New Challenges in Dementia Care: The Bi-Polarization of Relationships during the Age of COVID-19

It has been very difficult for many people to adjust to the swing from one extreme to another in terms of relationships in the face of COVID.  We are so used to living in the middle, straddling the concept of complete saturation and long-distance connections. We are used to employing the help that we need when we need it with few hiccups. We could go out, get what we need, bring those things home, and not be scared.  We could bring people into our homes and we could go to other people's homes. We could visit those that needed our connection, we could come and go as we please. There was no COVID anxiety attached to our previous interactions.

Now we live on the edges of this continuum. We find ourselves either saturated with relationships with those we are sheltering in place with; seeing them every day, all day, learning how to cope with that level of closeness.  We are also forced to maintain all of our other relationships as long term, from a distance and lacking in face to face connection.

image courtesy of pixabay

image courtesy of pixabay

This is taking a toll on those home-bound caregivers that are sheltering in place with their loved ones.  The anguish of managing bipolar relationships is adding a new version of anxiety that we have never seen before.
Caregivers are stuck alone in their homes, with little access to help for a myriad of reasons: care assistance not able or willing to provide in-home care, limited community services due to the strain COVID is placing on the overall health care environment and a forced estrangement of other family members that would have otherwise provided some type of respite or help for the primary caregiver.
In the home, it has now become a 24-7 stressor.  All-day, all night, the primary caregiver is alone to do what needs to be done. There are few. if any, opportunities to leave the house and go somewhere, anywhere, to get a breath of fresh air to revitalize the caregiving, to fill their cup with newfound patience.  The amount of worldly closures that are, in essence, non-essential, is taking a toll on caregivers who need somewhere to go to rejuvenate.
Additionally, being inundated with our "loved ones" consistently brings up new issues of frustration and irritation.  We all need a break from others and caregivers cannot get this break.

image courtesy of pixabay

image courtesy of pixabay

Without breaks, caregivers are fraying at the edges, finding the most simple of issues to be anxiety-provoking, driving them to become more annoyed than ever before. This taxing situation makes a caregiver less capable to give good care. Essentially as their cup is being drained without any opportunity to refill with self-care.

This concept of bi-polarization of relationships is probably not temporary either. With all that changes daily, increases in national and world cases, the unpredictability of the pandemic, and its ability to change our access to products and services, I predict this to be our new normal for a foreseeable future.
So how do we address this unconventional manner of managing relationships?  What can we do to bring self-care opportunities back to our caregivers?  How can we enhance service provisions and accessibility to community care? How do we help caregivers vent their growing frustrations, how do we help them fill their cups back up?
Here are some ideas:  If you have family members that are now distant, unable to visit, unable to provide respite then they could be good providers of case management.  A sister that lives in a different city or is currently quarantined would be a good provider of service coordination.  Perhaps they could take an hour or two a week and make phone calls on behalf of the person living with dementia and their primary caregiver.  They can call or email other family members to bring them up to speed on the caregiver and care recipient.  They can call doctor offices, get medications filled, do research on any upcoming health issues.
A brother that is unable to provide the weekly respite that he used to may be able to streamline grocery shopping or purchase household products that make caregiving more convenient.  Building a ramp to help get the wheelchair to the backyard or installing the shower handles could be very useful at this time.

image courtesy of pixabay

image courtesy of pixabay

Maybe a family member that is currently out of work has an hour a week to take mom out for a drive.  This socially acceptable, socially distancing activity can help everyone involved.  Mom gets out of the house, gets to breathe in some fresh air, and has an opportunity to connect with someone else.  The primary caregiver gets a small, much-needed break, without mom; able to fill up some of her cup.

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