How Do Caregivers Adapt as COVID Endures?

By Caitlin Rife, LMSW and Rachel Brodsky, MA, CMC

Who would have thought that almost a year after the onset of the COVID-19 pandemic, we would still be in the throes of it, with no end in sight? This time has been difficult for everyone, but particularly so for older adults whose struggle with social isolation has been a concern long before COVID. While some of the community has opened to an extent since the early days in March 2020, many older adults are still in isolation. The Centers for Disease Control and Prevention (CDC) reports that social isolation has significant health risks, including increased risks of premature death, dementia, heart disease, stroke, depression, anxiety, and suicide. Now we have an essential contradiction, in that isolation is required to protect lives and yet the isolation itself can be destructive and presents its own risks.

Older adults who live at home are unable to travel to see their families and families are afraid to visit for fear of exposing their loved ones to the virus. Nearby caregivers are separated and caregivers who live with their loved ones are more isolated than ever. Many long-term care facilities remain on lockdown and residents are still isolated in their rooms, unable to receive visits from family and friends or even to interact with fellow residents. Meanwhile, COVID has turned our personal lives upside down, routines have been altered, and stress levels are elevated.

How can we manage the additional challenges of being there for our loved ones in isolation? How do we stay in touch? How can we help them when we can’t even see them?

As the months have gone on, families have adjusted and developed routines for staying in touch. Frequent calls, video chats, and sending meals or groceries have helped take the edge off isolation for some. Many families took advantage of socially distanced outdoor visits in the spring and summer, enjoying pleasant weather by going for walks and sitting outside together. But now during the winter months, we face increased isolation being confined to our homes in cold weather that is only exacerbated by the specter of renewed lockdowns as infection rates increase all over the country. It is vital for caregivers, whether a loved one lives alone, in a long-term care facility, or in the caregiver’s home, to be aware of the impact of isolation and to be able to access resources to stay connected while ensuring everyone’s safety.

One approach to coping with being unable to visit long-term care facilities is to stay in touch with the care providers at the facility. Speak with them on a regular basis, maintain a friendly relationship with them, and enlist their help. Ask them to send photos and make appointments for video visits. If a family member isn’t able communicate as well by phone or video, ask to have regular video conversations with the care provider while the camera is on you and your loved one. This will give you the opportunity to connect a little and observe for physical and behavioral changes; your family member may be reassured by seeing you on the screen even without participating in the conversation. You will also be able to see how the providers are interacting with your family member, which will give you a sense of how they are doing. Conversations with care providers can also offer information and give you the opportunity to advocate for your family member’s needs.

There are things we can do to reduce isolation both for family members in long-term care and those who are isolated on their own. Sending or dropping off letters and packages creates a tangible shared connection. Ideas include handwritten letters, children’s artwork, books to read together and discuss, a themed care package or subscription box, or music to listen to together. Dropping off favorite foods can also provide that feeling of caring for your loved one, as well as encouragement to eat well. Including treats for care providers demonstrates appreciation for their care and compassion.

If accessing online resources is an option, then older adults can be connected to a wide variety of virtual events and experiences. The Edward A. Myerberg Center currently has a plethora of virtual programming ranging from art and fitness classes to social and educational groups, to increase engagement, movement, and companionship. Simply visit the virtual center or call 410-358-6856 for more information. The Baltimore County Department of Aging is also offering free online classes and activities that are open to anyone.

Technology can also help to ease some of the stress related to caregiving. The Echo Dot, and other virtual assistant devices, can be a useful tool for connecting with family members who are in a facility or for those who are on their own. These devices can be set up to allow connected users to “drop in” and initiate a phone or video call without any action on the part of the receiver. They also allow touch free phone calls and can be used for medication reminders and as an alternative to a medical alert device. Other popular features include stimulation and entertainment through music, games, and trivia, and can provide weather reports and news updates. Some in isolation feel better talking to Alexa when no one else is available.

Caregivers may be concerned that older adults who are isolated could get confused about their medications or forget to take them altogether. Many pharmacies offer home deliveries of presorted prescriptions which are individually packaged and labeled by dose and time. There are also devices such as the MedMinder that provide audio and visual alerts when it’s time to take the presorted medications and caregivers can be alerted when the medications are not taken.

Making sure that a family member in isolation is eating well is another common concern for many caregivers. Meals on Wheels is a reliable meal delivery service with a sliding fee scale that makes it easy to obtain healthy meals for people in isolation, as well as those individuals who are no longer able to safely cook for themselves. They also offer grocery shopping, safety checks, and case management. Caregivers can also send meals to family members through favorite local restaurants and grocery stores. The Myerberg Center has classes to help seniors learn the skills of ordering their own groceries and meals online.

Jewish Community Services has multiple resources to help support caregivers through this difficult time. The Friendly Caller Program connects isolated older adults with prescreened participants to make fun and friendly telephone calls to fight loneliness. Eldercare Management is a fee for service program that offers consultation and ongoing guidance and assistance when the circumstances of an elderly or ill family member may seem overwhelming. Counseling is often an essential service to help caregivers cope with stress and JCS has licensed mental health professionals available to help. Patient Care Connection is a grant-funded service that partners with specific doctors’ offices to support eligible caregivers and patients in obtaining resources that may be affecting their health, well-being, and ability to age safely in their own homes.

JCS has several community groups that are meeting virtually at this time, including those focused on Long-Term Care, Dementia, Parkinson’s Disease, Low Vision, and Suicide Loss.  For more information on JCS programs and services, visit our website or call 410-466-9200 to speak with an Intake Specialist.

As our community continues to navigate the challenges presented by the COVID pandemic, it is critical that caregivers know that they are not alone and that there are many resources available to help. Whether you call on a friend, a family member, or a professional, please reach out to someone. Reaching out is the first step towards reducing isolation.

Caitlin Rife, LMSW is a Community Based Clinician at Jewish Community Services

Rachel Brodsky

Rachel Brodsky, MA, CMC is an Elder Care Specialist at Jewish Community Services

JCS is a comprehensive human services organization providing a broad range of services that meet the diverse, multi-dimensional needs of individuals and families throughout Central Maryland. To learn more, visit jcsbalt.org or call 410-466-9200.  

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