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CAREGIVER NEEDS DURING COVID-19

September 1, 2020
By: 
Emily Fox
Research Assistant
Dalhousie University, AGE-WELL National Innovation Hub APPTA
Heather Higgins
Coordinator – Policy & Knowledge Exchange
AGE-WELL National Innovation Hub APPTA
Emily Kerry
Research Assistant
Agewell National Innovation Hub APPTA

Canadian caregivers play an integral role in the health and well-being of older adults. Over 7.5 million Canadians provide unpaid care for relatives and family friends, saving the Canadian healthcare systems upwards of $66.5 billion annually. Evidence shows that the support administered by unpaid caregivers is associated with a range of positive health outcomes for their care recipients, from fewer emergency room visits to reduced long-term care admissions. However, this comes at a physical, mental and financial cost to caregivers.
The challenges caregivers face continue to grow in both number and complexity and are compounded by the additional impacts of COVID-19. Canadian caregivers can exhibit increasing levels of chronic stress due to the added caregiving responsibilities placed upon them. Their ability to manage their own mental health and well-being while providing care is tested, often leading to caregiver burden. Evidence shows that caregiver burden can bring on negative health outcomes such as depression, anxiety, and a relatively higher mortality risk for caregivers. Caregiver burden not only has an impact on caregivers themselves, it also impacts care recipients by increasing their risk for depression, as well as decreasing the quality of their care and length of time they are able to remain living at home. Caregivers need to be supported in their responsibilities before they reach this stage.
The AGE-WELL National Innovation Hub surveyed Canadian caregivers to identify the areas where unpaid caregivers need support. One of the most sought-after interventions to support caregivers is increased education and training opportunities to address some of their most commonly reported needs. While COVID-19 restrictions limit the opportunities for in-person and group education and training sessions, there are increasing avenues for digital and virtual interactions.

Providing functional, emotional and financial support in the home

One of the most commonly reported needs of caregivers is functional supports. Related to the physical tasks of caregiving, functional supports range from in-home and community-based respite, home care and home support services. These programs provide opportunities for caregivers to spend time on their own mental and physical health as well as offer beneficial social opportunities for care recipients.
Caregivers have repeatedly identified respite care as being one of the most important services, citing several barriers to receiving respite care such as cost, scheduling inflexibility, and limited availability. However, many community centers and organizations that provided facility-based respite options have been forced to discontinue their services as a result of COVID-19 restrictions. Furthermore, physical distancing has limited in-home care, as well as unpaid help from family and friends. As such, increased education on professional care services is needed as caregiver responsibilities grow.
Without the availability of respite care and unpaid help, caregivers are in greater need of training in order to perform the daily tasks of caregiving that may have been previously fulfilled by support workers and services. These services cover instruction on medical caregiving tasks such as the appropriate procedures for lifting, bathing, wound and sore care, ostomy and catheter care, and medication management. Providing more functional supports through appropriate virtual training is a critical and immediate change that has the potential to reduce caregiver burden.
COVID-19 will have long-lasting mental health implications for many Canadians. For Canadian caregivers, these challenges are further amplified by their pre-existing need for increased access to formal mental health services. Mental health education and training needs range from self-care, grief and coping skills to more knowledge of disease trajectory. The existing mental health services need to be more accessible, affordable, and flexible for caregivers. Governments and health officials can take a more proactive approach by increasing mental health support through webinars, virtual group counselling, and individualized mental health care through video and telephone support.
Finally, the economic and financial insecurity resulting from COVID-19 adds a new level of complexity to the financial security of caregivers. Caregivers have identified a lack of awareness of existing financial supports, as well as insufficient tax credits and benefits. COVID-19 relief measures should consider the financial impacts on caregivers and provide online information sessions to help connect caregivers with the support they need.

Supporting Canadian caregivers during COVID-19

Caregiver supports need to be addressed immediately in order to reduce the impact of caregiver burden on caregiver and care recipient health outcomes. Research has shown the health and economic benefits of home care in comparison to residential care. However, Canadian caregivers need to be supported in their roles for these benefits to have a meaningful impact. The lifestyle and community changes associated with the outbreak of COVID-19 present additional challenges to caregivers; governments and health authorities need to consider alternative avenues of support in order to decrease the negative compounded impacts of caregiver burden and COVID-19 on Canadian caregivers and their care recipients.