Stay-at-home orders can make isolation even worse for many
By Liz Seegert

The coronavirus (COVID-19) pandemic has much of the world sheltering in place. While it may be frustrating and challenging for many of us, this increased isolation is especially hard on the mental and physical health of older adults — the same group most at risk of getting the virus with and severe consequences of infection.

About 28% of older adults in the United States, or 13.8 million people, live alone, according to a report by the Administration for Community Living’s Administration on Aging. While many older Americans say they’re not usually lonely or socially isolated, they now find themselves suddenly cut off from in-person contact with friends, family and activities that help keep them engaged. This increases anxiety and fear and potentially leads to long-term negative consequences, say mental health experts. But there are ways to ease the isolation.

Research links social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease and even death, according to the National Institutes of Health. People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility and lack of transportation are at particular risk.

Now, we can add COVID-19 mitigation measures to this list.

One Crisis on Top of Another

“What I have seen in my clinical practice is that disruption in routine and the unknown is very anxiety-provoking,” says Eve Byrd, a nurse-practitioner with expertise in geriatric psychiatry.

Byrd, who directs the Carter Center’s Mental Health Program, says one key strategy for maintaining good mental health in the current climate is limiting exposure to what’s on television. However, TV or radio may be the only sources of distraction for older adults, if poor eyesight limits their ability to read, knit or enjoy hobbies that require visual acuity.

“What I have seen in my clinical practice is that disruption in routine and the unknown is very anxiety provoking.”

What concerns Byrd most is that without people coming to visit or regular interactions with others in the community, it’s hard to know how well an older adult is truly functioning. Things can go badly very quickly.

“When that routine is disrupted it’s very, very scary, because they may not have the wherewithal to be able to reach out, especially if they’re in a building that doesn’t have any kind of services or isn’t checking in on people,” Byrd says.

So, some older people may become depressed, and begin to feel hopelessness about their situation. Some fear going out for groceries or to the pharmacy. They may stop preparing meals or taking their medication. Fortunately, service providers in many communities recognize this risk — and hundreds of volunteers have stepped forward to deliver meals, conduct wellness checks by phone or just leave a note on an older person’s door to let them know they’re not alone.

Our Commitment to Covering the Coronavirus

We are committed to reliable reporting on the risks of the coronavirus and steps you can take to benefit you, your loved ones and others in your community. Read Next Avenue’s Coronavirus Coverage.

Easing the Isolation

For older adults who suddenly find themselves homebound, there are numerous ways to cope, according to Byrd.

“Scheduling their day, if they’re able to do that, is really important,” she advises. “It’s a technique we use in psychosocial services called ‘behavioral activation’. And what that means is really being very intentional of thinking, what are the things that you enjoy doing, and then adding more of those to your day.”

It’s not about just turning off the television. It’s thinking of things that you enjoy doing, and then adding a couple of those activities to the day just so it’s less monotonous, Byrd says. It can be simple pleasures, like writing letters to friends, sitting on the front porch for 20 minutes, calling a grandchild, looking at an album of family photos, or at a magazine. It’s not as easy as it sounds, Byrd admits, but it really makes a huge difference.

“You have to kind of think of those simple pleasures and try your best to keep those routines up and stay really intentionally thinking about what are things that make me feel better versus sitting and kind of obsessing over these things that we don’t have control over right now,” Byrd says.

How to Be Alone, but Not Lonely

There’s a difference between being alone and being lonely, according to Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College in New York City and a professor at Hunter College’s School of Urban Public Health. Finkelstein is also a Next Avenue Influencer in Aging.

She recently wrote about how social distancing can not only save lives, but can also be an opportunity for those of us who have access to social networks, information and resources to help those who do not.

“For lots of people, getting out and doing errands is an important part of their socialization,” Finkelstein says. “I’ve characterized it as their spiderwebs; it’s in a lower level than a social network.” We can help our older relatives, friends or neighbors figure out how to keep those networks active.

“We need to be more committed in our actions as far as older adults, and we need to look for signs long after the crisis is over.”

If the older adult has internet access, you can help them sign up for services like grocery delivery, even if they normally go out to shop. Regular check-ins from multiple family members can be very helpful, especially if you can conduct Zoom or FaceTime chats. “But sometimes, technology just adds more anxiety,” Finkelstein says.

She suggests older adults even become “virtual” volunteers themselves, perhaps making phone calls to others who may feel isolated and alone. Many senior centers, places of worship or settlement houses welcome the participation.

“It would say to older people who are able, that ‘I’m helping, participating.’ Feeling like you’re contributing is a good antidote to the messages that are making you feel like you have a problem,” Finkelstein says.

The New York Academy of Medicine has compiled this list of additional ideas on how we can help our older neighbors who may be anxious about venturing out or have no one nearby to help.

Even when this public health threat eases, the mental health needs of older adults need to remain in the spotlight, Byrd says. Depression, anxiety and other issues are often overlooked as just something that happens to people as they age.

“We need to be more committed in our actions as far as older adults, and we need to look for signs long after the crisis is over,” she says.

By Liz Seegert

New York-based journalist Liz Seegert has spent more than 30 years reporting and writing about health and general news topics for print, digital and broadcast media. Her primary beats currently include aging, boomers, social determinants of health and health policy. She is topic editor on aging for the Association of Health Care Journalists. Her work has appeared in numerous media outlets, including Consumer Reports, AARP.com, Medical Economics, The Los Angeles Times and The Hartford Courant.

Stay-at-home orders can make isolation even worse for many
By Liz Seegert

The coronavirus (COVID-19) pandemic has much of the world sheltering in place. While it may be frustrating and challenging for many of us, this increased isolation is especially hard on the mental and physical health of older adults — the same group most at risk of getting the virus with and severe consequences of infection.

About 28% of older adults in the United States, or 13.8 million people, live alone, according to a report by the Administration for Community Living’s Administration on Aging. While many older Americans say they’re not usually lonely or socially isolated, they now find themselves suddenly cut off from in-person contact with friends, family and activities that help keep them engaged. This increases anxiety and fear and potentially leads to long-term negative consequences, say mental health experts. But there are ways to ease the isolation.

Research links social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease and even death, according to the National Institutes of Health. People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility and lack of transportation are at particular risk.

Now, we can add COVID-19 mitigation measures to this list.

One Crisis on Top of Another

“What I have seen in my clinical practice is that disruption in routine and the unknown is very anxiety-provoking,” says Eve Byrd, a nurse-practitioner with expertise in geriatric psychiatry.

Byrd, who directs the Carter Center’s Mental Health Program, says one key strategy for maintaining good mental health in the current climate is limiting exposure to what’s on television. However, TV or radio may be the only sources of distraction for older adults, if poor eyesight limits their ability to read, knit or enjoy hobbies that require visual acuity.

“What I have seen in my clinical practice is that disruption in routine and the unknown is very anxiety provoking.”

What concerns Byrd most is that without people coming to visit or regular interactions with others in the community, it’s hard to know how well an older adult is truly functioning. Things can go badly very quickly.

“When that routine is disrupted it’s very, very scary, because they may not have the wherewithal to be able to reach out, especially if they’re in a building that doesn’t have any kind of services or isn’t checking in on people,” Byrd says.

So, some older people may become depressed, and begin to feel hopelessness about their situation. Some fear going out for groceries or to the pharmacy. They may stop preparing meals or taking their medication. Fortunately, service providers in many communities recognize this risk — and hundreds of volunteers have stepped forward to deliver meals, conduct wellness checks by phone or just leave a note on an older person’s door to let them know they’re not alone.

Our Commitment to Covering the Coronavirus

We are committed to reliable reporting on the risks of the coronavirus and steps you can take to benefit you, your loved ones and others in your community. Read Next Avenue’s Coronavirus Coverage.

Easing the Isolation

For older adults who suddenly find themselves homebound, there are numerous ways to cope, according to Byrd.

“Scheduling their day, if they’re able to do that, is really important,” she advises. “It’s a technique we use in psychosocial services called ‘behavioral activation’. And what that means is really being very intentional of thinking, what are the things that you enjoy doing, and then adding more of those to your day.”

It’s not about just turning off the television. It’s thinking of things that you enjoy doing, and then adding a couple of those activities to the day just so it’s less monotonous, Byrd says. It can be simple pleasures, like writing letters to friends, sitting on the front porch for 20 minutes, calling a grandchild, looking at an album of family photos, or at a magazine. It’s not as easy as it sounds, Byrd admits, but it really makes a huge difference.

“You have to kind of think of those simple pleasures and try your best to keep those routines up and stay really intentionally thinking about what are things that make me feel better versus sitting and kind of obsessing over these things that we don’t have control over right now,” Byrd says.

How to Be Alone, but Not Lonely

There’s a difference between being alone and being lonely, according to Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College in New York City and a professor at Hunter College’s School of Urban Public Health. Finkelstein is also a Next Avenue Influencer in Aging.

She recently wrote about how social distancing can not only save lives, but can also be an opportunity for those of us who have access to social networks, information and resources to help those who do not.

“For lots of people, getting out and doing errands is an important part of their socialization,” Finkelstein says. “I’ve characterized it as their spiderwebs; it’s in a lower level than a social network.” We can help our older relatives, friends or neighbors figure out how to keep those networks active.

“We need to be more committed in our actions as far as older adults, and we need to look for signs long after the crisis is over.”

If the older adult has internet access, you can help them sign up for services like grocery delivery, even if they normally go out to shop. Regular check-ins from multiple family members can be very helpful, especially if you can conduct Zoom or FaceTime chats. “But sometimes, technology just adds more anxiety,” Finkelstein says.

She suggests older adults even become “virtual” volunteers themselves, perhaps making phone calls to others who may feel isolated and alone. Many senior centers, places of worship or settlement houses welcome the participation.

“It would say to older people who are able, that ‘I’m helping, participating.’ Feeling like you’re contributing is a good antidote to the messages that are making you feel like you have a problem,” Finkelstein says.

The New York Academy of Medicine has compiled this list of additional ideas on how we can help our older neighbors who may be anxious about venturing out or have no one nearby to help.

Even when this public health threat eases, the mental health needs of older adults need to remain in the spotlight, Byrd says. Depression, anxiety and other issues are often overlooked as just something that happens to people as they age.

“We need to be more committed in our actions as far as older adults, and we need to look for signs long after the crisis is over,” she says.

By Liz Seegert

New York-based journalist Liz Seegert has spent more than 30 years reporting and writing about health and general news topics for print, digital and broadcast media. Her primary beats currently include aging, boomers, social determinants of health and health policy. She is topic editor on aging for the Association of Health Care Journalists. Her work has appeared in numerous media outlets, including Consumer Reports, AARP.com, Medical Economics, The Los Angeles Times and The Hartford Courant.

How to overcome mental obstacles putting off an improvement
By Mindy Charski

Embarking on a home renovation is exciting for most of the couples Adam Mandel meets as owner of JRZ Construction, a design-and-build residential construction company in Dallas. Yet, multiple times a year, Mandel comes across resisters: people who don’t share their partners’ enthusiasm. Some balk at the expense or the disruption. But in other cases, it’s at least partly about a resistance to change.

“A lot of times people will say, ‘You know, I’ve been in this house for twenty or thirty years, and it works fine for me. So, what’s the point of making the change?’” Mandel says.

Actually, if you’re a reno resister, there may be good reasons to push through your opposition.

Reasons to Push Through Opposition to a Renovation

Updating your home could help increase its potential resale value. And some changes are necessary to make your home more livable. It’s no good when old grout lets water get behind shower walls, for instance. “You have to take care of this,” Mandel says. “It’s not a safe situation.”

“Change is innately anxiety producing and it’s important to identify, acknowledge and talk about the worry.”

If you’re putting off a renovation because you’re hesitant about making a home improvement, the following insights and advice might help you commit:

First off, recognize that it’s normal to resist change.

“Change is innately anxiety producing and it’s important to identify, acknowledge and talk about the worry,” says Dana Dorfman, a New York City psychotherapist and co-host of the podcast 2 Moms on The Couch.

Dealing With Your Emotions

While you may logically know it’s time for a renovation, your emotions may be getting the best of you. Acknowledge them. “Homes are symbolic representations of our life stages,” Dorfman says. “A renovation may reflect an upcoming stage about which there is inherent ambivalence.”

If you’re having mixed feelings about retiring and relocating, for example, you may not be rushing to do improvements that can help you sell your home faster.

It can be useful to jot down your worries and resistance. Since the brain is wired to protect people from pain and discomfort, it devises excuses for scenarios that could be problematic, Dorfman says.

Undeniably, paying for home improvements and living through the upheaval of a refresh can be stressful and uncomfortable. But irrational concerns can creep in too, Dorfman says — like thinking friends will be jealous of your new space and become less close. Identifying your apprehensions and putting them on paper can help you address them.

The Biggest Hurdle

The biggest hurdle for change is the “amorphous soup of variables and possibilities” it involves, says Nick Tasler, an organizational psychologist in Ponce, Puerto Rico. Renovations, after all, require a whirlwind of urgent decisions that can feel overwhelming.

“You need to zoom out and say, ‘What am I really trying to accomplish here and why?’” Tasler says.

Maybe you want to make changes to better age in place. Perhaps you want to modernize your kitchen so you’re not embarrassed when guests visit.

Says Tasler: “Once you get clear on [your goal], then it becomes much easier to say, ‘Now I understand the change better. I’m willing to do what I need to do to get out of my comfort zone and make it happen.’”

Help From Comforting Renovation Partners

Finding renovation partners you trust can also help get you over the hump.

Vicky Nave, principal designer at Avery Benjamin Interiors in Thousand Oaks, Calif., finds a large part of an interior designer’s job is counseling clients about a change they’ll create together and helping them feel confident the results will look beautiful. Nave looks with clients through design magazines, blogs and Pinterest to understand the design elements that excite them and build their comfort level about a project. She’s also careful not to overload clients with too many choices.

“By talking with my clients and understanding their design goals, I can guide them in the right direction at their own pace,” Nave says.

You might also want to start small. That’s an approach designer Lauren Fasolo of Ellce Designs in Naperville, Ill., sometimes uses with apprehensive clients.

Rather than renovating an entire first floor at the same time, for instance, she’ll concentrate on initially refreshing one area. “A lot of times, after they see it, they’re like, ‘Oh, now I get it,’” she says. “Then they’re more willing to move on together.”

Even just repainting, restaining wood floors or updating lighting can have a big impact on a room’s look.

Dealing With the Disruption

The commotion of a renovation project often requires adjustments to a daily routine. So, you may want to come up with plan to make it through the process.

To avoid the disruption of a four-day flooring job, Mandel says, one reluctant client and her husband went to a local hotel for a staycation. “They ended up having a great time,” he says, “and by the time she got back, the worst of it was done.”

By Mindy Charski

Mindy Charski is a Dallas-based business journalist, content writer and ghostwriter. She covers personal finance, marketing, small business and photography.

How to overcome mental obstacles putting off an improvement
By Mindy Charski

Embarking on a home renovation is exciting for most of the couples Adam Mandel meets as owner of JRZ Construction, a design-and-build residential construction company in Dallas. Yet, multiple times a year, Mandel comes across resisters: people who don’t share their partners’ enthusiasm. Some balk at the expense or the disruption. But in other cases, it’s at least partly about a resistance to change.

“A lot of times people will say, ‘You know, I’ve been in this house for twenty or thirty years, and it works fine for me. So, what’s the point of making the change?’” Mandel says.

Actually, if you’re a reno resister, there may be good reasons to push through your opposition.

Reasons to Push Through Opposition to a Renovation

Updating your home could help increase its potential resale value. And some changes are necessary to make your home more livable. It’s no good when old grout lets water get behind shower walls, for instance. “You have to take care of this,” Mandel says. “It’s not a safe situation.”

“Change is innately anxiety producing and it’s important to identify, acknowledge and talk about the worry.”

If you’re putting off a renovation because you’re hesitant about making a home improvement, the following insights and advice might help you commit:

First off, recognize that it’s normal to resist change.

“Change is innately anxiety producing and it’s important to identify, acknowledge and talk about the worry,” says Dana Dorfman, a New York City psychotherapist and co-host of the podcast 2 Moms on The Couch.

Dealing With Your Emotions

While you may logically know it’s time for a renovation, your emotions may be getting the best of you. Acknowledge them. “Homes are symbolic representations of our life stages,” Dorfman says. “A renovation may reflect an upcoming stage about which there is inherent ambivalence.”

If you’re having mixed feelings about retiring and relocating, for example, you may not be rushing to do improvements that can help you sell your home faster.

It can be useful to jot down your worries and resistance. Since the brain is wired to protect people from pain and discomfort, it devises excuses for scenarios that could be problematic, Dorfman says.

Undeniably, paying for home improvements and living through the upheaval of a refresh can be stressful and uncomfortable. But irrational concerns can creep in too, Dorfman says — like thinking friends will be jealous of your new space and become less close. Identifying your apprehensions and putting them on paper can help you address them.

The Biggest Hurdle

The biggest hurdle for change is the “amorphous soup of variables and possibilities” it involves, says Nick Tasler, an organizational psychologist in Ponce, Puerto Rico. Renovations, after all, require a whirlwind of urgent decisions that can feel overwhelming.

“You need to zoom out and say, ‘What am I really trying to accomplish here and why?’” Tasler says.

Maybe you want to make changes to better age in place. Perhaps you want to modernize your kitchen so you’re not embarrassed when guests visit.

Says Tasler: “Once you get clear on [your goal], then it becomes much easier to say, ‘Now I understand the change better. I’m willing to do what I need to do to get out of my comfort zone and make it happen.’”

Help From Comforting Renovation Partners

Finding renovation partners you trust can also help get you over the hump.

Vicky Nave, principal designer at Avery Benjamin Interiors in Thousand Oaks, Calif., finds a large part of an interior designer’s job is counseling clients about a change they’ll create together and helping them feel confident the results will look beautiful. Nave looks with clients through design magazines, blogs and Pinterest to understand the design elements that excite them and build their comfort level about a project. She’s also careful not to overload clients with too many choices.

“By talking with my clients and understanding their design goals, I can guide them in the right direction at their own pace,” Nave says.

You might also want to start small. That’s an approach designer Lauren Fasolo of Ellce Designs in Naperville, Ill., sometimes uses with apprehensive clients.

Rather than renovating an entire first floor at the same time, for instance, she’ll concentrate on initially refreshing one area. “A lot of times, after they see it, they’re like, ‘Oh, now I get it,’” she says. “Then they’re more willing to move on together.”

Even just repainting, restaining wood floors or updating lighting can have a big impact on a room’s look.

Dealing With the Disruption

The commotion of a renovation project often requires adjustments to a daily routine. So, you may want to come up with plan to make it through the process.

To avoid the disruption of a four-day flooring job, Mandel says, one reluctant client and her husband went to a local hotel for a staycation. “They ended up having a great time,” he says, “and by the time she got back, the worst of it was done.”

By Mindy Charski

Mindy Charski is a Dallas-based business journalist, content writer and ghostwriter. She covers personal finance, marketing, small business and photography.

This Harvard professor reveals what he learned from the experience
By Judith Graham

Caring for someone with a serious illness stretches people spiritually and emotionally, often beyond what they might have thought possible.

Dr. Arthur Kleinman, a professor of psychiatry and anthropology at Harvard University, calls this “enduring the unendurable” in his recently published book, The Soul of Care: The Moral Education of a Husband and a Doctor.

The book describes Kleinman’s awakening to the realities of caregiving when his beloved wife, Joan, was diagnosed with a rare form of early Alzheimer’s disease that causes blindness as well as cognitive deterioration.

Although Kleinman’s specialty is studying how patients experience illness, he wasn’t prepared for the roller coaster of family caregiving. Each time he adapted to Joan’s changing condition, another setback would occur, setting off new crises and fueling uncertainty and stress.

During 11 years of caregiving until Joan’s death in 2011, Kleinman learned that no one who goes through this experience emerges unchanged. He became less self-centered, more compassionate and more aware of how the health care system fails to support family caregivers ― the backbone of the nation’s long-term care system.

Realities of Caregiving

I spoke with Kleinman in mid-November at a caregiving panel. His remarks below are edited for length and clarity.

About his book: “I wrote it for a specific reason. I had spent my whole career as an expert on care. I myself was a psychiatrist who worked with patients with chronic medical disorders, [such as] chronic pain, diabetes, heart disease and cancer. I thought I knew it all. A veil of ignorance was raised from my eyes by my experience as a primary family caregiver.

“What is that veil of ignorance about? It’s about recognizing just how difficult family care is for [people with] dementia and, not just dementia, but many other problems.”

Daily responsibilities: “Let’s say in the fifth year, what was it like? I would get Joan up around 6 a.m. and take her to the bathroom. I have to handle the toilet paper, wash her hands, dress her to work out, take her to the bath and bathe her.

“Our health care system (is focused on) entirely the wrong issues. Economics is not the most central aspect of care; it’s caregiving.”

“I would shampoo her hair, dry her, pick out her clothes [for the day]. After that, I would prepare breakfast. As she got increasingly agitated, [that] became difficult because I had to sometimes hold her hands [to] keep her from throwing things or getting up and hurting herself. Because she was blind, she couldn’t see where she was. And then I would help her eat ― usually, at the end, feeding her ― and then take her to a room where we would sit and listen quietly to music.

“Maybe six, seven years into this, I would just sit there and hold her hands. And even that became difficult. So, I would tell her stories of the past … our stories. [Editorial note: This is just the beginning of a day full of similar tasks.]

“I discovered early on that the ritualization of acts of caring ― the dressing, bathing, all these things ― is a way of habit formation that keeps you going.”

Challenging masculinity: “We had a great relationship, but it was asymmetrical. For thirty-six years, my wife took care of me. I was raised as a classical male in the 1940s. When I showed an interest in cooking, my grandmother said to me, ‘What are you, a sissy?’ I was a tough kid on New York [City] streets. I had the most unpromising beginnings to be a caregiver. And my wife slowly socialized me to a different kind of masculinity, to be able to care.

“[Pay family members for caregiving] and you’ll see more men do it. Go to Australia, for example, where there’s very good compensation for care, and you’re astonished at the number of men who are caring for children, who are caring for elderly, and the like.”

Asking for help: “I have a wide circle of friends and colleagues, and [after the book] many of them said they had never realized what was involved. Part of that was my fault. I had a lot of trouble asking for help. Actually, at one point, I so exhausted myself that my kids, who are great, said, ‘You really need assistance.’ And they stepped in, as did my mother, who at the time was in her nineties.

“So, I had a great system of care around me, but I [also] needed a home health aide to [help with Joan and] keep myself going. I found an Irish woman … and she was fabulous.”

Maintaining presence: “In spite of that, I found it extraordinarily difficult in terms of other elements of care, one of which is presence. To keep your liveliness, your love, the presence of who you are going while you’re doing all this work of caregiving ― it is extremely difficult and demanding, but it’s crucial.

“When people ask ‘Why do you do [this]?’ the answer of most family caregivers I’ve spoken to is ‘Well, it was there to do. It’s got to be done, [so] you do it.’”

“To keep your liveliness, your love, the presence of who you are while you’re doing all this work of caregiving — it’s extremely difficult and demanding, but it’s crucial.”

Learning about failure: “I was fortunate in life; I had a golden career. I have a personality that is like a bulldog, and when I start something, I finish it. But there’s no finishing care. Every one of us [family caregivers], if we’re honest, you fail at a certain point. The frustrations build, anger mounts, you control your anger so you don’t injure the person you’re caring for. But you’ve got to somehow handle it inside you.”

The soul of care: “I think what lies at the soul of care is a form of love. You will do everything you can for another because they mean so much to you. [But] it is also problematic, because we all have complex relationships and we’ve got other things going on in our lives.

“We endure, we learn how to endure, how to keep going. We’re marked, we’re injured, we’re wounded. We’re changed … [in] my case, for the better. If you had known me before my eleven years of care, you wouldn’t recognize me today. I was your classical hard-driving Harvard professor … as tough as any other professor at Harvard Medical School.

“I’ve redeemed myself through this experience, in a way.”

A call for change: “How do we strengthen caregiving? How do we do those things that will make it recognized as important as it is? It’s going to take a radical rethinking. Our health care system [is focused on] entirely the wrong issues. Economics is not the most central aspect of care; it’s caregiving.

“Do you know not a single one of the senior neurologists I went to with Joan who wanted to do everything diagnostically made the recommendation ‘You want to think about a home health aide now, even though you don’t need it right now. You have to look into how you’re going to reconfigure your house [for] someone who’s both blind and with dementia. [Or] a social worker is a great navigator of what the health care system is about. You want to take advantage of that.’

“So, this is where I believe that our whole health care system has got to be rethought, from the bottom up with attention to care at its core.”

(This article originally appeared on Kaiser Health News.)

By Judith Graham

Judith Graham is a contributing writer to Kaiser Health News and Next Avenue.

This Harvard professor reveals what he learned from the experience
By Judith Graham

Caring for someone with a serious illness stretches people spiritually and emotionally, often beyond what they might have thought possible.

Dr. Arthur Kleinman, a professor of psychiatry and anthropology at Harvard University, calls this “enduring the unendurable” in his recently published book, The Soul of Care: The Moral Education of a Husband and a Doctor.

The book describes Kleinman’s awakening to the realities of caregiving when his beloved wife, Joan, was diagnosed with a rare form of early Alzheimer’s disease that causes blindness as well as cognitive deterioration.

Although Kleinman’s specialty is studying how patients experience illness, he wasn’t prepared for the roller coaster of family caregiving. Each time he adapted to Joan’s changing condition, another setback would occur, setting off new crises and fueling uncertainty and stress.

During 11 years of caregiving until Joan’s death in 2011, Kleinman learned that no one who goes through this experience emerges unchanged. He became less self-centered, more compassionate and more aware of how the health care system fails to support family caregivers ― the backbone of the nation’s long-term care system.

Realities of Caregiving

I spoke with Kleinman in mid-November at a caregiving panel. His remarks below are edited for length and clarity.

About his book: “I wrote it for a specific reason. I had spent my whole career as an expert on care. I myself was a psychiatrist who worked with patients with chronic medical disorders, [such as] chronic pain, diabetes, heart disease and cancer. I thought I knew it all. A veil of ignorance was raised from my eyes by my experience as a primary family caregiver.

“What is that veil of ignorance about? It’s about recognizing just how difficult family care is for [people with] dementia and, not just dementia, but many other problems.”

Daily responsibilities: “Let’s say in the fifth year, what was it like? I would get Joan up around 6 a.m. and take her to the bathroom. I have to handle the toilet paper, wash her hands, dress her to work out, take her to the bath and bathe her.

“Our health care system (is focused on) entirely the wrong issues. Economics is not the most central aspect of care; it’s caregiving.”

“I would shampoo her hair, dry her, pick out her clothes [for the day]. After that, I would prepare breakfast. As she got increasingly agitated, [that] became difficult because I had to sometimes hold her hands [to] keep her from throwing things or getting up and hurting herself. Because she was blind, she couldn’t see where she was. And then I would help her eat ― usually, at the end, feeding her ― and then take her to a room where we would sit and listen quietly to music.

“Maybe six, seven years into this, I would just sit there and hold her hands. And even that became difficult. So, I would tell her stories of the past … our stories. [Editorial note: This is just the beginning of a day full of similar tasks.]

“I discovered early on that the ritualization of acts of caring ― the dressing, bathing, all these things ― is a way of habit formation that keeps you going.”

Challenging masculinity: “We had a great relationship, but it was asymmetrical. For thirty-six years, my wife took care of me. I was raised as a classical male in the 1940s. When I showed an interest in cooking, my grandmother said to me, ‘What are you, a sissy?’ I was a tough kid on New York [City] streets. I had the most unpromising beginnings to be a caregiver. And my wife slowly socialized me to a different kind of masculinity, to be able to care.

“[Pay family members for caregiving] and you’ll see more men do it. Go to Australia, for example, where there’s very good compensation for care, and you’re astonished at the number of men who are caring for children, who are caring for elderly, and the like.”

Asking for help: “I have a wide circle of friends and colleagues, and [after the book] many of them said they had never realized what was involved. Part of that was my fault. I had a lot of trouble asking for help. Actually, at one point, I so exhausted myself that my kids, who are great, said, ‘You really need assistance.’ And they stepped in, as did my mother, who at the time was in her nineties.

“So, I had a great system of care around me, but I [also] needed a home health aide to [help with Joan and] keep myself going. I found an Irish woman … and she was fabulous.”

Maintaining presence: “In spite of that, I found it extraordinarily difficult in terms of other elements of care, one of which is presence. To keep your liveliness, your love, the presence of who you are going while you’re doing all this work of caregiving ― it is extremely difficult and demanding, but it’s crucial.

“When people ask ‘Why do you do [this]?’ the answer of most family caregivers I’ve spoken to is ‘Well, it was there to do. It’s got to be done, [so] you do it.’”

“To keep your liveliness, your love, the presence of who you are while you’re doing all this work of caregiving — it’s extremely difficult and demanding, but it’s crucial.”

Learning about failure: “I was fortunate in life; I had a golden career. I have a personality that is like a bulldog, and when I start something, I finish it. But there’s no finishing care. Every one of us [family caregivers], if we’re honest, you fail at a certain point. The frustrations build, anger mounts, you control your anger so you don’t injure the person you’re caring for. But you’ve got to somehow handle it inside you.”

The soul of care: “I think what lies at the soul of care is a form of love. You will do everything you can for another because they mean so much to you. [But] it is also problematic, because we all have complex relationships and we’ve got other things going on in our lives.

“We endure, we learn how to endure, how to keep going. We’re marked, we’re injured, we’re wounded. We’re changed … [in] my case, for the better. If you had known me before my eleven years of care, you wouldn’t recognize me today. I was your classical hard-driving Harvard professor … as tough as any other professor at Harvard Medical School.

“I’ve redeemed myself through this experience, in a way.”

A call for change: “How do we strengthen caregiving? How do we do those things that will make it recognized as important as it is? It’s going to take a radical rethinking. Our health care system [is focused on] entirely the wrong issues. Economics is not the most central aspect of care; it’s caregiving.

“Do you know not a single one of the senior neurologists I went to with Joan who wanted to do everything diagnostically made the recommendation ‘You want to think about a home health aide now, even though you don’t need it right now. You have to look into how you’re going to reconfigure your house [for] someone who’s both blind and with dementia. [Or] a social worker is a great navigator of what the health care system is about. You want to take advantage of that.’

“So, this is where I believe that our whole health care system has got to be rethought, from the bottom up with attention to care at its core.”

(This article originally appeared on Kaiser Health News.)

By Judith Graham

Judith Graham is a contributing writer to Kaiser Health News and Next Avenue.

Silver Disobedience influencer Dian Griesel on aging, priorities and surprise selfies
By Julie Pfitzinger

If you are on Instagram, chances are good that you’ve come across Silver Disobedience (@SilverDisobedience) blog posts featuring model and 50+ influencer Dian Griesel. In fact, you may be one of her 167,000 followers. In images shot in multiple locations around New York City, where she lives, Griesel, 59, always looks casually chic, wearing a confident smile telegraphing the impression that her moment is now.

And that’s true: beginning this month, Griesel, a Wilhelmina Icon model, will be featured in a new Lancôme campaign. Last year, she released The Silver Disobedience Playbook: 365 Inspirations for Living and Loving Agelessly. And her website, launched in 2017, offers her personal insights on creativity, health, philosophy, spirituality and more, in addition to featuring her daily blog post, read by more than 2 million followers.

Griesel, who is married with two teenagers, is also a certified counselor, president of DGI Companies, and serves as a consultant to multiple companies as a perception analyst, offering  expertise on marketing to an older demographic. She’s been a panelist at SxSW (South by SouthWest), and was selected by AARP as one of its Age Disruptors.

“Everything you’ve done at every stage of life adds up to your total big picture.”

In a recent phone conversation, Griesel, whose friendly voice brims with enthusiasm, talked about life both behind and in front of the camera. And she’s quick to note that it’s not just her moment, but a moment for all women over 50, because perceptions are slowly changing about what an older woman “looks like.”

At the same time, Griesel prefers to call herself “a guide, not a guru” when it comes to embracing aging. “We’re all going through the same emotions,” she says. “We all have the same insecurities. It’s universal.”

Julie Pfitzinger: How did you arrive at the moniker Silver Disobedience?

Dian Griesel: I love double entendres and wordplay. I have silvery white hair, of course, but I also wanted the name to represent a philosophical rebellion. Or a peaceful movement that would refuse the notion that anyone becomes irrelevant or obsolete.

Adults worry about becoming irrelevant in the workplace and in the larger world, but I have two teenagers, and they say that the worst insult teens can use against each other is to accuse someone of being irrelevant. Nobody wants that, and it doesn’t matter what age you are.

You’ve had many successful careers so far, and something you believe is of primary importance is challenging ourselves and staying engaged. In what ways?

We have to prioritize our health because we need strong, healthy bodies. This means eating well, managing our stress, staying hydrated. We need to stay social and spend time with others — that’s also a priority.

I also want people to challenge themselves to find out what really makes them happy. What do you do that you enjoy so much that you lose track of time while you’re doing it? Is it knitting? Writing? Painting? I believe it’s something you discover that you have such a great passion for that you really go into your own world while you’re doing it.

A line from one of your blog posts reads: ‘Being young is great. Being yourself at any age is priceless.’ Tell me more about this.

From the moment we were born, our physical being has been aging. And we need to honor it all the way through and not be afraid to be ourselves, exactly as we are.

Everything you’ve done at every stage of life adds up to your total big picture. We’re never ‘just’ anything; it’s part of a whole. We don’t give ourselves credit for what we have learned. We’ve all collected so many different skills and experiences.

As a working model and an Instagram influencer, your days must be very busy. Can you talk a little about your workflow?

I’m an early riser and up way ahead of everyone in the house; it’s a really peaceful time to get a lot of work done. I send emails to my staff, and then I write my blog for the day. I choose the photo, post on Facebook and Pinterest and then post to Instagram. By that time, everyone in my house is awake!

Modeling puts a big twist in the day. Typically, you don’t get your schedule for the next day until 5:30 or 6 p.m. the night before — and then I might find out I have to be on set by 6 a.m. the next morning.

With a daily Instagram presence, it would seem like you have to participate in a lot of photo shoots. How do those work? And where do you get the clothes?

Many of those photos are taken by professional photographers I’ve worked with, but I’ll often have young photographers reach out and ask to work with me because they are trying to diversify their portfolios. I never thought a fifty-nine-year-old woman with silver hair could be a face of diversity! (Laughs)

So, I tell them: ‘I’ll give you my iPhone and we can shoot for two hours.’ I bring a bunch of different outfits, we find a location and go. I pay everyone for their work, and I retain ownership of the photos. In a day, we might shoot eight hundred pictures, so I rotate a lot of clothes.

People might think I have a huge closet, but it’s just the opposite. This is pretty much what I have: jeans, black leather pants, white blouse and a black leather jacket. I’ve had the same dress suit for twenty years. I do a lot of shopping at Goodwill, the Salvation Army and local thrift shops. I’m always on the lookout for cool jackets and scarves.

Are you frequently recognized in public?

It does happen. I walk for exercise all over the streets of New York City, and invariably somebody will say something to me. Sometimes I’ll get tagged in someone else’s Instagram post.

Not long ago, I was tagged in a selfie that was taken at a thrift shop; I was concentrating on something on a rack, and I was in the background of the photo. The young girl had drawn a heart around my head and the caption read, ‘I hate myself, but my mom will love me forever!’ (Laughs)

By Julie Pfitzinger

Julie Pfitzinger is the editor for Next Avenue’s lifestyle coverage across the Living and Technology channels. Her journalism career has included feature writing for the Star-Tribune, as well as several local parenting and lifestyle publications, all in the Twin Cities area. Julie also served as managing editor for nine local community lifestyle magazines. She joined Next Avenue in October 2017. Reach her by email her at jpfitzinger@nextavenue.org.

Silver Disobedience influencer Dian Griesel on aging, priorities and surprise selfies
By Julie Pfitzinger

If you are on Instagram, chances are good that you’ve come across Silver Disobedience (@SilverDisobedience) blog posts featuring model and 50+ influencer Dian Griesel. In fact, you may be one of her 167,000 followers. In images shot in multiple locations around New York City, where she lives, Griesel, 59, always looks casually chic, wearing a confident smile telegraphing the impression that her moment is now.

And that’s true: beginning this month, Griesel, a Wilhelmina Icon model, will be featured in a new Lancôme campaign. Last year, she released The Silver Disobedience Playbook: 365 Inspirations for Living and Loving Agelessly. And her website, launched in 2017, offers her personal insights on creativity, health, philosophy, spirituality and more, in addition to featuring her daily blog post, read by more than 2 million followers.

Griesel, who is married with two teenagers, is also a certified counselor, president of DGI Companies, and serves as a consultant to multiple companies as a perception analyst, offering  expertise on marketing to an older demographic. She’s been a panelist at SxSW (South by SouthWest), and was selected by AARP as one of its Age Disruptors.

“Everything you’ve done at every stage of life adds up to your total big picture.”

In a recent phone conversation, Griesel, whose friendly voice brims with enthusiasm, talked about life both behind and in front of the camera. And she’s quick to note that it’s not just her moment, but a moment for all women over 50, because perceptions are slowly changing about what an older woman “looks like.”

At the same time, Griesel prefers to call herself “a guide, not a guru” when it comes to embracing aging. “We’re all going through the same emotions,” she says. “We all have the same insecurities. It’s universal.”

Julie Pfitzinger: How did you arrive at the moniker Silver Disobedience?

Dian Griesel: I love double entendres and wordplay. I have silvery white hair, of course, but I also wanted the name to represent a philosophical rebellion. Or a peaceful movement that would refuse the notion that anyone becomes irrelevant or obsolete.

Adults worry about becoming irrelevant in the workplace and in the larger world, but I have two teenagers, and they say that the worst insult teens can use against each other is to accuse someone of being irrelevant. Nobody wants that, and it doesn’t matter what age you are.

You’ve had many successful careers so far, and something you believe is of primary importance is challenging ourselves and staying engaged. In what ways?

We have to prioritize our health because we need strong, healthy bodies. This means eating well, managing our stress, staying hydrated. We need to stay social and spend time with others — that’s also a priority.

I also want people to challenge themselves to find out what really makes them happy. What do you do that you enjoy so much that you lose track of time while you’re doing it? Is it knitting? Writing? Painting? I believe it’s something you discover that you have such a great passion for that you really go into your own world while you’re doing it.

A line from one of your blog posts reads: ‘Being young is great. Being yourself at any age is priceless.’ Tell me more about this.

From the moment we were born, our physical being has been aging. And we need to honor it all the way through and not be afraid to be ourselves, exactly as we are.

Everything you’ve done at every stage of life adds up to your total big picture. We’re never ‘just’ anything; it’s part of a whole. We don’t give ourselves credit for what we have learned. We’ve all collected so many different skills and experiences.

As a working model and an Instagram influencer, your days must be very busy. Can you talk a little about your workflow?

I’m an early riser and up way ahead of everyone in the house; it’s a really peaceful time to get a lot of work done. I send emails to my staff, and then I write my blog for the day. I choose the photo, post on Facebook and Pinterest and then post to Instagram. By that time, everyone in my house is awake!

Modeling puts a big twist in the day. Typically, you don’t get your schedule for the next day until 5:30 or 6 p.m. the night before — and then I might find out I have to be on set by 6 a.m. the next morning.

With a daily Instagram presence, it would seem like you have to participate in a lot of photo shoots. How do those work? And where do you get the clothes?

Many of those photos are taken by professional photographers I’ve worked with, but I’ll often have young photographers reach out and ask to work with me because they are trying to diversify their portfolios. I never thought a fifty-nine-year-old woman with silver hair could be a face of diversity! (Laughs)

So, I tell them: ‘I’ll give you my iPhone and we can shoot for two hours.’ I bring a bunch of different outfits, we find a location and go. I pay everyone for their work, and I retain ownership of the photos. In a day, we might shoot eight hundred pictures, so I rotate a lot of clothes.

People might think I have a huge closet, but it’s just the opposite. This is pretty much what I have: jeans, black leather pants, white blouse and a black leather jacket. I’ve had the same dress suit for twenty years. I do a lot of shopping at Goodwill, the Salvation Army and local thrift shops. I’m always on the lookout for cool jackets and scarves.

Are you frequently recognized in public?

It does happen. I walk for exercise all over the streets of New York City, and invariably somebody will say something to me. Sometimes I’ll get tagged in someone else’s Instagram post.

Not long ago, I was tagged in a selfie that was taken at a thrift shop; I was concentrating on something on a rack, and I was in the background of the photo. The young girl had drawn a heart around my head and the caption read, ‘I hate myself, but my mom will love me forever!’ (Laughs)

By Julie Pfitzinger

Julie Pfitzinger is the editor for Next Avenue’s lifestyle coverage across the Living and Technology channels. Her journalism career has included feature writing for the Star-Tribune, as well as several local parenting and lifestyle publications, all in the Twin Cities area. Julie also served as managing editor for nine local community lifestyle magazines. She joined Next Avenue in October 2017. Reach her by email her at jpfitzinger@nextavenue.org.

Though hesitant at first, I was awarded for stepping out of my comfort zone
By Lisa Kanarek

Though hesitant at first, I was awarded for stepping out of my comfort zone
By Lisa Kanarek

The financial topic is one couples hate to think about, but should
By Kerri Fivecoat-Campbell

When my husband, Dale, passed away at age 57 from a sudden, massive heart attack two days before Thanksgiving in 2018, the last thing on my mind was the finances. This quickly changed, however, when I realized that as a relatively young widow of 54, I had just lost our second income.

To exacerbate my situation, due to my age and not having dependent children at home, I was ineligible to draw even partial Social Security income until turning 60. Nor could I withdraw from our retirement funds without heavy penalties and taxes until age 59 ½. On top of all that, my sole income from my freelance writing business would be subject to the higher single-payer tax bracket the following year.

However, I had learned an important life lesson from my parents when I was just 17; it proved invaluable after Dale’s death and could help you if you’re married and under 60.

According to the U.S. Census Bureau, the average age of widowhood in the United States is a surprisingly young 59.

When I was 17, my father also died suddenly of a massive heart attack at 58, and my mother was thrown into a similar situation. So, when Dale and I got married, 32 years before he died, we bought term life insurance policies. And we always carried extra life insurance through his job.

Those decisions saved me financially.

An Emotionally Draining Time

According to the U.S. Census Bureau, the average age of widowhood in the United States is a surprisingly young 59. That means there are many women who fall into the “donut hole” of not being able to draw Social Security benefits and who may have lost an income that had been essential for paying the bills.

Women are more likely than men to lose their spouse. And due to income inequality, they’re also typically more apt to be in a worse financial position if their spouse dies before they’re eligible for retirement benefits.

“Losing a spouse is a horrific event and if it happens unexpectedly, there is absolutely no time to plan,” said Michelle Brownstein, a Certified Financial Planner and vice president of private client services with Personal Capital in San Francisco.

One of the key ways to plan for this tragic possibility is to ensure both spouses have life insurance.

“Life insurance can really be that income replacement,” said Brownstein. She recommends owning term life insurance. “The earlier you purchase it, the better term life policy you can get and this will allow your spouse to continue to pay the bills without changing his or her lifestyle.”

Understanding the Household Finances

Another key component to being financially prepared in case a spouse dies: ensuring that each person in the relationship understands the couple’s finances and the way the household is run.

“After a marriage, one person typically takes the lead,” said Brownstein. “If that person passes, and the other doesn’t understand how the household functions day to day, it can make a very stressful time even more stressful.”

Rachel DeCarolis, wealth manager for Northstar Financial Planning in Windham, N.H., said although it may be an uncomfortable topic, spouses also need to discuss how the finances would change if something unexpected happened to either of them.

“Talking about how the income would change and how expenses would change could mentally get you in a good place,” said DeCarolis.

What One Couple Did and Didn’t Think About

Barb and Grant Froman didn’t necessarily plan for such an event before Grant died from a sudden massive heart attack at 54 in June 2018. However, the couple had been planning well for their financial future, with the idea of retirement in mind.

They had life insurance and investments, mostly from an inheritance Barb received from her mother’s estate. They carried no credit card debt and their home and vehicles were paid off.

“You pay on the life insurance year after year, never really thinking about it until something like this happens. And I suddenly looked at it and went, ‘Wow. Thank God for this,” said Froman, 55, who lives in York, Pa.

Although her only routine expenses are for things like utilities and food, Froman said she hadn’t thought about some other costs.

“There were a lot of things Grant could fix that didn’t require us spending money to pay someone, such as oil changes, carpentry, electrical and plumbing that I am finding has to be done by someone else,” said Froman.

Froman said she’s been helped by the assistance of an excellent financial adviser. Working with one when you are married can let you see whether you’re prepared for the worst and what to do if you’re not.

“Find a financial adviser that is a fiduciary, not one who is trying to sell products,” said Brownstein.

4 Recommendations for Widows

Here are four recommendations for women who are already widows:

Ask your adviser where you stand on drawing survivor’s benefits. Same-sex couples who are legally married and have been for more than a year are eligible for the same benefits as heterosexual couples. If you have a child at home age 16 or under, you’re likely eligible to draw Social Security benefits for the child.

Talk with a financial adviser or an attorney if your spouse had debt that you did not jointly own, as well as any outstanding medical bills. Depending on your state, you may or may not have to pay off that debt.

If your spouse was a veteran, see if you’re eligible for VA benefits.

Look into joining the local chapter of the Modern Widow’s Club, if there’s one where you live. The 20 chapters of the Modern Widow’s Club (10 more are coming in 2020) seek to empower widows, including providing financial advice from professionals.

By Kerri Fivecoat-Campbell

Kerri Fivecoat-Campbell is a freelance writer whose work has appeared on Forbes.com, AOL.com, Mainstreet.com, Creditcards.com, Bankrate.com and elsewhere.

The financial topic is one couples hate to think about, but should
By Kerri Fivecoat-Campbell

When my husband, Dale, passed away at age 57 from a sudden, massive heart attack two days before Thanksgiving in 2018, the last thing on my mind was the finances. This quickly changed, however, when I realized that as a relatively young widow of 54, I had just lost our second income.

To exacerbate my situation, due to my age and not having dependent children at home, I was ineligible to draw even partial Social Security income until turning 60. Nor could I withdraw from our retirement funds without heavy penalties and taxes until age 59 ½. On top of all that, my sole income from my freelance writing business would be subject to the higher single-payer tax bracket the following year.

However, I had learned an important life lesson from my parents when I was just 17; it proved invaluable after Dale’s death and could help you if you’re married and under 60.

According to the U.S. Census Bureau, the average age of widowhood in the United States is a surprisingly young 59.

When I was 17, my father also died suddenly of a massive heart attack at 58, and my mother was thrown into a similar situation. So, when Dale and I got married, 32 years before he died, we bought term life insurance policies. And we always carried extra life insurance through his job.

Those decisions saved me financially.

An Emotionally Draining Time

According to the U.S. Census Bureau, the average age of widowhood in the United States is a surprisingly young 59. That means there are many women who fall into the “donut hole” of not being able to draw Social Security benefits and who may have lost an income that had been essential for paying the bills.

Women are more likely than men to lose their spouse. And due to income inequality, they’re also typically more apt to be in a worse financial position if their spouse dies before they’re eligible for retirement benefits.

“Losing a spouse is a horrific event and if it happens unexpectedly, there is absolutely no time to plan,” said Michelle Brownstein, a Certified Financial Planner and vice president of private client services with Personal Capital in San Francisco.

One of the key ways to plan for this tragic possibility is to ensure both spouses have life insurance.

“Life insurance can really be that income replacement,” said Brownstein. She recommends owning term life insurance. “The earlier you purchase it, the better term life policy you can get and this will allow your spouse to continue to pay the bills without changing his or her lifestyle.”

Understanding the Household Finances

Another key component to being financially prepared in case a spouse dies: ensuring that each person in the relationship understands the couple’s finances and the way the household is run.

“After a marriage, one person typically takes the lead,” said Brownstein. “If that person passes, and the other doesn’t understand how the household functions day to day, it can make a very stressful time even more stressful.”

Rachel DeCarolis, wealth manager for Northstar Financial Planning in Windham, N.H., said although it may be an uncomfortable topic, spouses also need to discuss how the finances would change if something unexpected happened to either of them.

“Talking about how the income would change and how expenses would change could mentally get you in a good place,” said DeCarolis.

What One Couple Did and Didn’t Think About

Barb and Grant Froman didn’t necessarily plan for such an event before Grant died from a sudden massive heart attack at 54 in June 2018. However, the couple had been planning well for their financial future, with the idea of retirement in mind.

They had life insurance and investments, mostly from an inheritance Barb received from her mother’s estate. They carried no credit card debt and their home and vehicles were paid off.

“You pay on the life insurance year after year, never really thinking about it until something like this happens. And I suddenly looked at it and went, ‘Wow. Thank God for this,” said Froman, 55, who lives in York, Pa.

Although her only routine expenses are for things like utilities and food, Froman said she hadn’t thought about some other costs.

“There were a lot of things Grant could fix that didn’t require us spending money to pay someone, such as oil changes, carpentry, electrical and plumbing that I am finding has to be done by someone else,” said Froman.

Froman said she’s been helped by the assistance of an excellent financial adviser. Working with one when you are married can let you see whether you’re prepared for the worst and what to do if you’re not.

“Find a financial adviser that is a fiduciary, not one who is trying to sell products,” said Brownstein.

4 Recommendations for Widows

Here are four recommendations for women who are already widows:

Ask your adviser where you stand on drawing survivor’s benefits. Same-sex couples who are legally married and have been for more than a year are eligible for the same benefits as heterosexual couples. If you have a child at home age 16 or under, you’re likely eligible to draw Social Security benefits for the child.

Talk with a financial adviser or an attorney if your spouse had debt that you did not jointly own, as well as any outstanding medical bills. Depending on your state, you may or may not have to pay off that debt.

If your spouse was a veteran, see if you’re eligible for VA benefits.

Look into joining the local chapter of the Modern Widow’s Club, if there’s one where you live. The 20 chapters of the Modern Widow’s Club (10 more are coming in 2020) seek to empower widows, including providing financial advice from professionals.

By Kerri Fivecoat-Campbell

Kerri Fivecoat-Campbell is a freelance writer whose work has appeared on Forbes.com, AOL.com, Mainstreet.com, Creditcards.com, Bankrate.com and elsewhere.

Scheduling time for reflection will never be a waste of time
By Megy Karydes

When making New Year’s resolutions, some people choose to set an intention or goal and some choose a particular word to help them stay focused. Others, like Chicagoans Tracy Marks-Seglin, founder of Strategic Words Communications, and her urban planner husband Dave, think about what they want less (and more) of in the coming year and write those things down.

Regardless of how you approach the start of a new year, you’ll likely reflect on the past year and how you can make the coming one better. Since we’re entering a new decade, this type of reflection can take a bigger meaning in 2020.

So, here are 20 questions that can help you reach your goals in 2020 and beyond:

1. How do I define success? This may differ each year, so think about your definition for 2020.

“A lot of the time, we set goals to please other people: a spouse, family member or colleague.”

2. What am I most proud of in the last year — or the last 10 years? Start 2020 by celebrating your wins, says Amy Throw, president and chief encouragement officer with Amy Throw Group, a Saint Charles, Ill.-based coaching firm for women.
3. What did I enjoy doing the most in 2019? And what didn’t you enjoy? Don’t waste those learnings. “If you jump into 2020 without taking a moment to reflect, you can’t leverage 2019’s lessons and insights,” says Cathryn Lavery, productivity expert and founder of BestSelf Co., a personal development firm in Austin, Texas.
4. Whom do I want to become? “This is a deeper question that once answered, allows you to set up a lifestyle, and consistently improve to get closer and closer to your goal,” says Jody Michael, executive coach and founder of Jody Michael Associates, a coaching and consulting firm in Chicago.
5. What are my nagging regrets or unresolved issues from this year or earlier? Michael Hyatt, author of Your Best Year Ever and former chairman and CEO of Thomas Nelson Publishers, encourages people to write these down. Then, he says, consider what you can do in the coming year to address them.
6. What do I want more of in my life? Tracy Marks-Seglin and her husband, who are 54 and 58 respectively, write the answers on strips of paper on New Year’s Eve. Then, they hang the strips in a triple-ziplocked bag (to protect them from the elements) from a backyard tree and open them the following New Year’s Eve to see how many came to fruition. “At that point, we’re either really happy or mildly disappointed,” Tracy laughs.
7. What do I want less of in my life? Marks-Seglin and her husband repeat the above exercise of writing these things down on strips of paper. But rather than hang these from a tree, they burn them in the fireplace. “Burning the things we don’t want is so visceral and feels so freeing,” she admits.
8. What do I want to focus on? That’s a question suggested by Rebecca Kiki Weingarten, a professional and personal development coach at New York City-based TradeCraft Coaching and Consulting.
9. What can I stop procrastinating? Create a list of the “I SHOULDS” that you keep delaying and ask yourself what’s holding you back, says Throw.
10. What goals do I want for my own life, not for others? “A lot of the time, we set goals to please other people: a spouse, family member or colleague,” says Hyatt.
11. What support systems do I have in place to help me reach my goals? And, conversely, figure out the roadblocks to plan for; note these so you can think through strategies to deal with setbacks and slumps, says Weingarten.
12. What is one new thinking pattern I can discipline myself to use in 2020? Throw says that knowing this will require developing new habits.
13. What is one good habit that I have? Look for ways to better profit from it.
14. What is one habit I want to change? After you come up with this, determine how you can fix it.
15. What is one behavior or activity I will say NO to in 2020? Coming up with the answer will make it easier for you to say YES to an activity that will get you closer to your big bold audacious goal, Throw notes.
16. How can I parlay what I love doing into other opportunities? Marks-Seglin takes a hard look to identify what makes her happy personally and professionally. Then she works backward to think of ways she can incorporate these into other parts her life.
17. How can I be 1% better today than I was yesterday? For Jennifer Wisniewski, a certified life coach in Chicago, New Year’s resolutions seem to be more about the goal than the process. “If your concentration is only on the outcome, you will probably give up before that goal is reached,” she says. Use the “1% better” marker to focus on the present rather than looking at the future for your happiness, she advises.
18. When am I most relaxed to properly give myself the time I need to go through this process? Schedule the time, so it’ll happen.
19. What is the one big, bold audacious goal that gets me most excited? Throw says: Think how can you employ your natural skills, experience and successful behaviors to work toward this goal.
20. What can I do right now or in the next day, week or month, to help reach my one big goal in 2020? The hardest part for some people is getting started. “It can take longer than you thought it would to make real changes happen,” Weingarten says.

These 20 questions might be too many — or too few — for you. But you can use them as a starting point to help identify what makes you happy and what you need to put into place to help reach your 2020 goals. Good luck!

By Megy Karydes

Megy Karydes is a freelance writer whose work has appeared in Politico, Forbes, Fortune, USA Today and elsewhere. She is also an adjunct professor at Johns Hopkins University, where she teaches graduate-level communications courses.

Scheduling time for reflection will never be a waste of time
By Megy Karydes

When making New Year’s resolutions, some people choose to set an intention or goal and some choose a particular word to help them stay focused. Others, like Chicagoans Tracy Marks-Seglin, founder of Strategic Words Communications, and her urban planner husband Dave, think about what they want less (and more) of in the coming year and write those things down.

Regardless of how you approach the start of a new year, you’ll likely reflect on the past year and how you can make the coming one better. Since we’re entering a new decade, this type of reflection can take a bigger meaning in 2020.

So, here are 20 questions that can help you reach your goals in 2020 and beyond:

1. How do I define success? This may differ each year, so think about your definition for 2020.

“A lot of the time, we set goals to please other people: a spouse, family member or colleague.”

2. What am I most proud of in the last year — or the last 10 years? Start 2020 by celebrating your wins, says Amy Throw, president and chief encouragement officer with Amy Throw Group, a Saint Charles, Ill.-based coaching firm for women.
3. What did I enjoy doing the most in 2019? And what didn’t you enjoy? Don’t waste those learnings. “If you jump into 2020 without taking a moment to reflect, you can’t leverage 2019’s lessons and insights,” says Cathryn Lavery, productivity expert and founder of BestSelf Co., a personal development firm in Austin, Texas.
4. Whom do I want to become? “This is a deeper question that once answered, allows you to set up a lifestyle, and consistently improve to get closer and closer to your goal,” says Jody Michael, executive coach and founder of Jody Michael Associates, a coaching and consulting firm in Chicago.
5. What are my nagging regrets or unresolved issues from this year or earlier? Michael Hyatt, author of Your Best Year Ever and former chairman and CEO of Thomas Nelson Publishers, encourages people to write these down. Then, he says, consider what you can do in the coming year to address them.
6. What do I want more of in my life? Tracy Marks-Seglin and her husband, who are 54 and 58 respectively, write the answers on strips of paper on New Year’s Eve. Then, they hang the strips in a triple-ziplocked bag (to protect them from the elements) from a backyard tree and open them the following New Year’s Eve to see how many came to fruition. “At that point, we’re either really happy or mildly disappointed,” Tracy laughs.
7. What do I want less of in my life? Marks-Seglin and her husband repeat the above exercise of writing these things down on strips of paper. But rather than hang these from a tree, they burn them in the fireplace. “Burning the things we don’t want is so visceral and feels so freeing,” she admits.
8. What do I want to focus on? That’s a question suggested by Rebecca Kiki Weingarten, a professional and personal development coach at New York City-based TradeCraft Coaching and Consulting.
9. What can I stop procrastinating? Create a list of the “I SHOULDS” that you keep delaying and ask yourself what’s holding you back, says Throw.
10. What goals do I want for my own life, not for others? “A lot of the time, we set goals to please other people: a spouse, family member or colleague,” says Hyatt.
11. What support systems do I have in place to help me reach my goals? And, conversely, figure out the roadblocks to plan for; note these so you can think through strategies to deal with setbacks and slumps, says Weingarten.
12. What is one new thinking pattern I can discipline myself to use in 2020? Throw says that knowing this will require developing new habits.
13. What is one good habit that I have? Look for ways to better profit from it.
14. What is one habit I want to change? After you come up with this, determine how you can fix it.
15. What is one behavior or activity I will say NO to in 2020? Coming up with the answer will make it easier for you to say YES to an activity that will get you closer to your big bold audacious goal, Throw notes.
16. How can I parlay what I love doing into other opportunities? Marks-Seglin takes a hard look to identify what makes her happy personally and professionally. Then she works backward to think of ways she can incorporate these into other parts her life.
17. How can I be 1% better today than I was yesterday? For Jennifer Wisniewski, a certified life coach in Chicago, New Year’s resolutions seem to be more about the goal than the process. “If your concentration is only on the outcome, you will probably give up before that goal is reached,” she says. Use the “1% better” marker to focus on the present rather than looking at the future for your happiness, she advises.
18. When am I most relaxed to properly give myself the time I need to go through this process? Schedule the time, so it’ll happen.
19. What is the one big, bold audacious goal that gets me most excited? Throw says: Think how can you employ your natural skills, experience and successful behaviors to work toward this goal.
20. What can I do right now or in the next day, week or month, to help reach my one big goal in 2020? The hardest part for some people is getting started. “It can take longer than you thought it would to make real changes happen,” Weingarten says.

These 20 questions might be too many — or too few — for you. But you can use them as a starting point to help identify what makes you happy and what you need to put into place to help reach your 2020 goals. Good luck!

By Megy Karydes

Megy Karydes is a freelance writer whose work has appeared in Politico, Forbes, Fortune, USA Today and elsewhere. She is also an adjunct professor at Johns Hopkins University, where she teaches graduate-level communications courses.

After loss, it's a different path to 'the new normal' for those with depression
By Suzanne Boles

“Thank you for the intervention. Friends and family came to be with me. I agreed to be admitted to hospital. Am waiting for a bed. I had a horrible breakdown. I am sorry for worrying you.”

This was my message posted on Facebook to friends on October 19, 2014. It was over a year since my husband, Bob, passed away. Every day since he died on June 8, 2013 was like walking through thick, muddy water with a constant fog clouding my head.

I was a willing participant in the loss and grief cycle from day one. I had no interest in the future. The past was painful, the present bleak. Every day I woke up crying, for days, weeks, months, and soon a year passed. Depression is part of the initial journey. Many people feel like they can’t survive without their loved one. The agony is enormous, but the pain starts to diminish with time.

It is natural to experience intense grief after someone close dies, but complicated grief is different.

My story was different. The depression was pervasive and continued, even escalated. I journaled the experience, intermittently, in a blog. Posting my thoughts gave me temporary relief. Then I’d go down the rabbit hole again. What I didn’t realize was that I was experiencing something more than a normal grief journey. Though not diagnosed, researching my symptoms led me to what’s known as Complicated Grief.

The Intensity of Complicated Grief

According to The Center for Complicated Grief (CG) “[it] is a form of grief that takes hold of a person’s mind and won’t let go. It is natural to experience intense grief after someone close dies, but complicated grief is different. Troubling thoughts, dysfunctional behaviors or problems regulating emotions get a foothold and stall adaptation. Complicated grief is the condition that occurs when this happens.

“People with complicated grief don’t know what’s wrong. They assume that their lives have been irreparably damaged by their loss and cannot imagine how they can ever feel better. Grief dominates their thoughts and feelings with no respite in sight.”

According to the Mayo Clinic, CG can be determined “when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose CG when the grieving continues to be intense, persistent and debilitating beyond 12 months … Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done.”

The Diagnosis That Probably Saved My Life

I had seen several therapists. They tried to help, under the assumption that I was grieving as any woman would after the death of her husband. What I didn’t tell them was that my sadness had escalated to suicide ideation.

On the evening of Saturday October 18, 2014, I posted on Facebook: “Please take care of my cats.” My cry for help wasn’t a mystery to friends who were following my downward spiral. Phone calls went out from people in several cities to friends who lived near me who came to my house, then later family. Despite my uncharacteristic reaction screaming at everyone who entered the door and yelling at them to leave, I eventually calmed down and agreed to be taken to the hospital.

I was put in a room with no windows and a security guard. Some family members came in. The doctor followed and told me the medication I’d been taking for many years to control my clinical depression wasn’t working. When that happens, ironically, it can make you more depressed.

That diagnosis rocked me to the core and probably saved my life. Every day had been torture. And now I had someone who was telling me they could help me and life could actually get better.

I agreed to be admitted to hospital and new medication was prescribed by a hospital psychiatrist. I stayed there just over a week, eventually getting day passes, then a weekend pass. After my release, I was closely monitored to ensure my medication was doing what it should have done. I started seeking other ways to help me out of the dark pit and took part in several Cognitive Behavioral Therapy (CBT) programs, or what I refer to as retraining the brain to focus on the positive.

Live in the Moment

Today, I lead what those newly grieving are told is “the new normal life” because, when our loved ones die, life as we knew it is inevitably changed forever and will never go back to what we thought was our normal life. As Buddhist monk and peace activist, Nhat Hanh, said, “It is not impermanence that makes us suffer. What makes us suffer is wanting things to be permanent when they are not.”

The new life can be good if we come to terms with our losses; remember them with loving kindness; embrace our family, friends, and new people who come into our lives and accept that nothing is ever permanent in life. The biggest lesson I learned is to truly live in the moment and enjoy each precious day as a gift.

If you, or someone you know, has been suffering with extreme grief symptoms for over a year it might be time to seek help.

Coping with Grief and Loss

While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief and eventually, find a way to pick up the pieces and move on with your life. Here are some suggestions from Help Guide: 

1. Acknowledge your pain.
   2. Accept that grief can trigger many different and unexpected emotions.
   3. Understand that your grieving process will be unique to you.
   4. Seek out face-to-face support from people who care about you.
   5. Support yourself emotionally by taking care of yourself physically.

By Suzanne Boles

Suzanne Boles is a feature writer, content creator and writing coach. Her work has appeared in Costco Connection Magazine, on Headspace.com and Profitguide.com and in many business publications. She lives in London, Ontario Canada.

After loss, it's a different path to 'the new normal' for those with depression
By Suzanne Boles

“Thank you for the intervention. Friends and family came to be with me. I agreed to be admitted to hospital. Am waiting for a bed. I had a horrible breakdown. I am sorry for worrying you.”

This was my message posted on Facebook to friends on October 19, 2014. It was over a year since my husband, Bob, passed away. Every day since he died on June 8, 2013 was like walking through thick, muddy water with a constant fog clouding my head.

I was a willing participant in the loss and grief cycle from day one. I had no interest in the future. The past was painful, the present bleak. Every day I woke up crying, for days, weeks, months, and soon a year passed. Depression is part of the initial journey. Many people feel like they can’t survive without their loved one. The agony is enormous, but the pain starts to diminish with time.

It is natural to experience intense grief after someone close dies, but complicated grief is different.

My story was different. The depression was pervasive and continued, even escalated. I journaled the experience, intermittently, in a blog. Posting my thoughts gave me temporary relief. Then I’d go down the rabbit hole again. What I didn’t realize was that I was experiencing something more than a normal grief journey. Though not diagnosed, researching my symptoms led me to what’s known as Complicated Grief.

The Intensity of Complicated Grief

According to The Center for Complicated Grief (CG) “[it] is a form of grief that takes hold of a person’s mind and won’t let go. It is natural to experience intense grief after someone close dies, but complicated grief is different. Troubling thoughts, dysfunctional behaviors or problems regulating emotions get a foothold and stall adaptation. Complicated grief is the condition that occurs when this happens.

“People with complicated grief don’t know what’s wrong. They assume that their lives have been irreparably damaged by their loss and cannot imagine how they can ever feel better. Grief dominates their thoughts and feelings with no respite in sight.”

According to the Mayo Clinic, CG can be determined “when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose CG when the grieving continues to be intense, persistent and debilitating beyond 12 months … Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done.”

The Diagnosis That Probably Saved My Life

I had seen several therapists. They tried to help, under the assumption that I was grieving as any woman would after the death of her husband. What I didn’t tell them was that my sadness had escalated to suicide ideation.

On the evening of Saturday October 18, 2014, I posted on Facebook: “Please take care of my cats.” My cry for help wasn’t a mystery to friends who were following my downward spiral. Phone calls went out from people in several cities to friends who lived near me who came to my house, then later family. Despite my uncharacteristic reaction screaming at everyone who entered the door and yelling at them to leave, I eventually calmed down and agreed to be taken to the hospital.

I was put in a room with no windows and a security guard. Some family members came in. The doctor followed and told me the medication I’d been taking for many years to control my clinical depression wasn’t working. When that happens, ironically, it can make you more depressed.

That diagnosis rocked me to the core and probably saved my life. Every day had been torture. And now I had someone who was telling me they could help me and life could actually get better.

I agreed to be admitted to hospital and new medication was prescribed by a hospital psychiatrist. I stayed there just over a week, eventually getting day passes, then a weekend pass. After my release, I was closely monitored to ensure my medication was doing what it should have done. I started seeking other ways to help me out of the dark pit and took part in several Cognitive Behavioral Therapy (CBT) programs, or what I refer to as retraining the brain to focus on the positive.

Live in the Moment

Today, I lead what those newly grieving are told is “the new normal life” because, when our loved ones die, life as we knew it is inevitably changed forever and will never go back to what we thought was our normal life. As Buddhist monk and peace activist, Nhat Hanh, said, “It is not impermanence that makes us suffer. What makes us suffer is wanting things to be permanent when they are not.”

The new life can be good if we come to terms with our losses; remember them with loving kindness; embrace our family, friends, and new people who come into our lives and accept that nothing is ever permanent in life. The biggest lesson I learned is to truly live in the moment and enjoy each precious day as a gift.

If you, or someone you know, has been suffering with extreme grief symptoms for over a year it might be time to seek help.

Coping with Grief and Loss

While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief and eventually, find a way to pick up the pieces and move on with your life. Here are some suggestions from Help Guide: 

1. Acknowledge your pain.
   2. Accept that grief can trigger many different and unexpected emotions.
   3. Understand that your grieving process will be unique to you.
   4. Seek out face-to-face support from people who care about you.
   5. Support yourself emotionally by taking care of yourself physically.

By Suzanne Boles

Suzanne Boles is a feature writer, content creator and writing coach. Her work has appeared in Costco Connection Magazine, on Headspace.com and Profitguide.com and in many business publications. She lives in London, Ontario Canada.