'COVID-19 Survival Guide' from hospital psychologist explains how to navigate the virus from diagnosis to recovery

While the pandemic was turning the world upside down, front line worker Abigail Hardin was writing a survival guide.

A Rush University Medical Group rehabilitation psychologist who counsels patients from intensive care to rehab, Hardin drew on her professional experiences to write "The COVID-19 Survival Guide: How to Prepare for, Manage, and Overcome a Coronavirus Infection." The book offers readers advice on how to navigate the virus from diagnosis to recovery.

"Early on in the pandemic, there was a lot of discussion about survival rates. ... And then, what I was seeing in rehab, people were surviving COVID-19, but then they had to contend with these very serious ongoing issues that you don't necessarily think about," Hardin said. "You just think, 'Oh well, I'll survive, and everything will be fine.' That's not always true.

"So, I thought it was important for survivors of COVID-19 to have some sort of idea what they might be facing after that moment where they feel like, 'OK, I've survived, but what's next?'"

According to Hardin, preparing in advance of becoming sick puts you in the best position for survival, and also helps manage and mitigate everything that might come afterward. The guide helps readers create a COVID-19 prep kit; decide on legal documents, like living wills and powers of attorney; and understand do not resuscitate orders (DNR) and physician orders for life-sustaining treatment (POLST).

The book also walks readers through what to expect if they are hospitalized, including medical professionals who may be on your medical team and professionals you might want to consult. Also, she outlines the things you can do to optimize your recovery and enable your family and friends to help you. Resources in the book and on Hardin's website include COVID-19 kit packing lists, rehab goal worksheets, daily routine planner pages and journal/diary prompts.

"As a psychologist, I focus on making sure that the people who you really care about and who you know you can rely on are aware of what's going on in your life, so that they can support you," Hardin said. "Whether you're in the hospital or not, just contracting COVID-19 is a super scary thing to have happen. Keep the book by your bedside, read a couple chapters a night, and once you're done, you should feel much more ready to tackle COVID-19, if it should happen to you or even to a family member."

Vaccination information isn't addressed in the book, which was released in October, but Hardin said preparing for being sick remains important.

"I understand that people don't want to be defeatist, and they don't want to think, 'I'm going to get sick,' but you keep a survival kit in your car, right?" she said. "So why not prepare for these potential major life events, and then if it doesn't happen, great. But if it does, you're ready."

Hardin elaborates on the guide in the following interview, which has been condensed and edited for clarity.

Q: A COVID-19 kit, what does that entail?

A: The kit includes basic things that you might not think about. For example, when you're in the hospital, if you use hearing aids or glasses, and you don't have access to those in the hospital, it can impact what's called "hospital delirium," which we know has been a problem for people with COVID-19. So, by packing those and having an extra set of glasses and hearing aids in your kit, you're ready to go, so that you can minimize that problem in the hospital. So that's kind of what the kit is—everything you would need to get the most out of your hospitalization while minimizing any of the potential problems that can come along with being that sick.

Q: What's been the hardest thing for COVID-19 patients and survivors to wrap their heads around during their illness?

A: One (thing) I see a lot is people feel that their ability to function normally—moving, walking, going to work—that is their identity. After you've been critically sick, it might be a while before you're able to go back to literally walking and certainly before you're able to go back to work. And so, what I see a lot of is people really feeling very down and almost a loss of identity because while they're trying to get back on their feet, quite literally, they don't have a clear sense of who they are.

I've heard people say, 'How can I support my family? How can I be a good husband when I'm not able to go to work?' As a rehab psychologist, that really hits me because it's important that people, while they're recovering, feel a sense of identity and a sense of value in the world. So that's been really hard.

Q: Lingering pain post-COVID-19, does your book address that?

A: There's a heavy emphasis on that in the book. After you get sick, whether or not you were hospitalized with COVID-19, we're seeing both people who are critically ill and people who really were not critically ill, both showing very long-term symptoms like pain—and brain fog is a big one—all sorts of different physical symptoms, as well as mental health changes.

Returning to life after testing positive for COVID-19 is a huge emphasis of the book, and that is psychological as it is physical. So having a plan for how to reenter your life safely and in a way where you're pacing yourself, that's so important.

Q: Your book offers steps to chart one's rehabilitation progress to make sure pacing is happening, instead of pushing.

A: There's a way you can set up a strategy for pacing yourself when you're returning to activities. I give people strategies for how to return to their activities, how to identify which activities to return to immediately versus the ones to wait on, and then how to apply the idea of pacing yourself.

If you're involved with a formal rehabilitation program, you'll have access to experts who will help you walk through what kinds of physical exercises, brain exercises to do. For people who do not have those resources, there are some ideas about how to get started and how to self-assess.

And there are some ideas for how to process what you've been through from a psychological/emotional perspective, so that potential trauma or the experience of having been sick and having these ongoing symptoms doesn't derail your progress.

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