Isolation During COVID-19: The Challenges and Opportunities
Cancer can be an isolating disease - both physically and emotionally.
For one thing, cancer patients often have compromised immune systems due to the disease or its treatment, requiring them to physically limit their exposure to the outside world. That can lead to emotional isolation, when certain social connections are cut off and feelings of loneliness start to creep in.
Additionally, cancer patients are more susceptible to contracting viruses such as COVID-19, which for some has led to additional layers of isolation and feelings of extreme loneliness.
However, she notes that despite those complications, some patients are finding opportunities to connect with others during this time.
Living with a compromised immune system can be difficult enough, but the added anxiety over contracting COVID-19 can be a heavy burden.
"Some patients are feeling even more isolated, because they are not comfortable allowing anybody to be in their home or to even have contact with people in their household, because of their extreme vulnerability during their time of treatment," DuBenske said.
In addition, opportunities for in-person socializing have become tricky. Even if patients previously had regular check-ins with friends and families, physical distancing guidelines may have temporarily put a halt to these visits. Patients may also struggle with the abrupt suspension of an in-person support group they relied upon before the pandemic.
Even a visit to the clinic can be isolating in its own way. DuBenske says she's heard from some patients that even sitting in the waiting room is a much different experience than ever before. While many patients are still coming in for care, changes have been made to appointment times and waiting rooms to space people out.
"When there are more people in the waiting room, it presents a chance for some informal peer-to-peer support," she said. "Now, there aren't as many people in the waiting room, and they're sitting far apart from each other."
While the immediate urge is to find a "fix" to isolation, DuBenske says it's important to acknowledge these feelings before anything else.
"The first thing I help my patients do is just identify their feeling and validate it for them," she said. "We acknowledge that this is a time of extra loneliness, and then we can start thinking about how we can cope with it."
Coping will look different for each individual, but involves finding creative solutions for each person's unique needs. For some people, it will mean drawing on existing social connections, and finding new ways to maintain them. That could be accomplished through increased calls or video chats, or sending cards and letters. Some patients may want to use the time for internal reflection. Journaling or looking through family photos may be helpful there.
Individual patients will also have to determine what level of risk they are willing to accept when it comes to in-person exposure to others. That might mean making decisions about when it's okay leave the house, as well as who is allowed to visit.
Once a decision is made, DuBenske says it's important for friends and family to respect it, even if they don't understand or disagree.
"What's really hard for patients is the judgement they may receive from the people who are close to them," she said. "I would encourage people to accept their loved one who is going through cancer with where they're at and their decision," DuBenske said.
For some patients, the current state of the world has actually made them feel less isolated, and has created new opportunities for understanding, communication and support.
"Before COVID-19, cancer patients often felt very alone in their need to isolate and use precautions and keep people away and restrict contact, and now everybody has to do that," DuBenske said. "So there's been a sense of validation and understanding that comes with that. A lot of my patients have felt that their friends and families understand them better, which makes them feel less isolated."
Additionally, just because support groups have had to hit pause on in-person meetings doesn't mean help isn't available. Many support groups have gone virtual, meeting over video chat. That move, DuBenske says, has opened doors for some patients who may not have previously been able to join in-person meetings, due to physical distance from the group's location or not being physically able to leave the house.
Some groups, including Imerman Angels, also provide personalized peer support that can be done over the phone or e-mail for those who prefer one-on-one interaction.
And even though there are fewer people in the waiting room at the clinic, it may actually be a unique opportunity to strike up a conversation. "Even though you're sitting farther apart, there are opportunities to connect with other patients," DuBenske said. "It's a little bit more private than it otherwise might have been in the waiting rooms, because there aren't so many people there."
In addition, DuBenske says cancer patients can teach the rest of us a thing or two about dealing with a tough time, such as COVID-19. That includes accepting things out of our control, rolling with the punches, and living a life that corresponds with our values.
"Cancer patients go through this isolating, life changing event, where they recognize their vulnerability," she said. "They recognize the fragility of life and because of that, do a little bit of life review and reprioritizing, and that's a great lens for the rest of us to look at this experience through."
Date Published: 06/09/2020