Tips for continued recovery from COVID-19

It is normal to feel tired and weak after being in the hospital.

Try to set priorities and plan to do important or difficult activities at times you have the most energy. Pace yourself by breaking down tasks into smaller steps and taking breaks. Try to do activities in less tiring positions, such as sitting down to do a task. Take naps during the day as needed, and keep a good bedtime routine to help you sleep well.

More energy conservation resources:

• Energy conservation

Eat healthy meals while sitting up at a table if you can. If you have a poor appetite, try eating smaller meals more often. Choose foods that are high in protein and calories, or try supplements like Ensure or BOOST.

You may experience some changes to your thinking and concentration after a hospital stay. It is normal to not be able to remember everything that happened while you were unwell and in the hospital.

Keep your mind active by doing activities that use your thinking and memory skills (reading, word puzzles, looking at photo albums). Stay organized and use a calendar to keep track of the date as days go by.

More cognitive support resources:

• Keeping a healthy mind at home
• Learn more – What is delirium?
• Learn more – What is cognitive impairment?

It is normal to feel weaker after a stay in the hospital.

Keep your body active by returning to normal daily activities as much as possible, such as having breakfast in your kitchen instead of in your room. If you are able, stay active throughout the day by taking short walks within your home with help or any walking device you may need. Slowly increase your level of independence as you do personal care activities (brushing teeth, changing clothes, walking to bathroom, etc.) Remember to save your energy for the activities that are most important to you.

More physical recovery resources:

• Safely moving while doing your daily self care activities
• Bed exercises and deep breathing exercises
• Seated exercises for seniors (10 min)
• Standing exercises for seniors using a walker (10 min)
• Stretch, Lift, or Tap (SLoT) exercises 

It's OK to not feel OK, even after your recovery from COVID-19. An ICU stay or hospital admission with a potentially life threatening illness are by definition potentially traumatic events. Acute stress reactions are common and normal.

You may experience any of the following for the first month after such an experience:

• Intrusion symptoms: Upsetting memories of your illness may pop into your mind throughout the day, or you may have repeated upsetting dreams.
• Negative mood symptoms: You may have a hard time feeling positive emotions like happiness or love.
• Dissociative symptoms: You may experience time slowing, being in a daze, or seeing yourself from an someone else’s perspective.
• Avoidance symptoms: You may unconsciously avoid memories, thoughts, feelings, people, or places related to your COVID-19 illness experience.
• Arousal symptoms: You may have trouble falling or staying asleep, feel irritable, have trouble focusing on tasks.

You may also be at risk for post-traumatic stress disorder, which is a failure to recover fully from a traumatic event. We know that people with past mental health issues, trauma and lower social support are more at risk.

You should seek specialized assessment if you still experience several of the following without improvement after one month:

• Nightmares, flashbacks, intrusive thoughts, a sense of being distanced/numbed from life, negative ways of thinking about yourself, the world or your future, avoidance of triggers, feeling jumpy and irritable or poor sleep.

This is a stressful time and there are many resources to help you feel better emotionally after you have been in the hospital. If you think you have PTSD due to COVID-19 and were admitted to Sunnybrook for a COVID-related illness, you may seek an assessment through the Post Trauma Mental Health Clinic. You would need a referral from your family doctor or Sunnybrook physician. Your doctor can contact 416-480-4073 for details.

If you or someone you know is thinking about suicide or in severe emotional distress, please call 911 or visit your local emergency department. If you feel like you are in crisis or need somebody to talk to, community resources are here to help:

• Crisis Services Canada
  • Phone: toll-free at 1-833-456-4566
  • Text: 45645 (available 4 p.m. – 12 a.m. EST)

Give yourself the chance to connect to what gives you joy. Connect with family and friends using the phone or computer, take deep breaths, do something that makes you laugh, open some windows, and don’t be afraid to ask for help from your family or healthcare providers. A good daily routine can help maintain positive habits.

More emotional recovery resources:

• COVID-19: Practical cognitive behavioural strategies to manage your mental health
• Simple ways of finding happiness in challenging times
• City of Toronto: COVID-19 mental health resources
• CAMH: Coping with stress and anxiety during the COVID-19 pandemic 
• eMentalHealth: Mental wellness and resiliency while coping with COVID-19
• US VA National Center for PTSD: Coronavirus resources for managing stress