5 Ways to Deal With Caregiving Stress During COVID

New report reveals caregiver mental health concerns at crisis levels during COVID

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Last week, I met with a stressed and burned out caregiver. Before the coronavirus pandemic, the care recipient (the husband) had a home health aide three days a week and attended an adult day program five days a week. These resources helped his wife (the caregiver) to continue to work to support them, prepare for retirement, and have a break from caregiving.

Since the coronavirus pandemic started, the husband’s adult day program has closed, and the caregiver opted not to have the health aide come to their home due to her concerns about COVID exposure. As a result, the caregiver was experiencing lots of stress and overwhelm trying to figure out how to work and give care full-time.

This caregiver is not alone. A national survey published by the Centers for Disease Control and Prevention in August 2020, found that 32.9% of caregivers reported mental health problems like anxiety, depression, or substance use compared to 6.3% of non-caregivers.

This same study found that 30.7% of caregivers of older adults had the highest rates of suicidal thoughts — much higher than other high-risk groups like essential workers (21.7%), young adults ages 18-24 (25.5%), Hispanics/LatinX folks (18.6%) and African American/Black folks (15.1%).

Family caregivers during COVID are more stressed and overwhelmed than ever before and here are some reasons why:

• Approximately 61% of caregivers are employed while caregiving.
• Many resources that caregivers rely on, like senior centers and adult day programs, have been closed for several months.
• Caregivers may not be comfortable with home health aides coming into the home for fear of exposure to COVID, so have canceled home health aide assistance, and as a result are providing many of the more challenging tasks, like toileting, grooming, bathing, etc.
• With changes in routines and social interaction being limited, the care recipient is more likely to decline in mental and physical health.
• People who require caregiving are likely to have medical vulnerabilities, increasing their susceptibility to COVID. Naturally, this comes with a host of anxiety, fear, and uncertainty related to COVID exposure.

Altogether, this means that caregivers have more caregiving tasks, more stress and worry, fewer community resources needed to care for their loved one, and don’t have the breaks from caregiving that are essential to maintaining health and wellness.

5 Self-Care Strategies for Caregiving During COVID

1. Identify what gets in your way of taking care of yourself.

Take some time to acknowledge the most common obstacles to your self-care.

The most common barrier I hear is:

• “I don’t have time.”
• “My loved one needs all my time.”

While this may be true, often when I ask caregivers to look a little deeper, we discover other barriers like:

• "I feel guilty taking time to enjoy myself when my loved one cannot."
• "Other people might think that I’m shirking my responsibilities or being selfish if I make time for myself."

After you identify your own unique barriers to self-care, think of how these barriers or beliefs originated, for example:

• Were you raised to put others before yourself?
• Were you raised to hold a certain level of “duty” to your family?

2. Shift how you think about self-care.

Not only is taking better care of yourself important, so too, is how you think about taking the time for yourself. Shift from the old way of thinking to a new way of thinking. For example:

• Instead of saying: "I can’t take a walk, my mom needs me. And if I'm honest, I feel guilty getting outside on this beautiful day when my mom is stuck inside."
• Try saying: "Taking a walk for myself now will give me some time to be alone and decompress, which will lower my stress. My mom will sense that my mood has changed and benefit from my taking care of myself."

3. Set goals for taking better care of yourself.

Rate how well you are taking care of yourself in each of these categories. Use the scale 0 = poorly to 5 = outstanding to rate how well you are taking care of yourself.

• Sleep. Are you getting enough sleep? Rate yourself between 0 to 5.
• Eating habits. Are you getting adequate nutrition? Rate yourself between 0 to 5.
• Exercise/Fitness. Are you getting enough exercise? Rate yourself between 0 to 5.
• Medical and mental health appointments. Do you put off your mental health or medical appointments or prioritize them? Rate yourself between 0 to 5.
• Substance Use. Are you drinking more than you used to? Rate yourself between 0 to 5.

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Now, select the category that stands out to you most and identify one way that you could start to take better care of yourself in this area. For example:

• Substance Use. I've been drinking a bottle of wine a night, I am going to cut down to one glass.
• Sleep. I've been going to bed too late, I’m going to get in bed an hour earlier.

4. Set yourself up for success.

Imagine what moving toward your self-care goal looks like, identify any problems, then troubleshoot the steps to eliminating or moving past the problems. For example:

Category: Substance Use

• Goal: Drink one glass of wine per night (instead of one bottle)
• Potential Problem: When you see a bottle of wine sitting on the counter, you're tempted to keep pouring until the bottle is empty.
• Solution: Pour a glass of wine, put the cork back on, put the bottle all the way in the back of the fridge, and place other objects in front of it. The more distance and obstacles you put in front of the bottle of wine, the less likely you are to go through the trouble of getting it out again.

Category: Sleep

• Goal: Go to bed an hour earlier at night.
• Potential Problem: You get busy watching a TV show or doing a hobby and forget about the time.
• Solution: Set an alarm on your phone for 30 minutes before your desired bedtime to remind you to start getting ready for bed.

5. Ask for help.

With many of the formal caregiving supports unavailable, it's essential to build an informal care team by asking your friends, family, neighbors, church family/friends, and health aides for help.

Asking for help is really hard for caregivers to do. It can help to remind yourself that you're worth it. Your health is just as important as the care recipient’s.

This is a very painful time. Please take care of yourself. If you or someone you know is in crisis or struggling with thoughts about harming yourself or others, please reach out to the National Suicide Prevention Lifeline at 1-800-273-8255. To find a therapist, please visit the Psychology Today Therapy Directory.