How to Deal With a Remote Caregiver During a Pandemic

The COVID-19 pandemic represented a solution to problems that most people never thought they would face: a shortage of toilet paper, universal homeschooling, and a new virus that killed more than 100,000 Americans in less than three months. It has also revolutionized the nursing landscape. An estimated 39.8 million people in America are caring for adults (ages 18+) with a disability or illness, and the onset of the pandemic – and physical distancing in particular – has further complicated an already difficult job.

Typically, about 13 percent of Americans provide long-distance caregiving, which means they live approximately 100 miles or more from the person or people they care for. But in an era of social distancing — especially when it comes to the elderly and other vulnerable populations — caregivers who were once considered “local” have in many cases become remote caregivers unable to provide their usual type of care. If you find yourself in this position caring for a parent or other loved one, here are some expert tips on how to navigate our new reality.

What makes this situation different

Typically, the main disadvantages of remote caregivers include the inability to meet with staff at the point of care, lack of support from social workers, and simply not knowing how the patient looks on a regular basis. But this does not necessarily apply in the current situation, which has more to do with the fact that the access of former local caregivers to health care providers – and in some cases to the patients themselves – is becoming increasingly limited.

According to Dr. Sarah Douglas , Nursing Professor and Associate Dean of Research at Case Western Reserve University, who recently completed research on telecommuting, a major challenge for “local” telecommuting is to think about alternative ways of delivering care. get the benefits that you are used to receiving through personal experiences and being aware of the stress associated with it.

“For example, it’s not uncommon for visits to an oncologist’s office to be late,” explains Douglas. “When the caregiver was with the patient and the wait was tense, at least you knew why things were taking longer than expected (the doctor is late, the patient’s lab results have not yet returned, etc.). When you, the guardian, are waiting in the parked car, you don’t know what’s going on and you can’t go to the reception [to] find out how much more they think will pass before the oncologist arrives – it can be stressful. ”

Tips for telecare providers

If you’ve recently found yourself in a quasi-distance caregiver position, Douglas has some tips to help ease your burden.

Schedule meeting calls

The lack of permission to accompany someone to a medical facility creates many problems. One way to mitigate them, Douglas says, is to make a schedule with the patient in which they will contact you and give you an update on their status during the visit (even if it’s just “I’m still in the waiting room”). “). If the patient does not have a cell phone, ask them at the front desk if they can use the facility’s phone to provide you with updated information. If this is not possible, Douglas recommends asking if you can speak to a designated social worker to see if that person would want to call you.

Contact a social worker

Write a note and ask the patient to give it to their social worker, if available. In this note, ask a social worker if he / she can call or email you at a prearranged time to discuss any questions, concerns or concerns you (or they) may have. “Use this great resource to provide you with information and support for caring for your loved ones,” says Douglas. “In addition, social workers can often help develop strategies to reduce stress – be it more traditional methods (for example, deep breathing to manage anxiety) or perhaps some specific strategies that are unique to your situation ([if] the social worker calls you at a specific time to find out what questions or concerns you have) ”. The support services you once used as a local caregiver are still available — in most cases, this is sufficient for you to initiate contact.

Use video conferencing

In her latest study, Douglas found that using video conferencing during oncologist visits reduces stress and anxiety for those caring for long-distance patients who cannot be present in person. This is only relevant today; While some hospitals may have been reluctant to use apps like FaceTime for video conferencing in the past, they have eased restrictions due to the pandemic, Douglas says.

“There will be some return to the more limited use of telemedicine / video conferencing technologies as the COVID problems diminish,” she says, “but in my opinion it will not be as limited as it was before COVID. So take advantage of the fact that there are many platforms you can use right now – and find the one you like and start the process. “

Mental health and care during a pandemic

The COVID-19 pandemic has not done much harm to our collective mental health, and carers and their loved ones are no doubt suffering. Even if the patient is part of a community (such as a nursing facility or a retirement community), most residents are required to stay in their rooms, according to Karen Whitehead, a social worker who specializes in working with caregivers at a distance. If you are caring for an elderly person, Whitehead advises keeping in mind that this situation is unprecedented in their life, as well as in ours. Because of this, she recommends staying in touch with people as much as possible. “While we can stay connected using Zoom, Facetime, or even plain text, our loved ones may not be familiar with these technologies,” Whitehead says. “Calling more often, sending a postcard, or writing a letter may be more common for older people.”

If you’re worried that a loved one is feeling isolated or depressed, or that their anxiety is increasing significantly, Whitehead says it might be time to bring in a mental health professional. If the person you are caring for lives in a community, they may already know someone to intervene. “Many older people may resist mental health services because they are not a typical part of their generation,” explains Whitehead. “It is often best to start with the primary care physician or health care provider they are most familiar with. If you can first express your concerns to your loved one, it will help them feel overwhelmed now and can help them be more open to conversation. ”

At the same time, caregivers should not ignore their own mental health. Whitehead suggests taking additional steps that can give you more peace of mind, such as setting up a medical alert system or regular patient appointments. “This can help reduce anxiety about being alone for extended periods of time,” she adds. If not, Whitehead said that if you are increasingly concerned about their safety, bringing a patient into your home, living with them, or hiring a caregiver may be a necessary step, although it raises a whole new set of problems associated with the pandemic era, especially in respect of patients from risk groups.

Conversation in a nursing home

While discussing the possibility of transferring a loved one to a nursing home or skilled care facility is never easy, COVID-19 has made the discussion – and the decision – even more difficult. As of today, roughly one third of COVID-19 deaths in the United States occur in nursing home residents or employees, so even if under normal circumstances a medical facility would be the best place for your loved one, it might not be. Now. “There is never a good time for this difficult conversation,” Whitehead says. “It is important to consider the risks and benefits of COVID for a loved one. If they are no longer safe in their current situation or it is time to move to the next level of care, do your research first. ”

First, states are publishing COVID data for long-term treatment . “Find out who has had cases and who has not. Visit the sites yourself to review current protocols and their future plans, ”says Whitehead. “Compare this information with your state’s advice and the CDC’s. Most importantly, talk to your loved one’s health care providers to help you determine if the time is right and what they suggest to minimize the impact on your loved one. If they were safer, if they were assisted with long-term care, it might be better than [the patient] staying at home alone, falling down, and going to the emergency room several times. “

Guardian resources

Whether you are a telecare newbie or a seasoned professional, Douglas recommends the following resources:

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