A psychologist’s tips for self-care

By Dr. Micaela Thordarson, pediatric psychologist at CHOC Children’s

Self-care is the critical maintenance we need to be able to keep functioning. Sometimes self-care is compared to the way we care for our cars. Often, self-care is talked about as the equivalent to getting your car detailed or putting on a special coat of wax to keep the color shiny. But actually, self-care is much more closely comparable to putting gas in your car. If you don’t stop for gas every so often, your car will stop functioning – no matter how much you want to keep driving down the road! It’s the same for self-care. Without self-care, your brain, body and emotions will simply shut you down and make continued functioning impossible.

Examples of self-care

Self-care takes many different forms! There are the essentials like eating, drinking water, bathing and sleeping. As silly as that sounds, simply stop for a moment and think about how often this week you skipped a meal or prioritized something else over getting a good night’s sleep.

There are also a wide range of other forms of self-care that are tied directly to a person’s specific preferences! Extroverts practice self-care by engaging in enjoyable social interactions while introverts may curl up on their own with a great book or an exciting new TV show. High-energy folks tend to prefer self-care like exercise or exhilarating hobbies, while others may want peaceful or calming activities to recharge or find joy.

The most rewarding forms of self-care are also determined by whatever challenges exist in a person’s life. Right now, during the COVID-19 pandemic and stay-at-home orders, many people are feeling isolated, so they are using technology to connect and practicing self-care by reaching out to loved ones in new ways. Others are experiencing cabin fever and so they take a break from their daily responsibilities to walk around their neighborhood.

Self-care for parents

Parents are being asked to take on more during these times than ever before. With schools and many offices closed, many parents are juggling working from home, monitoring their child’s distance learning, organizing activities to keep kids entertained and engaged, and more. That is why it’s important for parents and caregivers to practice self-care.

I think the best metaphor for this is the use of oxygen masks on planes. Taking care of yourself makes it possible for you to care for others. If you fall apart, everyone who relies on you will also be feeling lost or unraveled! Caregivers are often so selfless; I find it’s helpful to point out that taking care of ourselves is just one more way we take care of others.

Proper self-care improves productivity, improves mood, improves attention and concentration, increases patience, and increases the rewarding experiences that you can have when serving in a caregiving role!

What happens when we ignore self-care

Think of practicing self-care like a bank account. There are baseline transactions that must occur every day, like eating and sleeping. Beyond that, the need for self-care varies with daily stresses. The number of stressors in a day are like withdrawals and thus determine the balancing requirements for self-care, which are like deposits.

Ironically, the more stressed we are, the less we tend to prioritize self-care, which can lead to very serious things like burnout or “breakdowns.”

Burnout is probably the biggest outcome of neglecting self-care. Other things include increased chances of getting sick, increased unpleasant emotions, decreased hope and/or productivity, or a feeling of helplessness.

Wanting to give up, feeling apathetic or disengaged, an increase in irritability, a decrease in patience, frequent judgment thoughts towards your kids, and resentment are all signs more self-care is needed STAT!

If you feel “too busy” for self-care

Stopping for self-care makes you better at your job. When you have the patience to stop and take a breath before snapping, or the concentration to remember every last little detail, you are on your A-game. So basically, if you want to be performing at your absolute best, self-care is one requirement to get there — and stay there!

Self-care doesn’t have to cost money or take much time. Pausing for one minute just to take five slow breaths can make a massive difference in your day! Or, when you get in your car, before starting the ignition, take a moment to pick your favorite music or flip through a photo album on your phone of treasured memories is another tiny thing to do for yourself.

How a psychologist practices self-care

I can also be guilty of saying, “I’m too busy for this” so one thing I’ve learned to do is to simply stop and do nothing for one minute. No thinking, no planning, no texting, no calling, no reading emails. Just sit there and either look out the window or take some breaths or think about what it feels like to sit on the beach.

I also love the outdoors, so for self-care I spend time hiking to take a break from human interaction since I get so much of it daily. Before the stay at home orders were in place, sometimes I would go by my siblings’ homes and borrow my nephews to get to have some silly, bouncy, fun time if that’s the mood I need! On particularly packed days, my self-care is as simple as making sure I eat lunch and take bathroom breaks, even if it means I am running a few minutes late.

Get more information on Coronavirus (COVID-19)

Related posts:

  • Breastfeeding during COVID-19
    We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding ...
  • How donating plasma after COVID-19 can help others
    For Steve Emfinger, donating his blood plasma at CHOC Children’s was fast, painless and a way to give meaning to his battle with COVID-19. “It was very simple,” he said. “And ...
  • CHOC teen advisers encourage peers to wear masks during COVID-19
    Months into the COVID-19 pandemic, some teens are struggling with staying home more than usual, disappointment over canceled events, and wearing masks. The Centers for Disease Control and Prevention recommends the ...

From hotline to surgery – How CHOC guided a family through an emergency during COVID-19

As the parent of a child with gastrointestinal issues, Kris wasn’t immediately concerned when her son Nolan complained of a stomachache while they were watching TV together. When his pain quickly got worse and Nolan started to vomit, Kris knew it was time to call CHOC.

“With COVID-19 going on, I didn’t know if the pediatrician’s office or emergency room was the best place to bring him. I didn’t want to take a spot in the waiting room from someone who needed it more than us,” Kris said.

Nolan_with_Kris
Nolan with his mom Kris

Luckily, Kris had noticed on social media that CHOC had implemented a COVID-19 hotline (1-844-GET-CHOC) staffed by a team of registered nurses. She called the hotline for advice on where to safely seek care for her son during the pandemic.

“As the parent of an immunocompromised child, I knew CHOC could help,” Kris says. “A nurse took our call, and within a few minutes we were on a Zoom video call with a doctor. She gave us very clear parameters of what to watch for and when to call back. Nolan’s symptoms got worse, and when we called back, we were immediately patched through to a video call with a pediatrician.”

Dr. Lori Openshaw, a CHOC Children’s pediatrician, spoke with Kris and Nolan via video chat. After taking a medical history, Dr. Openshaw was able to walk Kris through doing an abdominal examination on Nolan, while the physician closely observed via video. With Kris’ help, Dr. Openshaw better understood the location and intensity of Nolan’s pain, and what might be causing his symptoms.

“Dr. Openshaw told me exactly what to do. She told me where to push on his stomach and where not to push. She paid attention to Nolan’s facial expressions during the exam,” Kris says.

Dr. Openshaw highly suspected that Nolan may have appendicitis and needed an urgent surgical evaluation. She directed Nolan and his mom to get to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital quickly.

“By the time we got to CHOC, they were ready for us,” Kris says. “Dr. Openshaw had called the emergency department and told them we were coming. She gave us instructions to wait in the car at valet, and a staff member would come to the car and ask for our name. It was clear that everyone from valet to security was following protocol implemented to keep people as safe as possible during this pandemic.”

Nolan’s room in the emergency department was ready and waiting for him. He and his mom noted how everyone in the emergency department, and the medical unit to which he was admitted overnight, was calm and collected, which in turn helped them feel calm during a stressful health emergency.

Although Nolan has been a patient at CHOC many times before, he and Kris noticed that a few things were different about this trip to CHOC. To protect the health of patients, families, doctors, nurses and staff during the pandemic, CHOC had implemented a variety of safety measures. Kris and Nolan noticed that everyone underwent a health screening before entering the hospital, people wore masks (and more protective equipment when necessary), social distancing measures were in place with people staying 6 feet apart whenever possible, and additional cleaning measures were carried out on top of CHOC’s already stringent cleaning practices.

“Seeing people go above and beyond to keep patients safe, healthy and comfortable during this time is what makes CHOC so different and so special,” Kris says.

Testing confirmed Nolan did indeed have appendicitis, and his surgery was scheduled for the next morning with  Dr. Mustafa Kabeer, a pediatric general and thoracic surgeon. Surgery was a success.

Nolan_aftersurgery
Nolan was in good spirits while recovering from surgery.

Nolan appreciated that staff made him feel as comfortable as possible during his stay.

“CHOC sees you as a person, not just a patient,” Nolan says. “Everyone explained to me what would happen and what medicine I would get. They made it easy for me to understand what was going on, which made the process feel smooth.”

Having a hospitalized child during a pandemic isn’t something Kris envisioned, but she knew Nolan was in good hands.

“It gave me peace of mind that there was consistency in protocols from each area of the hospital that we interacted with,” Kris says. “Everything was well thought out, and it was clear that everyone had bought into the changes being implemented throughout the hospital.”

Kris noticed that staff were reminding each other of changes in protocol, which further reassured her that the hospital was a safe place.

“Hearing nurses and other staff remind each other of things – whether that be a change in protocol, or where an item had been moved to – reassured me that the decisions CHOC had made to keep people safe were being upheld throughout the hospital.”

Nolan shares in his mom’s appreciation for CHOC.

“You never want to be sick, but if you’re going to be sick, you want to be sick at CHOC,” he says.

Nolan only had to stay at CHOC one night after surgery for observation and went home the next day. Dr. Openshaw, although not Nolan’s primary pediatrician, called several times to check up on him after surgery.

“Dr. Openshaw’s care and follow-up made us feel comfortable and assured,” Kris says.

Today, Nolan is back at home, getting reacclimated to distance learning while his school is closed – he’s also learning how to cook and do laundry before he heads off to college in the fall.

Kris is happy to have this health scare behind them, but grateful she knew who to call when her son was sick.

“CHOC has always known what is best for my child. No matter what is going on around us – even a pandemic – doing what’s best for my child will always be CHOC’s priority,” Kris says. “I knew the only place I would trust information from during this time was CHOC. The fact that they had set up a COVID-19 hotline for parents was just another sign that they are always three steps ahead in every situation.”

Get more information on Coronavirus (COVID-19)

Related posts:

  • Breastfeeding during COVID-19
    We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding ...
  • How donating plasma after COVID-19 can help others
    For Steve Emfinger, donating his blood plasma at CHOC Children’s was fast, painless and a way to give meaning to his battle with COVID-19. “It was very simple,” he said. “And ...
  • CHOC teen advisers encourage peers to wear masks during COVID-19
    Months into the COVID-19 pandemic, some teens are struggling with staying home more than usual, disappointment over canceled events, and wearing masks. The Centers for Disease Control and Prevention recommends the ...

Keeping children safe in and around cars during COVID-19

Under COVID-19 stay-at-home orders, children are spending more time at home and playing outdoors, increasing their potential access to unlocked cars. Parents who are worried about bringing children into stores or pharmacies might also consider allowing them to wait in the car.

Both these scenarios put children at risk of heatstroke, which can happen when body temperature rises to dangerous levels and it isn’t able to cool itself quickly enough. A child’s body warms three to five times faster than an adult.

In the past two years, more than 100 children died of heatstroke because they were left alone or became trapped in a hot car. Nearly every state has experienced a child vehicular heatstroke death.

These tragedies are preventable. Community educators at CHOC Children’s recommend the following tips for avoiding heatstroke:

  • Never leave your child alone in the car, for any amount of time. In California, it’s against the law to leave any child younger than 6 alone in a vehicle without a person who is at least 12 years old.
  • During this pandemic, consider having an older sibling watch younger children at home if you need to leave the house for an essential errand. Another option might be having essential items delivered to the home.
  • Remember that cracking open a window will not cool down the car and therefore will not prevent heatstroke.
  • Children as young as 1 and 2 are known to climb into unlocked cars and in trunks to play, but they can’t always get out. Teach children not to play in cars and keep your car doors and trunk locked so they can’t get in on their own. Keep key fobs out of reach, so children cannot open locked cars on their own.
  • Create reminders for yourself not to forget your child in the backseat of your car. Leave an important item in the backseat near your child, like a wallet or cellphone that is needed at your final destination.
  • If you notice a child alone in a car, call 911.

Parents can retain these tips by remembering to ACT

Avoid leaving your child alone in the car.

Create reminders, such as one that ensures you dropped your child off at daycare that morning.

Take action. If you see a child alone in a car, calling 911 could mean saving their life.

Heatstroke symptoms include dizziness, disorientation, agitation, confusion, sluggishness, hot and dry skin that is flushed but not sweaty, loss of consciousness, rapid heartbeat and hallucinations. These symptoms can progress to seizures, organ failure or death if not immediately treated.

If a child is experiencing heatstroke, there are several things you can do until medical assistance arrives. Take the child to a cool place, remove as much of their clothing as possible, and apply cold packs or ice to areas with large blood vessels (neck, groin, armpits) to accelerate the cooling process.

Get more information on Coronavirus (COVID-19)

Related posts:

  • Breastfeeding during COVID-19
    We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding ...
  • How donating plasma after COVID-19 can help others
    For Steve Emfinger, donating his blood plasma at CHOC Children’s was fast, painless and a way to give meaning to his battle with COVID-19. “It was very simple,” he said. “And ...
  • CHOC teen advisers encourage peers to wear masks during COVID-19
    Months into the COVID-19 pandemic, some teens are struggling with staying home more than usual, disappointment over canceled events, and wearing masks. The Centers for Disease Control and Prevention recommends the ...

Tips for deciding where to go for care during COVID-19

At CHOC Children’s, we know you want to give your child the very best care every day, especially during these uncertain times.

Kids are kids, even during a pandemic. They catch colds, break bones, need vaccinations and have asthma attacks.

If your child is ill, injured, due for a vaccination, experiencing a mental health issue or a flare up of a chronic condition, what should you do? Contact their pediatrician or specialist? Call a nurse helpline? Visit the emergency department?  We know it can be scary and stressful to have a sick child – especially during this time of COVID-19, so we have prepared the following recommendations to help you decide where to go for your child’s care:

Contact your child’s pediatrician or specialist

  • Your pediatrician’s office is a place for check-ups and vaccinations, and your primary resource for sick visits, when your child has symptoms like fever, runny nose, cough, ear pain, headaches, sore throat, rashes or abdominal pain.
  • Your child’s pediatrician or specialist knows your child’s medical history, providing you additional peace of mind. If your child has a flare up of a chronic condition, consider following up directly with their pediatric specialist at 1-888-770-2462.
  • And rest assured, during this extraordinary time, we are taking extraordinary measures to keep our offices safe.

Call 1-844-GET-CHOC (open 24/7 and staffed with pediatric nurses)

  • If you don’t have a regular pediatrician and you’re concerned about your child’s fever, runny nose, cough, ear pain, headaches, sore throat, rashes or abdominal pain, call 1-844-GET-CHOC to speak to a nurse in English or Spanish.
  • The nurse will evaluate your child’s condition; if it seems serious, the nurse can connect you to a CHOC physician who can immediately conduct a telehealth visit and possibly recommend that you go to the emergency department for further evaluation or testing.

Visit the emergency department

  • Although visiting an emergency department (ED) seems scary during this time of shelter in place, it is the best place for apparent life-threatening events, which could include rapid and fast breathing, head trauma, trauma with loss of consciousness or vomiting, motor vehicle accidents, severe abdominal pain or dehydration. It’s also the best place to take infants less than 28 days with a fever of 100.4 degrees or higher.
  • Not all emergency departments take care of children on a regular basis. It is best to go somewhere that specializes in children’s health with specialized training and equipment made just for kids.
  • Like our physician offices, we are going to extraordinary lengths to keep our ED safe, including universal screening and social distancing.

Keeping your child healthy requires your attention, even during these stressful times.  Ask yourself: What would I have done before COVID-19?

If you are concerned about your child’s illness, injury or mental health, visit your pediatrician or specialist, call 1-844-GET-CHOC or go to the emergency department.

And please do not let lack of insurance prevent you from getting medical care for your child. CHOC Children’s is a non-profit pediatric healthcare system. If you do not have or have recently lost your medical coverage, call us at 1-714-509-8600. We can help.

This article was last updated on April 16, 2020.

Get more information on Coronavirus (COVID-19)

Related posts:

  • Breastfeeding during COVID-19
    We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding ...
  • How donating plasma after COVID-19 can help others
    For Steve Emfinger, donating his blood plasma at CHOC Children’s was fast, painless and a way to give meaning to his battle with COVID-19. “It was very simple,” he said. “And ...
  • CHOC teen advisers encourage peers to wear masks during COVID-19
    Months into the COVID-19 pandemic, some teens are struggling with staying home more than usual, disappointment over canceled events, and wearing masks. The Centers for Disease Control and Prevention recommends the ...

Helping kids cope with COVID-19 stress

By Dr. Tiffany Torigoe-Lai, pediatric psychologist at CHOC Children’s

Many parents are feeling the strains of the COVID-19 pandemic, many children may be feeling COVID-19 stress, too. Children can display stress in different ways, such as wanting to be alone, needing more attention, moodiness, inflexibility and increased distractibility. The good news is that there are many things you can do as a parent to help support your child during this time.

Here are some guidelines as to how best to support your child in coping with COVID-19 stress:

Start a conversation with your child

  • Find what they know. It may not always be apparent, but those little eyes and ears are constantly soaking up bits and pieces of information around them. Saying something as simple as, “What have you heard about the coronavirus?” or “What questions do you have about the coronavirus?” shows children and adolescents that it’s OK to talk about the coronavirus and it’s not so scary that even the grownups don’t want to talk about it.
  • Share information using developmentally appropriate language. Focus on answering your children’s questions, but do not provide more details than they are asking about. Focus on providing messages to help your children feel safe, such as “We’re doing all we can to stay safe,” but be truthful. This will help maintain that you are a reliable source of information for your child.
  • It’s OK if you don’t know the answer. Children ask some tough questions! Use those moments as an opportunity to show your child how to find the answer together. Ensure you are getting information from reputable sources, such as the Centers for Disease Control and Prevention or other government or state websites. If you can’t find an answer to their question, it’s OK to let them know that you don’t have the answer but will let them know as soon as you find out.
  • Let children talk about their fears. It’s natural for children to worry, so let them know that it’s OK to come to you when they have those feelings. This builds trust and a sense of safety. Be careful not to invalidate their worries or fears. Instead of saying, “Don’t worry about it,” acknowledge their feelings by saying something like, “I can tell you’re really worried about what could happen.”
  • Show them what they can do! Stress and anxiety can stem from feeling helpless and out of control, so reminding children of what they CAN do at this time to stay safe can help ease their worries. Remind them how they can stay safe and healthy through frequent hand-washing and social distancing. Empowering your children to help others in the world, for example, by donating to a food bank or writing letters to healthcare workers or first responders, shows them that they can help, too!

Establish daily routines can help ease COVID-19 stress:

  • Set up a daily schedule similar to their school days. Schedules help ease stress by providing children with a roadmap of what to expect and what is expected of them during their day. This also helps give them a sense of control, particularly during a time of uncertainty. Developing a schedule at home that is similar to one of their school days will help with adjusting to the transition of learning at home as well as returning to school in the future. Learn more about the importance of setting up structure and routine for kids during this time.
  • Maintain typical sleeping and eating routines. When children and adolescents are at home all day, it can be easy for them to feel like they are on summer vacation. Bedtimes are often shifted to much later in the evenings, which can make it harder for parents to implement typical routines during the daytime. Additionally, an overly tired or hungry child can become more easily overwhelmed, which could lead to emotional meltdowns. Establishing regular snack and mealtimes as well as routine sleep and wake times will help decrease physical and emotional stress on your child.
  • Get your children’s input. Work with your children to find out what they would like to do in their day and integrate those (realistic) activities into their schedule. This will help with transitions, particularly between preferred and less preferred activities. Here’s a list of activity ideas for kids during this time.
  • Make time for play! Playtime is crucial to a child’s development, so ensure you also make time to play with your child as part of their daily routine. That special time, even if it’s for 15 minutes, will help to strengthen your bond with your child and will help them feel loved and safe, which ultimately will help them cope with stress.
  • Find ways for continued active social interactions with family and friends. It’s important for children to stay socially connected to their family and friends while practicing social distancing, as socialization can be a source of support and coping. Ensure that social interactions through online methods, whether via video chat or online gaming, are part of your child’s daily routine. These active interactions tend to work better to reduce stress and worry. Find creative alternative ways to continue to celebrate important traditions, holidays and milestones in their lives. If your child feels disappointed about canceled events, here’s tips for talking about it.
  • Get physical! Exercise and physical movement are also important parts of a child’s daily routine. Research has shown that engaging in physical activities can help combat the effects of stress. With the limitations of social distancing, you’ll have to find inventive ways to get their bodies moving, such as morning stretches, online exercise videos, dance parties, and/or walks around the block.

Take care of yourself to ease COVID-19 stress:

  • Find your own supports. One of the best ways to help your children cope with stress is to ensure that you as a parent are also mindful of your own mental health needs. Remember, children are always watching and learning from adults, so they are taking their cues from you as to how to respond to this stressful situation. If you are stressed and anxious, they can sense that too. Talk to a trusted friend or family member about how you are feeling or reach out to a mental health provider if needed.
  • Take a break. With your child home with you all day, you constantly wear multiple hats as a parent, teacher, chef, cleaner, etc. It’s exhausting! It’s OK to take a break and take some space to cool down. Not only does it provide a time and space for you to relax when you are feeling overwhelmed, but it also models good coping for your children when they are over stimulated or stressed.
  • Limit you and your children’s exposure to the news and social media. While it’s important to stay abreast of the changes happening in response to COVID-19, frequent exposure to news coverage can increase your own anxiety as well asyour children’s anxiety. It’s best to take periodic breaks from the news and social media and to limit your children’s exposure to news media al We know that stress and worry increase the more time people spend with the news and social media during stressful times. Instead, take time to engage in relaxing or fun activities when you’re starting to feel stressed.
  • Here’s more tips for how parents can deal with COVID-19 stress.

When to seek more help for COVID-19 stress:

Drastic changes in a child’s mood, eating, and/or sleeping patterns, increased irritability or tantrums, decreased interest in socializing with friends or family members, decreased enjoyment in preferred activities, and/or increased questioning or seeking of parental reassurance may be signs that more help is needed. If you have concerns about your child’s behaviors, you should contact your primary care physician or a mental health professional for further consultation. Many providers are offering telehealth appointments during this time.

Get more information on Coronavirus (COVID-19)

Related posts:

  • Breastfeeding during COVID-19
    We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding ...
  • How donating plasma after COVID-19 can help others
    For Steve Emfinger, donating his blood plasma at CHOC Children’s was fast, painless and a way to give meaning to his battle with COVID-19. “It was very simple,” he said. “And ...
  • CHOC teen advisers encourage peers to wear masks during COVID-19
    Months into the COVID-19 pandemic, some teens are struggling with staying home more than usual, disappointment over canceled events, and wearing masks. The Centers for Disease Control and Prevention recommends the ...