There have always been both pleasures and pressures in caring for older or infirm family members. In a world with COVID-19, the upsides are still there—time with someone who may have cared for you in the past and the satisfaction of giving back—but the stresses can be magnified by new worries and gaps in the usual systems of support.

New Risks of Social Isolation, Overload, and Stress

Among the risks of caregiving before the pandemic were the tendencies for the caregiver to become isolated, overburdened, and overwhelmed. Those risks have only become greater with new measures to protect older and infirm people from the virus. Fear of serious illness or death from COVID-19 is a new reality, and because that risk is higher for older people, caregivers tend to live with a baseline level of worry during the pandemic that they didn’t have before. That worry may be compounded by other factors, such as the following:

• Social isolation—Minimizing in-person social contacts is one of the key recommendations to control the spread of the disease. That means limiting the number of people who come into the older person’s home. It can also mean limiting social interactions for the older person’s caregivers to reduce the risk of carrying the virus to your older relative. Since social support is critical to maintaining resilience and emotional strength for both caregivers and people receiving care, that can set up a conflict. How do you find the balance between disease prevention and emotional needs—for your older relative and for you?
• Limits on elder services—Clear evidence of the special vulnerability of older and infirm people to COVID-19 has also led to cutbacks in some of the services older people and their families have long relied on—community meal programs, adult day care, and respite care, to name a few. Families have also become more cautious about bringing paid or volunteer help into the home. Additionally, family members who normally share caregiving responsibilities may need to step away to avoid exposing their loved one to health risks. With new limits on the availability of these types of services and the narrowing of options to share care, caregivers have taken on a bigger share of the care burden. That can increase the risk of caregivers doing too much, pushing themselves beyond their limits, and burning out.
• Separation from older relatives—Family members and friends who provided supplemental care and social connection to older people in assisted living or nursing home facilities are also affected by the pandemic. Many of these facilities have adopted strict, no-visitor policies, leaving family members shut out from physical contact. Unable to connect with their older relative in person, they worry about the effects of social isolation on their loved one, or if all of the care their relative needs is being provided by the facility’s staff. This, too, is a source of caregiver stress.
• Loved ones experiencing increased stress—Change can be difficult for anyone, and those who are at an increased risk of serious harm from COVID-19 have had to face a number of changes over the last several months. Loved ones who are now unable to leave their home may be dealing with frustration due to canceled activities, lifestyle restrictions, or dependency on others. Others may be anxious about their health or the health of friends and family members. These fears and frustrations can lead to angry outbursts, prolonged sadness, and even depression. Dealing with these heightened emotions can be an additional source of stress for caregivers.

Signs of Caregiver Stress

It’s common for caregivers to focus so much on the person they are caring for that they neglect their own needs. You may not even notice as your stress and worry increase to the point that they are affecting your health and your ability to function at your best.

You are likely to be experiencing caregiver stress if you

• Feel overwhelmed
• Worry constantly
• Have trouble sleeping or find yourself sleeping too much
• Have gained or lost weight without intending to
• Are easily irritated or provoked to anger
• Have lost interest in activities you used to enjoy
• Often feel sad
• Have frequent headaches, muscle or back pain, or stomach problems
• Are drinking too much or abusing drugs or prescription medications

Each of these is a sign of excess stress. Some are signs of anxiety and depression, which are treatable conditions. For the sake of your health and wellbeing, and for the benefit of the person you care for, pay attention to these signs as possible causes for concern. Make room in your life to care for yourself.

How to Care for Yourself as a Caregiver

To take good care of others, you need to be feeling well and thinking clearly. To be supportive, you need to be resilient and patient. Those important qualities are undermined when your health and wellbeing are weakened by caregiver stress. Here are some ways to take care of yourself as a caregiver.

Take care of your health.

• Eat a healthy diet, and keep to regular mealtimes. Make it a habit to eat fresh fruits and vegetables, whole grains, and healthy proteins every day.
• Be sure to drink plenty of water.
• Get some physical activity every day. Go for a walk or run, or try an indoor exercise routine. Take an online yoga or workout class. If you can get outside, fresh air and sunshine are good for your health and mood.
• Adopt healthy sleep habits. Stay on a regular sleep schedule. Calm down with low light and no TV or devices as bedtime approaches. Take a nap during the day if your nighttime sleep is interrupted.
• Avoid excessive alcohol or substance use.
• Follow the U.S. Centers for Disease Control and Prevention (CDC) guidelines to protect yourself and others from COVID-19.

Manage your stress.

• Make time to unwind. Take “mini-breaks” throughout the day and longer breaks when you can. Going for a short walk outside, reading a chapter of a book, doing a puzzle, or watching a funny video can relax you, lift your mood, and recharge your energy.
• Connect with people you enjoy and trust. Even if you can’t be together in person, make time for phone calls and video chats. Talking with someone who listens to and understands you is powerful medicine.
• Don’t rely only on social media for human connection.
• Limit your exposure to news and social media that makes you tense or anxious. Find ways to stay informed with smaller doses of the news.
• Laugh. It’s great therapy. Take a break for a funny movie or TV show. Look for the humor in your daily life.
• Practice stress-reduction techniques. Try activities, such as deep breathing, meditation, or listening to calming music.
• Focus on what you can control and accept what you can’t. Understand that you can control your own behavior and how you react to the situations you face. You usually can’t control the behavior of other people.
• Limit worrisome “what if” thinking. It’s always true that bad things can happen, but try not to ruminate on those worries. If you find yourself settling into a “worry groove,” refocus your thoughts on something positive, or take a step that’s within your control to reduce the risk that concerns you.
• Go easy on yourself. Caregiving can be a challenge in the best of times, and it can be especially difficult during this pandemic. Don’t fault yourself for forgetting things or for feeling frustrated or angry at times.
• Remind yourself of everything you are doing. Forgive yourself for any lapses, and think about how to recharge yourself so that you’ll have the energy to keep going.

Seek extra support.

• Know that you aren’t alone. You may not see them, but there are millions of caregivers in this country, many of them experiencing the same roller coaster of joy, frustration, and worry that you are. Search online for “caregiver support group” and the name of your community. Spending time with other caregivers, even if it’s limited to online chats or posts, can make you feel less isolated. You may also learn about support services in your community you hadn’t considered.
• Reach out to family and friends. A good conversation when you’re feeling overwhelmed can improve your mood. It can pull you back from the tangle of issues to consider practical steps you might take to address the most important problems first. And, there may be ways that family and friends can help you with some of the tasks you’re facing.
• Contact your employee support program. The program has experts on elder care and stress management who can help you navigate the challenges you are facing. They can direct you to additional resources you may need, from services in your community to support groups or professional counseling.
• Talk with a professional. If stress, anxiety, or negative thinking are making it difficult to get through the day, make an appointment to talk with a psychologist, therapist, social worker, or professional counselor.
• Your employee support program can help you find someone to talk with.

Plan for backup care.

It’s natural to worry about what might happen to your older relative if you were to become sick, a concern that has added weight during the COVID-19 pandemic. To lift this burden from your mind, make a plan for your older relative’s care in case you do get sick:

• Think about who could step in as your backup. Identify friends, family members, or neighbors who could take over the care of your older relative should you get sick. Talk to them about what’s involved, and ask them if they’d be willing to take on the responsibility if needed. You might want to choose more than one person, either to share the responsibilities or to have a backup for the backup.
• Write out a care plan, and share it with your backup. Include details of your daily routine, names and contact information for your older relative’s doctors, medication doses and refill instructions, and any tips you can share about keeping your relative calm and happy.
• Identify other helpers. Because of the pandemic, you will need to limit the number of people who come into contact with your older relative, but you might enlist others to lighten the load for your backup by dropping off groceries or prepared meals, filling prescriptions, or spending time with your relative by video chat.
• Think about how you could quarantine safely if you became sick. How might you isolate yourself to minimize the risk of giving the virus to your relative?

Disclaimer: This document is intended for general information only. It does not provide the reader with specific direction, advice, or recommendations.  Recommendations related to COVID-19 vary based on region and timing, therefore local recommendations should be followed. You may wish to contact an appropriate professional for questions concerning your particular situation.