COVID-19 Lockdown Measures: Impact On Older Adults With Dementia And Their Caregivers In Singapore

Family caregivers typically rely on community-based services and social support networks to supplement their caregiving of older adults with dementia (OAwD). In April 2020, the Singapore government implemented a partial lockdown to contain the spread of COVID-19. We assessed the policy's impact on the physical and mental health of caregivers and their OAwD. As part of a larger study, 30 caregivers were interviewed and rated the stress they experienced when caring for an OAwD during the partial lockdown. Qualitative analyses found significant behavioral changes in OAwD such as irritability, aggression and hallucinations, which led some caregivers to believe their dependents’ condition had deteriorated, as well as heightened levels of caregiving stress. Overall, our preliminary results suggested that although social distancing measures may be effective in containing the spread of COVID-19, these measures could lead to negative outcomes on vulnerable populations such as OAwD and their caregivers.

Social Isolation, Caregiving Alone, and Caregiving Stress in Family Caregivers of Older Adults in Korea

The tendency of caregiving alone is increasing, and these solo caregivers often perceive caregiving responsibilities as a burden. Still, literature on positive aspects of caregiving shows that not all caregivers experience severe distress. Little is known on which factors make a difference in experiencing caregiving distress among solo caregivers. We focused on the empirical findings on the negative impact of social isolation on caregiver’s mental health, examining if and how the intersection of solo caregiving and social isolation is related to severe caregiving stress among caregivers of older adults in Korea. We analyzed 501 family caregivers of older adults in Korea using survey data from the Care Work and the Economy research project (2018). We conducted ordinal logistic regression analysis. The findings show that solo caregivers with a lack of social time fall under the most at-risk group of caregivers in terms of experiencing severe stress (OR=3.72, SE=0.93) whereas solo caregivers with enough social time did not show significantly higher stress compared to the reference group (OR=1.50, SE=0.43). Being socially isolated caregivers still had high levels of stress despite the division of care (OR=2.16, SE=0.55), implying the need to provide caregivers more time for social interaction with others. The current public long-term care insurance in Korea provides limited hours of in-home care aide services to enable aging in place of older adults. To reduce the social isolation of caregivers, it is necessary to extend the service hours and provide support, such as creating online caregiver networks.

Predictors of COVID-19 Related Stress Among Custodial Grandmothers

This paper examined predictors of COVID-19 stressors among 316 custodial grandmothers raising school-aged grandchildren using regression. Grandmothers, who were participants in two nationwide behavioral RCTs, completed an online questionnaire in Spring 2020. Predictors included grandmother demographics, depressive symptoms, perceived caregiving stress and reward, stress management strategies, and grandchild factors. Outcomes included grandmothers’ stress related to using bad coping habits (r2=.24), grandchildren’s remote learning(r2=.39), household conflict (r2=.29), COVID-19 fear and uncertainty (r2=.28), and finances(r2=.24). Regression results indicated that grandmothers’ pre-existing depressive symptoms predicted all outcomes except remote learning stress. Higher caregiving stress was associated with all outcomes, except concerns about using bad coping habits. Grandmothers with less perceived access to care reported greater concern about bad coping habits and remote learning stress, while minority grandmothers reported more financial stress and COVID-19 fear and uncertainty. Findings suggest that the COVID-19 pandemic has compounded the stress experienced by already burdened custodial grandmothers.

Early Life Adversity, Depressive Symptoms, Marital Satisfaction, and Chronic Stress

Poor marital satisfaction may exacerbate the association between early life adversity (ELA) and psychological distress, and this effect may be amplified in the context of chronic caregiving stress. The goal of this study was to test whether marital satisfaction moderated the relationship between ELA and depressive symptoms, and whether these associations were moderated by chronic caregiving stress. Method: The sample consisted of 145 mothers in a romantic relationship, caregiving for either an adolescent on the autism spectrum, or a typically developing adolescent. Participants completed the Childhood Trauma Questionnaire assessing exposure to trauma and neglect, the Center for Epidemiologic Studies Depression Scale assessing depressive symptoms, and the Relationship Assessment Scale assessing marital satisfaction. Prior work indicates that mothers of adolescents with autism experience greater parenting stress than mothers of typically developing adolescents. Results: Marital satisfaction moderated the association between ELA and depressive symptoms among mothers experiencing chronic parenting stress, but not among mothers of typically developing adolescents. More specifically, the positive association between ELA and depressive symptoms was exacerbated among participants with lower marital satisfaction. These results suggest that poor marital satisfaction, in addition to concurrent chronic stress, may worsen the psychological consequences of ELA. These effects provide a better understanding of interpersonal factors impacting the long-term consequences of ELA on psychological well-being. Longitudinal studies are needed to observe how these associations change or if they remain stable, as a function of time.

The Role of Personal, Social and Religious Resources in Caregiving Stress

This study puts personal, social, and religious resources as a stress buffer for caregivers. The limitation of personal, social, religious resources have a detrimental effect on the mental health of caregivers of a family member with schizophrenia (hereinafter referred to as People with Schizophrenia, or PwS). Following the caregiving stress process theory, this study aims to clarify not only the role of personal and social resources but also the religious ones. For this purpose, in-depth interviews with a life history method were done to twenty (20) caregivers of PwS. The result shows that personal resources like coping mechanism management (for example, by doing a positive comparison with others and reducing the expectations on the PwS) would help to perceive the role of a caregiver more positively. Meanwhile, social resources like social support were received by the caregivers from their significant others (family members) and similar others (support group). Social support was received in the form of emotional support, caregiving help, and instrumental aid. Religious resources in the form of religious coping were also used as a buffer for the stress that came from caregiving. This was done by positive religious coping, such as asking for help from God during difficult times, involving God in everything they do, and surrendering themselves to God to get the strength to face life problems. These three resources (personal, social, religious) were needed by the caregivers so they can preserve their mental health.

The Role of Personal, Social and Religious Resources in Caregiving Stress

This study puts personal, social, and religious resources as a stress buffer for caregivers. The limitation of personal, social, religious resources have a detrimental effect on the mental health of caregivers of a family member with schizophrenia (hereinafter referred to as People with Schizophrenia, or PwS). Following the caregiving stress process theory, this study aims to clarify not only the role of personal and social resources but also the religious ones. For this purpose, in-depth interviews with a life history method were done to twenty (20) caregivers of PwS. The result shows that personal resources like coping mechanism management (for example, by doing a positive comparison with others and reducing the expectations on the PwS) would help to perceive the role of a caregiver more positively. Meanwhile, social resources like social support were received by the caregivers from their significant others (family members) and similar others (support group). Social support was received in the form of emotional support, caregiving help, and instrumental aid. Religious resources in the form of religious coping were also used as a buffer for the stress that came from caregiving. This was done by positive religious coping, such as asking for help from God during difficult times, involving God in everything they do, and surrendering themselves to God to get the strength to face life problems. These three resources (personal, social, religious) were needed by the caregivers so they can preserve their mental health.

The Role of Religious Coping in Caregiving Stress

Studies explaining how stressors and religious coping affect caregivers’ depression have been rarely conducted in the Indonesian context. Therefore, this study discusses stress process theory by examining the role of religious coping as a moderating variable between relational deprivation and loss of self on depression. In a quantitative study of 50 caregivers of persons with schizophrenia in Indonesia, this study analyzed the moderating variables using multiple regression. The results showed that higher relational deprivation will lead to increased depression, but religious coping mechanisms can reduce the effect of relational deprivation on depression (buffering effect). Religious coping can also minimize the effect of loss of self to depression. Subjective stressors and religious coping offer new theoretical insights and must be considered when studying caregiving stress. In this regard, mental health services aiming to enhance caregivers’ welfare need to be provided by the state and community.