We've Just Begun Social Distancing~ Here Are My Thoughts

It is March 14, 2020. I am in my house under self imposed isolation. Not because I have been exposed to Covid 19, let alone tested positive, but because I am 79 years old. Not frail, not sick, just 79 years old.

What I am noticing from this now two week isolation, is the similarities between my behavior and thoughts, and end of life behavior and thoughts. I'm thinking and acting like someone with a life threatening illness.

I was doing the laundry, an everyday, normal function, when I looked in the mirror and saw my no make up face and a body still in her bathrobe at 9AM. Who was this person? This person that always puts makeup on, showers daily and dresses very nicely even if she has no where to go?

This is the same as a person with a life threatening illness who thinks why bother, it doesn’t matter, this isn’t important. Isolation from others is teaching me this about my self ——- I do a lot for others, for their thoughts of me, why else do I wear makeup? Get dressed? Bathe (well maybe just for the smell of me)?

I started thinking about how aimless I have become. Floundering to be useful, feeling guilty for not “doing something”, for not appearing productive. Through this isolation my sense of purpose has been affected. Why do I get up in the morning? What do I do all day to keep busy, to fill my time?

So it is with someone with a life threatening illness, from new diagnosis to weeks before death (once labor begins, weeks before death, mental activity changes and this doesn’t apply). They lose their purpose for getting up in the morning, for what to do about the life they are leaving behind? Apathy and depression often follow.

When someone has been told they have a life threatening illness, that they probably can’t be fixed, their life changes, their fears take hold, their thoughts turn to new areas of consideration, their living patterns change.

My husband and I, at 86 he is in this isolation with me, are more attuned to each other, more affectionate, trying to be more connected, nicer, more considerate. It's like unconsciously we are reaching out to what truly matters. It is the same with family and friends. I now think about texting and phone calling just to visit, just to say hi. So it is with someone approaching the end of their life. People often become the focus, relationships matter more.

I’m going to qualify this entire blog by saying we die the way we have lived and according to our personality. A personality that didn’t perceive others, consider others, relate to others will not suddenly, because they can’t be fixed, become Mother Teresa-like. (I do wonder if maybe, just maybe, a glimpse of what might have been glides through their mind hoping to be perceived).

These are the same questions of self searching that affect someone facing the end of their life. Now, I may not be facing the end of my life, right now, and I hope as you read this you aren’t either BUT we will all be in this approaching end of life spot someday, as are the patients we serve and care for.

As I’m sitting at my computer I look out my window and see, in March, snow quietly falling. I see inches of snow, birds at the feeder, all is quiet, all appears right with the world. An illusion, yes, all is not right with the world, but touching into that peacefulness, that calm is healing for my restless mind and spirit.

My wish for you in this time of isolation, of social distancing, is to let the distancing be physical but not emotional. Reach out to others, use this time to evaluate your life, activities, your purpose. Use this separation from the normal pace you have developed to recharge, relax, and reevaluate.



Was just commenting to a fellow hospice-worker yesterday “I wonder what Barbara Karnes would have to say about COVID-19…” This came after a recent re-watching of your New Rules for End of Life Care video, and a discussion about your singular talent for explaining difficult concepts in ways that all can understand, and feel comforted and at peace by your explanations.

With the uncertainty and fear due to COVID-19, we all could use a moment of peace, a moment of perspective. I’m going to read my way through the rest of your recent blogposts, and resubscribe, but I wanted to pause and thank you. for providing me with that moment of peace that I needed.


Hi Cathy, you address a situation I have been thinking about for several days. How do we protect our healthcare workers AND how do we protect patients and family from the healthcare worker. The HC worker is out and about, exposed, the patient and families are isolated. You added another component with the healthcare worker returning home to an elder and/or exposing their significant others. I, like everyone else, don’t have answers. Seems like a lot of us see the problems but not solutions. I think the biggest problem right now is not everyone is on the “same page”. Some of us see the dangers, others ignore or are oblivious to the dangers, or maybe just don’t care. I wish I had concrete guidance for you, a do this and you will be fine kind of guidance—but I don’t. I remember saying to my first patient with AIDS in the ‘80s, “I’ve never taken care of someone with AIDS before. We don’t know very much about this disease right now but if I make mistakes it will be on the side of being overly cautious”. I think that guidance holds true today. My blessings are with you, your family and mom.

Cathy Bacinelli

Thank you Barbara for your kind words and understanding. Though we (I recently moved in with my mom to help her) are not quarantined yet, I do worry about what I may bring home (mom is 87). I am a hospice Social Worker and my job requires me to travel to patient homes, wherever that may be. Right now, I am not allowed in any SNF’s but so far, home patients/families are still allowing visits. So far, none of our patients have been affected by Covid-19, but realistically, how long can that last? I pray for everyones safety and this to be over quickly. Be well all.


Hi Michael, good to hear from you. It has been awhile. Of course you can share this, and any of my blogs, with your team and families. That is why I write them. Blessings to you and your team in the work you all are doing. Stay safe. We need you. Barbara


Hi Jackie, just wanted to touch you and can only do it with words. Thank you for sharing your thoughts with me. Life is hard work and this particular part of life is showing us another example of how hard it can be. I did see “A Beautiful Day In The Neighborhood” and I want to be like Mr. Rodgers when I grow up. Enjoy the painting. I got out my coloring books, not just a time filler, but a concentration tool for getting my mind off everything else. Blessings! Barbara.

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