVE campaign – Put up a decal in the window of your home or business, keep informational cards on hand for someone who might need the national suicide hotline number. If they are local, the call goes straight to DIAL HELP. To receive these items, call the GLRC Foundation office at (906) 523-9688 or talk to any member of West End Suicide Prevention.
Support and be present at locally held events such as suicide prevention walks and Walk a Mile in Our Shoes.

Get involved in a community coalition. Almost every U.P. county has a suicide prevention-related group. Contact Amy Poirier at (906) 523-9688, apoirier@greatlakesrecovery.org for info on a coalition near you, or go to glrc.org/wesp to learn more about West End Suicide Prevention.

If you’re concerned your child or a child you know may be having suicidal thoughts or feelings, talk to the child. Get them the help they need, and help the child as well as their parent understand that they’re not alone.

Before you get to that point, if you have a kid or know anybody (child or adult), take one of the free suicide prevention courses.

You can also join a free and confidential parent support group–the Parents Support Network of the Upper Peninsula of Michigan. It meets for an hour and a half each month, currently virtually, and is peer-led by facilitators that have had experience with their own kids’ mental health concerns.

Note from the editor: We are very pleased to announce that Health & Happiness U.P. Magazine’s 2021 annual donation is going to Great Lakes Recovery Centers’ children’s suicide prevention and awareness efforts. For a list of businesses that have helped support this donation, click here.

Excerpted from the Winter 2021-22 issue of Health & Happiness U.P. Magazine. Copyright 2021, Empowering Lightworks, LLC. All rights reserved.

Creative Inspiration: Urgent Gifts, Marty Achatz

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U. S. Poet Laureate Joy Harjo says, “If you do not answer the noise and urgency of your gifts, they will turn on you. Or drag you down with their immense sadness at being abandoned.”

Gifts are strange things. They come to us out of nowhere. Surprise and fill us with pleasure. There is power in unwrapping a gift. Beneath the bows and paper, in the darkness of the unopened box, anything could exist. A box of chocolates. Music box. Book. Tickets to Walt Disney World. Words.

Yes, words. Because I’m a poet, I have always believed words are gifts. Think of the word “cleave.” It can mean to “divide or split as if by a cutting blow.” But it can also mean to “adhere firmly and closely . . . unwaveringly.” In one word, there is both separation and connection, loss and love. That’s a remarkable gift.

Back in January of this year, I received an email about a grant program sponsored by the National Endowment for the Arts called the Big Read.

The NEA Big Read involves organizations creating programming centered around the themes and ideas of one book. Part of that programming involves giving away copies of the chosen book to community members. A gift of words.

One of the options for the 2021-2022 NEA Big Read cycle was U. S. Poet Laureate Joy Harjo’s poetry collection “An American Sunrise.” Filled with cleaving (the removal history of Harjo’s people from their homelands) and cleaving (love poems for Harjo’s mother and husband and children), the book spoke to my artistic gifts.

So, I set about writing an NEA Big Read grant. I pulled together partnering organizations, contacted artists and writers, planned events—keynote addresses, poetry workshops, art exhibits, and a chapbook contest. I dreamed big. It was like writing a detailed, twenty-page letter to Santa Claus and dropping it in the mailbox.

The dream was simple in concept: to build bridges. I wanted to highlight the history, culture, and contributions of indigenous peoples. Through Joy Harjo’s words, I hoped to create a dialogue across the Upper Peninsula and bring people together. Using poetry as a vehicle, my NEA Big Read dream would hopefully be a catalyst for cultural understanding and change.

This dream was a gift to me.

A noisy, urgent gift, as Joy Harjo says. And I followed Harjo’s advice: I didn’t ignore that gift.

Several months after sending off my “letter to Santa,” I received an email one morning from Arts Midwest, the organization that administers the Big Read program for the National Endowment for the Arts. That email had one word in its subject line: “Congratulations.” I sat in my office for a few moments, feeling a lot like a kid on Christmas morning, knowing that my dream had become reality.

As I sit writing this article, I’m approaching the final weeks of programming for the NEA Big Read at Peter White Public Library. Over the past month, I’ve heard the Teal Lake Singers Drum Circle perform. Listened to poets and scholars and teachers of Anishinaabemowin. Soon, I will have the opportunity to speak personally with Joy Harjo, listen to her read her poetry, ask her questions.

However, the path to my NEA Big Read dream hasn’t been without its share of struggles, personal and professional. Sickness occurred. Scheduled speakers became unavailable. Loved ones passed. Events needed to be rescheduled or completely reinvented at the last minute. Big dreams are like that. They rearrange themselves like waves rearrange a shoreline.

But dreaming big is important.

Paying attention to your gifts (no matter what they are) isn’t just important. It’s necessary and life-sustaining. Sharing those gifts and dreams with others can be a powerful force for good in the world at large.

One of the events of the NEA Big Read was a three-day poetry chapbook writing competition. Participants were given a list of eighty writing prompts to spark their creativity. One of the writing prompts was this:
Make a list of things you want to do today. Let your imagination run wild with the list, accomplishing impossible things.

Try it right now. Make that list. Dream big. Dream impossible. Use your gifts. Make the world a better place.

Martin Achatz is a husband/father/teacher/poet/dreamer who lives in Ishpeming.  He is a two-time U.P. Poet Laureate and teaches in NMU’s English Department.  He also serves as the Adult Programming Coordinator for Peter White Public Library, where he recently organized and ran the NEA Big Read. 

Excerpted from the Winter 2021-22 issue of Health & Happiness U.P. Magazine. Copyright 2021, Empowering Lightworks, LLC. All rights reserved.