Impact of COVID-19 on Dementia Caregivers and Factors Associated With their Anxiety Symptoms

Little is known about the family experience of caregiving for persons living with dementia (PLWD) at home during the COVID-19 pandemic. The purpose of this study was to examine the influence of COVID-19 on concerns of current family caregivers of PLWD. Study participants were recruited from the parent study, Healthy Patterns Clinical Trial (NCT03682185). Data was collected from 34 caregivers via semi-structured telephone interviews. Over 70% of the study participants reported worrying about spreading COVID-19 to the PLWD, 41% reported they had taken on additional caregiving duties for others in their family since COVID-19, and 62% reported one or more anxiety symptoms. Dementia caregivers who reported anxiety symptoms reported lower scores on functional independence of their care recipients compared to dementia caregivers who did not report anxiety symptoms ( p=0.036). Health care professionals should be alert to the concerns expressed by dementia caregivers for their well-being during this unprecedented pandemic.

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Influence of COVID-19 on dementia caregivers living in community

Innovation in Aging ◽

10.1093/geroni/igaa057.3477 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 950-951

Author(s):

Yeji Hwang ◽

Anjali Rajpara ◽

Sonia Talwar ◽

LaShauna Connell ◽

Katie Ramirez ◽

...

Keyword(s):

Health Care Professionals ◽

Neuropsychiatric Symptoms ◽

Study Participant ◽

Well Being ◽

Anxiety Symptoms ◽

High Risk Population ◽

Dementia Caregivers ◽

Telephone Interviews ◽

Care Recipients ◽

Study Participants

Abstract Community-residing persons living with dementia (PLWD) are a high-risk population for the Coronavirus Disease 2019 (COVID-19) because of advanced age, comorbidities, and impaired cognition. While family caregivers report additional anxiety symptoms by caring for PLWD at home, little is known about their caregiving experience during the current COVID-19 pandemic. The purpose of this study is to examine the influence of the COVID-19 on dementia caregivers. Study participants were recruited from parent study, the Healthy Patterns Clinical Trial (Hodgson; R01NR015226). Data were collected from June 13th to August 28th, 2020 via semi-structured telephone interviews. Thirty-four dementia caregivers participated in this study. Mean caregiver age was 59.2±12.7. Over 70% of the study participant reported worry about spreading COVID-19 to the PLWD and 41.2% reported that they have taken on additional caregiving duties for others in their family or network since COVID-19. In this sample, 61.8% of the dementia caregivers reported one or more anxiety symptoms. Independent t-tests were conducted to compare dementia caregivers who reported anxiety symptoms and those who did not report anxiety symptoms. Anxiety symptoms in dementia caregivers were related to poor physical function of their care recipients (p=0.036). However, anxiety symptoms of dementia caregivers were not related to either cognitive level (p=0.11) or number of neuropsychiatric symptoms of their care recipients (p=0.366). Health care professionals should be alert to the anxiety and concerns expressed by dementia caregivers in order to maintain and improve the well-being of both caregivers and their care recipients during this unprecedented pandemic.

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Effects of Positive Thinking on Dementia Caregivers’ Burden and Care-Recipients’ Behavioral Problems

Western Journal of Nursing Research ◽

10.1177/0193945919861970 ◽

2019 ◽

Vol 42 (5) ◽

pp. 365-372

Author(s):

Abir K. Bekhet ◽

Mauricio Garnier-Villarreal

Keyword(s):

Behavioral Problems ◽

Family Members ◽

Well Being ◽

Positive Thinking ◽

Moderating Effects ◽

Dementia Caregivers ◽

Care Recipients ◽

Patient Dependency ◽

The Family ◽

The Relationship

Most dementia care is provided at home by family members. This caregiving places an additional burden on the family members, which can negatively impact their physical and psychological well-being. The caregivers’ burden can also contribute to behavioral problems in the care-recipients. The purpose of this study was to examine the mediating/moderating effects of positive thinking (PT) on the relationship between caregivers’ burden (embarrassment/anger, patient’s dependency, and self-criticism) and their care-recipients’ behavioral problems (memory, depression, and disruption) in a sample of 100 dementia caregivers. Results indicated that caregivers’ embarrassment, self-criticism, and perception of patient dependency predicts depression in care-recipients, and these relationships are moderated by PT. Results also indicated that as PT increases, the relationship between embarrassment and disruption goes down as well as does the relationship between self-criticism and depression. The study provided direction for the development of a PT training intervention to help caregivers to combat their burden.

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Tele-Savvy: An Online Program for Dementia Caregivers

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317518755331 ◽

2018 ◽

Vol 33 (5) ◽

pp. 269-276 ◽

Cited By ~ 12

Author(s):

Patricia C. Griffiths ◽

Mariya Kovaleva ◽

Melinda Higgins ◽

Ashley H. Langston ◽

Kenneth Hepburn

Keyword(s):

Psychological Symptoms ◽

Well Being ◽

Advanced Dementia ◽

Online Program ◽

Dementia Caregivers ◽

Convenience Sample ◽

Program Evaluations ◽

Care Recipients ◽

Person With Dementia ◽

Behavioral And Psychological Symptoms

Introduction: This study examined the feasibility and efficacy of Tele-Savvy, an online version of the Savvy Caregiver Program, a psychoeducation program for caregivers caring for a person with dementia. Methods: A convenience sample of 22 caregivers from the Atlanta VA and 42 caregivers from 14 different states enrolled in Tele-Savvy. Pre- and post-program evaluations assessed caregiver burden, caregiver competency, and frequency of behavioral and psychological symptoms of dementia (BPSD). Results: Fifty-seven caregivers completed the 6-week Tele-Savvy program. Caregivers whose care recipients exhibited higher average BPSD frequency at baseline demonstrated significantly greater burden decreases post-program. Caregivers of care recipients in more advanced dementia stages demonstrated a significantly greater improvement in caregiver competence. Discussion: The results point to the feasibility of achieving significant results in caregivers’ well-being and care recipients’ BPSD with a fully online program. Tele-Savvy may be particularly efficacious for caregivers whose care recipients exhibit higher BPSD frequency and are in later dementia stages.

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Associations between changes in loneliness and social connections, and mental health during the COVID-19 Pandemic: The Women’s Health Initiative

The Journals of Gerontology Series A ◽

10.1093/gerona/glab371 ◽

2021 ◽

Author(s):

Joseph S Goveas ◽

Roberta M Ray ◽

Nancy F Woods ◽

Jo Ann E Manson ◽

Candyce H Kroenke ◽

...

Keyword(s):

Mental Health ◽

Older Women ◽

Living Arrangements ◽

Stressful Life Events ◽

Well Being ◽

Anxiety Symptoms ◽

Social Connections ◽

Social Connection ◽

Lifestyle Behaviors ◽

Factors Associated

Abstract Background Older women have faced significant disruptions in social connections during the coronavirus disease 2019 pandemic. Whether loneliness increased, or whether a change in loneliness from pre- to intra-pandemic period was associated with mental health during the pandemic is unknown. Methods Older women (n=27,479; mean age 83.2 [SD: 5.4] years) completed surveys in mid-2020, including questions about loneliness, living arrangements, changes in social connections, and mental health. Loneliness was also previously assessed in 2014-2016. We examined whether loneliness changed from the pre- to intra-pandemic period and explored factors associated with this change. In multivariable models, we investigated the association of changes in loneliness and social connections with mental health. Results Loneliness increased from pre- to intra-pandemic levels. Factors associated with worsening loneliness included older age, experiencing stressful life events, bereavement, histories of vascular disease and depression, and social connection disruptions. Factors associated with a decrease in loneliness included identifying as Black, engaging in more frequent physical activity, being optimistic, and having a higher purpose in life. A 3-point increase in loneliness scores was associated with higher perceived stress, higher depressive, and higher anxiety symptoms. Social connection disruptions showed modest or no associations with mental health. Conclusions Loneliness increased during the pandemic in older women and was associated with higher stress, depressive and anxiety symptoms. Our findings point to opportunities for interventions targeting lifestyle behaviors, well-being, disrupted social connections, and paying closer attention to those with specific medical and mental health histories that may reduce loneliness and improve mental health.

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Me and My Parents: A Qualitative Study of the Role of Birth Order Child in Family

Open Journal for Psychological Research ◽

10.32591/coas.ojpr.0502.03055b ◽

2021 ◽

Vol 5 (2) ◽

pp. 55-64

Author(s):

Diesmy Humaira Biruny ◽

Latipun Latipun

Keyword(s):

Data Analysis ◽

Birth Order ◽

Interpretative Phenomenological Analysis ◽

Well Being ◽

Phenomenological Analysis ◽

Analysis Technique ◽

The Family ◽

Study Participants ◽

Initial Process

Birth order is one of the most extensive human experiences and is considered to determine how smart, good, responsible, sociable, emotionally stable, and open to new experiences. Therefore, parents assume the birth orderly child is always reliable and can open the way to help his younger siblings later which makes his role very necessary in the family. This study aims to analyze how the role of the birth orderly child in the family is to find the initial process of the birth orderly child to reach his role in the family. Using the Interpretative Phenomenological Analysis (IPA) data analysis technique, this study involved 5 study participants with criteria for children in the first birth order. The results show that with the duties and responsibilities that were carried out early on, the recognition of roles and goals in achieving the well-being of the family made the birth orderly child able to proceed and make himself a role in the scope of the family.

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Mental Health Consequences of Lockdown During the COVID-19 Pandemic: A Cross-Sectional Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.605279 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ahmed Msherghi ◽

Ali Alsuyihili ◽

Ahmed Alsoufi ◽

Aimen Ashini ◽

Zenib Alkshik ◽

...

Keyword(s):

Demographic Data ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Psychological Status ◽

Sectional Study ◽

Cross Sectional ◽

The Family ◽

Clinically Significant ◽

Study Participants ◽

Libyan Population

ObjectiveWe aimed to provide an overview of the psychological status and behavioral consequences of the lockdown during the COVID-19 pandemic in Libya.MethodsA cross-sectional study was conducted among the Libyan population through May and June 2020 in more than 20 cities. The survey comprised basic demographic data of the participants and anxiety symptoms measured using the seven-item Generalized Anxiety Disorder scale (GAD-7) with ≥15 as the cut-off score for clinically significant anxiety symptoms. Additionally, a survey regarding the lockdown effect was administered, which consisted of several parts, to measure the lockdown status.ResultsA total of 8084 responses were recorded, of which, 5090 (63%) were women and 2994 (37%) were men. The mean age (SD) for study participants was 27.2 (8.9) years. Among the participants, 1145 (14.2%) reached the cut-off score to detect anxiety symptoms; however, of the study variables, only five were predictors of clinically significant anxiety: age, gender, marital status, work status, being a financial supporter for the family, and being infected with COVID-19. Women had 1.19 times higher odds to exhibit anxiety symptoms than men. Increasing age was significantly associated with reduced likelihood of exhibiting anxiety symptoms, whereas being married was significantly associated with higher likelihood of anxiety symptoms, compared to not being married. Being suspended from work was associated with an increase in the likelihood of anxiety symptoms. However, we found that being infected with COVID-19 was associated with a 9.59 times higher risk of exhibiting severe anxiety symptoms. Among the study participants, 1451 (17.9%) reported a physical and/or verbal abuse episode from family members, 958 (11.9%) reported abuse outside the family, and 641 (7.9%) reported abuse from enforcers, during the lockdown.ConclusionOur study provided an overview of the psychological and behavioral status, among those who resided in Libya during the civil war and COVID-19 pandemic. The study demonstrates a concerningly high level of clinically significant anxiety during lockdown among the Libyan population during Libya’s lockdown period.

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Challenges in Resource Utilization for Caregivers of Persons With Dementia: A qualitative Study

Innovation in Aging ◽

10.1093/geroni/igab046.2244 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 588-588

Author(s):

Jen Weaver ◽

Eric Owens ◽

Meredith Boe ◽

Jessica Bride ◽

Maritza Dowling ◽

...

Keyword(s):

Cognitive Impairment ◽

Primary Caregivers ◽

Well Being ◽

Health Department ◽

Community Dwelling ◽

Dementia Caregivers ◽

Black Females ◽

Unpaid Care ◽

Care Recipients ◽

Home Based

Abstract This study highlights primary caregivers’ experiences with health department policies designed to support people with cognitive impairment/Alzheimer’s Disease and Related Dementias (ADRD). Caregivers were defined as individuals aged 45-85 that provide at least 10 hours of unpaid care. Five, 90-minute focus groups were conducted virtually with 24 caregivers of individuals with cognitive impairment/ADRD. Transcripts were analyzed thematically. Caregivers were primarily Black females (75%) with at least a high school education (42%). Care recipients were likely to be community-dwelling parents (71%), with moderate or advanced (79%) dementia. Caregivers described challenges with accessing resources intended for care recipients, especially as cognitive impairment worsened. Caregivers reported providing care 24/7 as traumatizing. Home-based personal aides and companionship services did not reduce this burden. COVID-19 impacted caregivers and care recipient’s access to resources increasing burden. Policies need to be flexible for ever-changing needs of individuals with ADRD and support the overall well-being of the caregivers.

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Dementia Caregiving During the “Stay-at-Home” Phase of COVID-19 Pandemic

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa129 ◽

2020 ◽

Author(s):

Jyoti Savla ◽

Karen A Roberto ◽

Rosemary Blieszner ◽

Brandy Renee McCann ◽

Emily Hoyt ◽

...

Keyword(s):

Family Caregivers ◽

Stress Responses ◽

Well Being ◽

Role Overload ◽

Transactional Model ◽

Dementia Caregivers ◽

Telephone Interviews ◽

Primary Appraisal ◽

Secondary Appraisal ◽

At Home

Abstract Objective The objective of this study was to assess family caregivers’ primary appraisal of stressors related to COVID-19 stay-at-home orders, secondary appraisal of resources and support availability, and use of coping strategies as predictors of perceived role overload during the stay-at-home phase of the pandemic. Method Telephone interviews with 53 family caregivers of persons with dementia from rural Virginia 2 weeks after enactment of the governor’s stay-at-home order using structured and open-ended questions were conducted. Results Caregivers who were more concerned about the COVID-19 pandemic were at greater odds of experiencing high role overload than those who recognized positive aspects of the pandemic, as were those who received insufficient support from family and friends. Discussion Use of the transactional model of stress responses yielded important insights about families coping with dementia. Caregivers’ perceptions of the pandemic’s impact varied, with differential effects on their well-being.

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Exemplary Care among Chinese Dementia Familial Caregivers

Healthcare ◽

10.3390/healthcare6040141 ◽

2018 ◽

Vol 6 (4) ◽

pp. 141

Author(s):

Bobo Hi Po Lau ◽

Vivian Weiqun Lou ◽

Karen Siu Lan Cheung

Keyword(s):

Social Support ◽

Psychological Symptoms ◽

Principal Component ◽

Well Being ◽

Dementia Caregivers ◽

Care Recipients ◽

Back Translation ◽

Familial Caregivers ◽

Behavioral And Psychological Symptoms ◽

Familial Dementia

Objective: This study investigates the feasibility of using the Exemplary Care Scale (ECS) among Chinese dementia familial caregivers, and reports its psychometric properties. Method: Back translation was used to develop the Chinese version of ECS (C-ECS). Three hundred and ninety-seven dyads of caregivers and their relatives with dementia responded to an assessment battery which included questions on care recipients’ cognition, behavioral and psychological symptoms, daily activities assistance, social support, and caregiver well-being. Results: Results of an exploratory principal component analysis revealed two subscales in the 11-item C-ECS: considerate caregiving and preserving esteem. C-ECS and its subscales demonstrated sufficient reliability, as well as criteria-related validity through its association with care recipient’s cognition and health, and caregivers’ well-being and social support. Discussion: Our findings provide preliminary support to C-ECS as a reliable and valid measure of exemplary caregiving among Hong Kong Chinese familial dementia caregivers. In the light of the increasing importance of familial care in dementia care planning, we recommend the use of this brief scale in regular caregiver assessment in research and service delivery.

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Snapshot of stress and anxiety related to COVID-19 among health care professionals of central India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203918 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3531

Author(s):

Ujwala Ukey ◽

Sarita Sharma ◽

Pragati Rathod ◽

Sonali Patil ◽

Uday Narlawar ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

High Stress ◽

Central India ◽

Well Being ◽

Role Reversal ◽

Online Questionnaire ◽

Significant Difference ◽

Study Participants ◽

Mental Well Being

Background: Health care professionals are particularly vulnerable to emotional distress in the COVID-19 pandemic, due to risk of exposure to the virus, concern about infecting and caring for their loved ones, longer work hours, and involvement in emotionally and ethically fraught resource allocation decisions. The sudden role reversal from healthcare provider to the confirmed or suspected patient potentially leads to a sense of frustration. During the COVID-19 battle the doctors and nurses in India are handling increased infection risk, paucity of protective gear, and assault.Methods: An online questionnaire based cross sectional study was conducted among health care professionals in a tertiary health care setting in central India. Proforma had questions on impact of COVID 19, mental well being, stress and anxiety.Results: Of the 237 study participants, 182 had moderate and 25 had high stress. Anxiety was present in 46%. There was a significant difference in stress (χ2=11.22, p<0.001) and anxiety (χ2=6.6712, p=0.009) in study participants <40 years and ≥40 years age. Multivariate logistic regression showed significant role of sleep and appetite disturbances. Positive correlation was established between perceived stress and anxiety (R=0.713).Conclusions: A state of good mental well-being despite the presence of stress and anxiety simultaneously indicates.

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