Caregiving in the Age of COVID-19

By Leila Thayer, Alzheimer’s Association

The COVID-19 pandemic has changed our world in profound ways. Shelter-in-Place orders across the country have significantly limited our ability to connect with our friends and families. Wearing masks and practicing social distancing is mandatory in many shops and recommended in all other social interactions. Visiting elderly relatives and friends is discouraged, and most long-term care facilities have stopped allowing visitors. Whether the person with dementia lives at home or in a facility, this can cause a slew of complications for the family caregiver.

In this time of COVID-19, nearly every family caregiver has become a long-distance caregiver. Whether a caregiver lives just down the street from his loved one or a thousand miles away, his ability to see his loved one in person is significantly affected by our living conditions during this pandemic. There are significant health risks posed by in-person visits to both the person with dementia and the caregiver. And although dementia most likely does not increase the risk for COVID-19, the patient’s age and other health conditions that often accompany dementia may make her more vulnerable. In this unique time, the most responsible thing for a caregiver to do is to minimize in-person interactions with his loved one, particularly if that person is residing in a long-term care facility.

Care facilities have been particularly hard-hit by this pandemic and having a loved one in a facility can be nerve-wracking for the caregiver. It is important to talk with the facility about what procedures they have in place should one of their residents test positive for COVID-19. Most long-term care facilities have quarantine procedures in place and will isolate any person who has tested positive, following the Center for Disease Control guidelines. Caregivers should ensure that the facility has updated emergency contact information on file, including another family member or friend as a back-up contact.

If you are not satisfied with the care being provided at the facility, it may be possible to move your loved one into another facility. However, this decision should not be made lightly. There is no way to guarantee that a new facility will remain free of COVID-19 cases, and many facilities have stopped accepting new residents due to concerns of infection. Before making the decision to move your loved one, call other facilities and see if there have been any cases of COVID-19 and if they are accepting new residents.

Although it can be difficult to not see your loved one, it is critical that you not visit your family member if you are exhibiting symptoms of COVID-19. Elderly people, especially those with other health conditions, are at a higher risk for complications and the best way to protect your loved one is to keep a safe distance.

Even with the increased challenges presented by the pandemic, family caregivers can still remain connected to their loved one. Technology has given us an opportunity to maintain visual communication with all of our loved ones, and this can be especially useful for family members. If your loved one is currently living in a care home, consider providing her with a tablet or an iPad so that you can call her with video. Many people in the middle or late stages of dementia have difficulty communicating over the phone and incorporating video can help. Some care homes have already started programs wherein staff facilitates these video calls on behalf of the family, ensuring that there are no technological issues that might impede communication. However, please consider that not every patient with dementia is capable of understanding remote communication. It can be very confusing to a person with cognitive difficulties, and it will not necessarily be a successful way to interact.

Most importantly, it is critical that caregivers follow Shelter-at-Home orders and other guidelines to stay safe. Here are some ways that you can protect yourself and your loved ones:

• Stay at home whenever possible

• Wear a mask when you are in a public space, such as the grocery store or bank

• Use grocery and pharmacy delivery services to minimize the number of times you have to leave your home

• Consider utilizing telehealth services instead of going into your doctor’s office. Medicare has expanded telehealth benefits to allow seniors to access health care from the safety of their homes

• Cover your cough or sneeze with a tissue, then throw the tissue in the trash

• Wash your hands frequently and thoroughly for at least 20 seconds

TIPS:

If you are considering moving the person into your home, here are some things to think about:

• Does he or she want to move? What about his or her spouse?

• Is your home adapted to support person with cognitive difficulties?

• Will someone be at home to care for the person?

• How does the rest of the family feel about the move?

• How will this move affect your job, family, and finances?

• What respite services are available in your community to assist you?

• How will providing direct care for a person with dementia impact your own health?

Moving a person with Alzheimer’s disease from familiar surroundings may cause increased agitation and confusion. Make sure to talk with your loved one’s physician or a social worker and call the Alzheimer’s Association for assistance before making a decision.