According to the CDC, 1 in 4 adults over age 18 reported providing assistance to someone who has a long-term illness or disability within 30 days of completing their 2009 survey. Caregivers provide care to others in need of help with everyday tasks such as grocery shopping, managing finances or bathing. Persons requiring assistance may be limited in their abilities physically or mentally or both. There are paid caregivers that usually work through health care agencies and unpaid caregivers who are usually family members or friends of the person requiring assistance. In this article, we will focus on unpaid caregivers who are also called informal caregivers. In 2009 the value of informal caregiving in the US was estimated to be $450 million dollars. 

Informal caregivers have been studied extensively over the years, as they tend to have poor health outcomes due to the stress of caregiving. They have elevated levels of depression and anxiety, worse self-reported physical health than non-caregivers, decreased function of their immune system, and increased risk of early death. Fifty-three percent of caregivers report declining health due to caregiving that eventually limits their ability to provide caregiving services. Twenty-seven percent of caregivers reported significant financial burden due to caregiving as a result of loss wages and increased medical expenses. 

Despite the negative consequences, many caregivers do experience a sense of fulfillment and purpose from caregiving. They also may learn new skills and meet new people due to their caregiving duties. Thus, the focus for providers caring for caregivers are to (1) identify them as caregivers, (2) assess for caregiver burnout and (3) provide resources for assistance in their duties of caregiving. 

The COVID19 pandemic presents special challenges to caregivers both in their ability to provide care to their loved ones requiring assistance and in their own ability to receive care for themselves. The ability to provide care has been changed by social distancing rules that impact the ability to receive assistance in the home to help with caregiving and to visit loves ones in care facilities and hospitals. The concern for loved ones who are considered high risk for undesirable outcomes for COVID19 is very stressful. They also have the additional stress of not being able to provide care in the usual manner.  Furthermore, they have become isolated from their regular daily activities and care providers to avoid becoming infected with COVID19 themselves. 

While there are many things that have changed for caregivers during this time, there are still agencies that are providing advice and assistance to help adjust to the new normal. The Alzheimer’s Association has great information on their website for COVID19 caregiving. They also have free support groups available to dementia caregivers. The federal government now allows for telephone visits to be conducted without video conferencing so that you may stay in touch with your health providers if you need refills or are experiencing depression or anxiety. Your local disability or elderly services agency may be able to provide assistance with caregiving. Your local geriatrics specialist may be able to provide a list of resources as well. 

It is important now more than ever to support caregivers. If you know any caregivers, please reach out to them and ask if you are able to help them in any way. It may be providing a listening ear or helping them find agencies that could help address problems they may be experiencing. Either way, they will appreciate the thought. 

By Dr. Anisa Shomo, MD Director of Family Medicine Scholars at UC College of Medicine

Sources: CDC Alzheimer’s Association for Greater Cincinnati

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