Caregiving can be both rewarding and challenging. According to the World Health Organisation (WHO), caregivers may be at increased risk of negative health consequences such as stress, depression, and anxiety1,2. The current COVID-19 situation may pile on more stress to caregivers3. These could be due to routine changes and additional caregiving needs while balancing other responsibilities such as work4. As such, it is important to manage these additional stressors and worries during this time.
Here are some key strategies that may be useful to support caregivers of seniors.
1) Prepare for caregiving
Changes in daily routine due to COVID-19 may require additional caregiving duties. Have a discussion with family member/s about what to expect and develop a plan for caregiving that is realistic and balances out other responsibilities and duties5. Modify existing daily routines to meet the current realities of the situation and focus on what can be realistically accomplished5.
Be prepared by creating a care plan for seniors. This plan should have information on their health conditions, medications and their availability, upcoming medical appointments, healthcare providers, and emergency contacts4, 6. Identify alternate caregivers in case a primary caregiver falls ill or is unable to provide care to the senior.
2) Seek additional support for caregiving
When creating a caregiving plan, seek help from other members of the household and distribute duties equally and fairly. With many community activities still suspended, try to make alternate arrangements to support seniors. Caregivers should check back with the community agencies about remote communication plans to support the caregiver. For example, if the senior has previously attended day care, check with the agency on how they can continue engaging the senior through the telephone or a video call. This will also allow the caregiver to have some respite.
Seek any additional support that is required for services for seniors (e.g. meal delivery, home nursing, etc). View resource list below on providing care for seniors with unique needs such as cognitive impairments.
3) Establish boundaries
Caregivers may need to balance caregiving duties with work and other duties. It is important to communicate that although the caregiver is at home, other responsibilities have not changed7. Try to prepare a daily/weekly plan that takes into account other duties and establishes clear boundaries with specified times and places at home. Share this plan with family member/s. Seniors with cognitive difficulties may have difficulties in understanding and respecting these boundaries, and may need additional aids such as visual reminders. View resource list below on how to support them.
4) Create time for positive shared activities
It is normal to face increased stressors in the current situation. Balance this by making time for shared positive activities with the seniors5. Think about activities that have made you both feel better in other stressful situations. This could be watching a movie that both of you enjoy, listening to your favourite songs, playing a board game, or engaging in religious activities together. Remember to share positive emotions and experiences.
5) Maintain positive social connections
Positive social connections are important for our mental and emotional well-being7. It is important to maintain these social connections while following social distancing guidelines. Connect with your loved ones via telephone, video calls, or social media5. It is normal to feel worried or helpless about the current situation. Seek support from your family members and friends, and share your worries and concerns and how you are currently coping8.
Plan for regular respite time and create a respite zone at home.
6) Maintain your health and well-being
An important part of caregiving is to maintain one’s own health and well-being, especially given the potential for additional stressors during the current time and reduced access to respite care options4, 9. Feelings such as loneliness, boredom, fear of contracting disease, anxiety and stress, are normal reactions to a stressful situation such as a disease outbreak5, 10.
Try relieving stress by:
- Taking frequent breaks and remind yourself of how the family overcame previous stressors and of the strengths and coping abilities that you have.
- Reminding yourself that this current situation is temporary and focus on what is within your control11.
- Practising self-care and doing things that you enjoy and find relaxing. For example, reading, baking, or watching a movie. Refer to the visual guide offered by HealthHub9 for tips on taking care of yourself. Keep this in a place that can be easily seen to provide frequent reminders to yourself. Providing full-time care with little or no time away might result in increased stressors and tension12. Plan for regular respite time and create a respite zone at home11. This refers to an area (e.g. bedroom) that provides a place to take a break from caregiving13.
- Maintaining regular sleeping patterns and remember to have good sleep hygiene (e.g. avoid caffeine before sleep, reduce screen time in the night and create a peaceful environment)9. For more information, refer to HealthHub. Remember to eat healthy, well-balanced meals, drink sufficient water, and include regular exercise in your schedule. Take a walk or consider home workouts that are available online for keeping active at home. These steps improve your physical well-being and can make a positive impact on your mental well-being too14.
7) Be informed of facts from official sources and avoid excessive media exposure
It is important to be informed about updates relating to COVID-19 and to understand the increased risks seniors face15, 16. However, a constant influx of such information can be overwhelming and worrying. Limit the time spent on news and be aware of untrustworthy sources or rumours, which may promote fear or panic. Obtain information from reliable sources such as www.gov.sg and www.moh.gov.sg.
8) Seek additional support when necessary
If increased stressors and worries impact your daily life and your ability to provide care for others, seek additional support from professionals. Here are a few resources that provide support that are available at no cost. Visit www.go.gov.sg/hotlines for a comprehensive list of hotlines to seek help.
|1||The National CARE Hotline||1800-202-6868|
|3||Agency for Integrated Care||1800-650-6060|
|4||ComCare Call Hotline||1800-222-0000|
9) Seek help if experiencing violence or abuse
If your family is experiencing conflicts, seek help early to prevent escalation of violence or abuse. If you or anyone you know is experiencing family violence, please call the Family Violence Specialist Centres or the police immediately.
|1||Police||999 / SMS 71999|
|2||Big Love Child Protection Specialist Centre||6445-0400|
|3||HEART @ Fei Yue Child Protection Specialist Centre||6819-9170|
|4||PAVE Integrated Services for Individual and Family Protection||6555-0390|
|6||TRANS SAFE Centre||6449-9088|
Caregiving Resources for Elderly with Unique Needs
|1||Elderly with Dementia||https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care|
|3||Elderly with Acquired Brain Injury||https://www.psychology.org.au/getmedia/c7e9f8db-fb82-4314-bd2a-2ed2bdec7079/APS-CCN-IS-COVID-19-Acquired-brain-injury-P1.pdf|
|5||Infographics for social distancing for seniors||Posters on COVID-19:
The contributors are Clinical Psychologists in the Clinical and Forensic Psychology Service (CFPS) at the Ministry of Social and Family Development (MSF).
1 Centres for Disease Control and Prevention. 2020. Alzheimer’s Disease and Health Aging: Caregiving. Retrieved from https://www.cdc.gov/aging/caregiving/index.htm
2 World Health Organisation. (2017). Integrated Care for Older People: Guidelines on Community-level Interventions to Manage Declines in Intrinsic Capacity. Retrieved from: https://www.who.int/ageing/health-systems/icope/evidence-centre/ICOPE-evidence-profile-caregiver.pdf?ua=1
3 Australian Psychological Society. (2020). Coronavirus (COVID-19) Anxiety and Staying Mentally Healthy: For Older Adults. Retrieved from: https://www.psychology.org.au/getmedia/5f9cc6d4-ad5c-4b02-8b7f-d4153cb2ba2b/20APS-IS-COVID-19-Public-Older-adults_1.pdf
4 Gov.UK: Department of Health & Social Care. (2020). Coronavirus (COVID-19): Providing unpaid care to adults with learning disabilities and autistic adults. Retrieved from: https://www.gov.uk/government/publications/covid-19-providing-unpaid-care-to-adults-with-learning-disabilities-and-autistic-adults/coronavirus-covid-19-providing-unpaid-care-to-adults-with-learning-disabilities-and-autistic-adults
5 The National Child Traumatic Stress Network. (2020). Parent/Caregiver Guide to Helping FamiliesCope With the Coronavirus Disease 2019 (COVID-19). Retrieved fromhttps://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf
6 Alzheimer’s Disease Association. (2020). Medication Management with Dementia. Retrieved from: https://alz.org.sg/medication-management-dementia.
7 Australian Psychological Society. (2020). Maintaining your Mental Health during Social Isolation. Retrieved from: https://www.psychology.org.au/getmedia/53f35a80-8a72-48fa-a5db-e09e1feb5335/20APS-IS-COVID-19-Isolation-P2_1.pdf
8 Public Health England. (2020). Guidance for the Public on the Mental Health and Wellbeing Aspects of Coronavirus (COVID-19). Retrieved from: https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19
9 Healthhub. (2019). Looking After Yourself. Retrieved from https://www.healthhub.sg/live-healthy/819/looking-after-yourself
10 Centres for Disease Control and Prevention. (2020). Coronavirus Disease 2019 (COVID-19): People At Increased Risk. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html
11 Agency of Integrated Care. (2019). A Caregiver’s Guide to Avoid Burnout. Retrieved from https://www.aic.sg/resources/Documents/Brochures/Caregiving%20Support/Caregiver%20Burnout%20Guide%20EN.pdf
12 American Psychological Association. (2020). Older Adults and Disasters: How Caregivers Can Be Prepared and Assist Others. Retrieved from https://www.apa.org/pi/aging/resources/caregivers-disasters.pdf
13 Alzheimer’s Association. (2020). Coronavirus (COVID-19): Tips for Dementia Caregivers. Retrieved from: https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care
14 Australian Psychological Society. (2020). Tips for Coping with Coronavirus Anxiety. Retrieved from: https://www.psychology.org.au/getmedia/3821ed7a-1a8a-4e1d-b303-2943ea9ae6b7/20APS-IS-COVID-19-Public-P2_2.pdf
15 Ministry of Health (2020). Support Measures for Seniors during Covid-19. Retrieved from https://www.moh.gov.sg/news-highlights/details/support-measures-for-seniors-during-covid-19
16 World Health Organisation (2020). Mental health and psychosocial considerations during the COVID-19 outbreak. Retrieved fromhttps://apps.who.int/iris/bitstream/handle/10665/331490/WHO-2019-nCoV-MentalHealth-2020.1-eng.pdf