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In a recent national survey that was done between May and June of 2020 33% of caregivers reported mental health problems like anxiety, depression or substance use. Okay, I imagine you might be thinking, isn't everyone experiencing these problems more with COVID? And that's an excellent question. And the researchers looked at that. And they found that 6.3% of non caregivers are reporting anxiety, depression and substance use disorders. This is at a clinical level. So 33% versus 6.3%. And here's why this is so important. The same study found that 30.7% of caregivers of older adults thought about suicide between May and June of this year, which is much higher than even the highest risk groups like essential workers are young adults. The highest of all groups for suicidal thoughts, was caregivers. I want to be sure that if you are caring for somebody that you have resources to support yourself as well.

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I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say in my therapy groups, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place. Let's get started.

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There's a common myth out there, that older adults are all alike. This idea couldn't be further from the truth. In fact, older adults are incredibly diverse. In addition to this podcast, I have a business where I provide training and education to mental health and senior care providers all about caring for older adults, specifically as it relates to mental health or sexual health, or even equity and inclusion in senior care. Of course, they provide these trainings over zoom during COVID. Safety first, right. And this past week, I want to tell you, I presented to senior care providers in Georgia, on equity and inclusion in senior care, and it got a lot of buzz. So if you'd like to learn more about training and education for senior care professionals, or even mental health professionals, head on over to my website www.drreginakoepp.com. I'll link to my website in my show notes. Go check it out.

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November is National caregiver month. But I really think this entire year should be dedicated to caregivers for all that they have been through during COVID. In today's episode, I'll be sharing some statistics about the toll of caregiving during COVID and five strategies for helping caregivers prioritize their self care. As you listen to this episode, I want you to go all the way through until the end. If you stop at simply the statistics I'm about to share with you that will leave you with a bleak picture of the toll of caregiving during COVID on caregivers. And I don't want to leave you with that bleak picture. Because there is a lot that you can do if you're a caregiver to prioritize yourself care. And there's a lot that you can do as professionals to help caregivers navigate these turbulent waters of caregiving during COVID. And so please listen all the way through to the very end so that you get the benefit of all of the strategies that I'll share with you.

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In this episode today, you may be surprised to hear that the majority of caregivers, and I'm not talking 50% I'm talking the gross majority, like two thirds of caregivers continue to work at least 30 hours a week at minimum. So if you're caring for an older adult and you're working during COVID, you've had to change your entire routine. After the last several months. senior centers have closed Adult Day programs have closed and caregivers really rely on the services to support their loved one so that they can also have a break and have a life and work.

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That's not all though. Many caregivers have been reluctant to use home health aides because of COVID and fears about COVID and so even many of the care like like the grooming And the bathing and the toileting tasks are now falling on caregivers more than ever before. And that's not even to mention that the older adult that you're caring for and possibly you, the caregiver may even be more vulnerable when it comes to your own health surrounding COVID. All of these losses in the caregiving structure it's like a caregiving infrastructure that caregivers rely on means that caregivers don't have the resources that they need to care for their loved one, and don't have the breaks from caregiving that are essential to maintaining health and wellness.

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But listen, the toll is on caregivers, and it's on the older adult, I, I work with families from a systems perspective, which means that my client, or my patient, depending on where I'm working, if it's in the hospital, or if it's in a clinic, my client or my patient is the whole family. It's the older adult who might have an illness, and it's also the family who's caring for them. The whole family is suffering, the caregiver and the older adult. And if that wasn't enough, there's anxiety and uncertainty about COVID. And now we're on another wave of COVID. So then also now with the older adult, more socially isolated, the older adult is more likely to decline in mental and physical health, which is tragic. caregivers and older adults are in an impossible bind right now.

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So if you're caring for someone with dementia, for example, with all of the lack of resources and the changes to routine and the changes to the caregiving infrastructure, chances are that your loved one is going to be more agitated or even depressed. Because yes, people with dementia can have depression, or have other behavioral challenges. And this is putting more burden and weight on the caregivers. In fact, just last week, I met with a caregiver who, since COVID, started tell works from home, right? Her husband who has dementia who used to go to a day program can no longer go to the day program because it's closed. So now he is also at home at the same time. Before the COVID pandemic, his home health aide would come to his home three days a week. And he you know, like I said, go to an adult day program five days a week. And these resources were essential to helping his wife, the caregiver, continue to work so that she can pay for all of the expenses that come with caregiving and her own livelihood and their house. And so that she wouldn't have to give up her whole life in exchange for Caregiving. But since COVID, his adult day program is closed. And she has opted off and on throughout COVID to not have the health aid come due to her concerns that the health aide wasn't following COVID precautions or concerns that maybe the health aide was exposed. And so as a result, my client, the caregiver and the and the husband living with dementia are experiencing lots of stress and overwhelm, trying to figure out how to work and caregiver full time.She's exhausted, as you can imagine. And as a result, she just like other caregivers, is more stressed out and burned out than ever before.

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And here's the thing, she's not alone. In a recent national survey that was done between May and June of 2020 33% of caregivers reported mental health problems like anxiety, depression or substance use. Okay, I imagine you might be thinking, isn't everyone experiencing these problems more with COVID? And that's an excellent question. And the researchers looked at that. And they found that 6.3% of non caregivers are reporting anxiety, depression and substance use disorders. This is at a clinical level. So 33% versus 6.3%. And here's why this is so important. The same study found that 30.7% of caregivers of older adults thought about suicide between May and June of this year, which is much higher than even the highest risk groups like essential workers or young adults. The highest of all groups for suicidal thoughts was caregivers. I want to be sure that if you are caring for somebody that you have resources to support yourself as well. So if you're struggling with suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255. It's free It's a national program, and they're there to help you. So please don't hesitate to call. This is why I'm having this episode today. This is why it's so important that we should not only be looking at November for national caregiver month, we should be looking at the whole year of 2020. That should be the year of the caregiver.

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Now I want to share five strategies for taking care of yourself during an incredibly difficult time. So as I get started with these strategies, I want to thank the Rosalyn Carter Institute for Caregiving for prompting some of these questions that I'm about to ask you, and some of these recommendations that I'm about to share with you. So the first strategy for prioritizing your self care during COVID is to think about why you don't take better care of yourself. So the most common answer to this question that I get is, I don't have time or my loved one needs me all the time. And actually, that might be true. But I also wonder if there's something more in addition to that. So when I asked caregivers to look a little bit deeper about why they don't take better care of themselves, I often hear more deeply ingrained thoughts. Like I feel guilty for taking time for myself, when my loved one is stuck in the bed, or when my loved one can't take care of themselves. Or other people might think that I'm shirking my responsibilities or being selfish if I spend too much time in self care.

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So I want you to really reflect on what gets in your way. Why don't you take better care of yourself? Don't judge it. Just imagine it, just think of it, bring it to the surface. And after you reflect on this a bit, think of how these thoughts or beliefs got started, like, were you raised to put other people before yourself, were you raised to hold a certain level of duty to your family, I'm a caregiver because I'm a dutiful wife, or a dutiful daughter, or a dutiful husband. So the first thing about why you don't take better care of yourself. And then to reflect on where that idea or this belief got started. And then the second is to begin thinking in a new and different way about taking better care of yourself.

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So now that you know some of what makes it hard or why you don't do it, consider new ways of thinking that include your own needs. So for example, instead of saying, I can't take a walk, my mom needs me. And if I'm honest, I feel guilty getting outside on this beautiful day when my mom is stuck inside. Try saying taking a walk for myself now will give me some time to be alone and decompress, which will actually lower my stress. And then when I come home, my mom will sense that my mood has changed. And she'll benefit from that. She benefits from me taking care of myself.

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Number three, is to set goals for taking better care of yourself. So for this strategy, I'm going to give you categories for you to think about how well you already care for yourself. And then I want you on each of these categories to rate yourself from zero to five, like zero is poor, and five is excellent or outstanding. So I'm going to ask you about sleep. How well do you care for yourself when it comes to sleep? Zero is poor and five is outstanding. Give yourself a number. And so for caregivers I hear, oh, I don't get enough sleep or I'm sleeping too much. Alright, moving on to eating habits or nutrition. How well do you take care of yourself when it comes to eating? Do you overeat or under eat? And just think of yourself generally how nutritious are the meals that you're getting? Zero is poor and five is outstanding or Excellent. So give yourself a number anywhere between zero and five. All right, moving on to exercise or even mild exercise or getting outside for fresh air. Zero is poor and five is outstanding or Excellent. So when you think about your own physical wellness, and your exercise or fitness, how well are you taking care of yourself in this in this capacity? Give yourself a number between zero and five. How about failure to take care of yourself when you're sick? So many caregivers. I know what everybody else's needs the head of their own. And then when they have their own illness don't take care of themselves. And so maybe you have a cold or allergies, and you're not staying in your bed when you need to. So how well do you care for yourself when you're not? Well, zero is poor, and five is outstanding. All right. Now how well do you do when it comes to making your own medical appointments, or your own mental health appointments? Zero is poor, and five is outstanding. Give yourself a number. The study that I mentioned earlier, also identified that caregivers are drinking more now than ever before. And so I added drinking to this list. How are you doing with substance use if you're doing poorly, what it's zero, or outstanding, is five. So give yourself a number between zero and five. So of these six categories, which one stands out to you most, where are you doing the most poorly in, simply choose that category. And here's where setting a goal comes in. Choose the one category and then identify one way that you could start to take better care of yourself in this one category.

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So if it's drinking, for example, like I've been drinking a bottle of wine tonight, I'm going to cut down to two glasses max. So if that is your goal, write that down. Or if you're not getting enough sleep, I've been going to bed too late, I'm going to get in bed one hour earlier each night. Just simply choose one category. And one way to start taking better care of yourself. The fourth strategy is to set yourself up for success. So imagine what moving toward your goal looks like. And then troubleshoot your steps like imagine any obstacles or barriers that will get in your way, and then come up with a solution for it. So if you're cutting down on your drinking, pour a glass of wine, and then put the cork back in the bottle. And if it's a white wine, put it back in the fridge behind other objects, put other objects in front of it. Because the more distance and obstacles you put in front of that bottle of wine, the less likely you are to drink more of it.

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Alright, so that's one way, if it's sleep, set an alarm for 30 minutes before the time that you actually want to go to bed, so that you're reminded to start getting ready for bed earlier. This is a great strategy for setting you up for success. And number five, is to ask your friends and family and neighbors and health aides for help all of these people or your care team. It might not be as formal as before COVID. Maybe it's your neighbor, maybe it's a family member. Maybe it's a sister who lives in another state who could talk with your loved one on the phone. ask them for help ask them for some time. This can be really hard to do. Because caregivers are notorious for having a hard time asking for help themselves. They are the helpers. You're the helper. What happens when the helper needs help? And I want to say you've done harder things than asking for help. But even more, you're worth it. Your health is just as important as everyone else's.

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I want to speak for a minute to family members and friends of somebody who's caregiving. Think of ways to be helpful. Can you drop off a meal or run an errand offer to meet for a chat outside on the patio. In fact, just last week, one of my dear friends had to move her mom into a Memory Care Unit after her mom was in a hospital for a few weeks as a result of agitation and delusions from dementia. I mean, a horribly tragic, tragic experience. And if you've gone through this, you know how stressful This is. Because it COVID my friend only had a small window of time that they could move her mom's furniture out of the assisted living into storage. And so when my friend reached out to me to see if her daughter could come hang out with me and my kids for the day, of course was the first thought in my mind. And you know what, we had a blast. It was so much easier being with my kids when I added a third one to the mix. So find ways to be helpful. Show caregivers in your life. Some love they need it now, more than ever before.

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All right. Alright, I'm going to recap on the five strategies for improving your self care five strategies for prioritizing yourself care. Here they are again, one, think about Why you don't take better care of yourself? no judgment. Be a detective, get clear. Number two, begin thinking in a different way about taking better care of yourself. Number three, set goals for taking better care of yourself. Number four, set yourself up for success. And number five is ask your friends, family, neighbors health aides for help. Get a care team around you and may not be formal, it may not look the same as it did before COVID. I mean, my heart really goes out to you. But ask your informal care team for help. Let me also share that if you are struggling during COVID with anxiety, depression, substance use as a caregiver, you're not alone. And please reach out to a mental health provider for help or national caregiving centers for help as well. I'll link in my show notes to how to find a therapist just for you. And also which national caregiving centers are reputable. Check them out. I'll link to them in the show notes. And please remember that your health is just as important as everyone else's, especially the person you're caring for. They need you they rely on you to be healthy, both mentally and physically.

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So please take care of yourself. That's all for today. If you like this episode, be sure to subscribe and leave a review. And just a reminder that the information shared in this episode is for educational purposes only, and does not take the place of licensed medical or mental health care. I'll see you next week. Same time, same place. Bye for now.