Being a Caregiver During COVID-19 Feels Like One Big Calculated Risk.

It is not a comfortable feeling.

From the very beginning of the pandemic, family caregivers were forced to make decisions with little information based on fact. Should we keep mom in assisted living or bring her home? Should we keep the home health aide or let them go while we are working from home? Should we postpone the trip to the doctor, the chemo treatment or the visit with family for the holiday?

I live in New Jersey and we were hit hard. Early on mom and I were forced to make decisions based on calculated risks. It required intentional conversations between mom and me and with her live-in caregiver. Because her caregiver is with mom when I am not, we knew she was not working for multiple families. Because she does not drive, we knew her outside interactions would be limited to her daughter. We shared with one another the precautions we were taking at home in terms of disinfecting, shopping and no visitors. We agreed that we would all abide by these limits. The decision to keep mom’s live- in aide finally came down to this: If the aide got sick, I was her backup. If I got sick, she was my backup. Keeping her on was a risk we were willing to take.

Mom is diabetic and she manages it well. However, early in the coronavirus upheaval she developed a wound, not something you ignore with in her medical condition. She had never had one before and was reluctant to go to the wound center at the local hospital. I wasn’t thrilled myself, but never having cared for a wound, I felt it was important to go. It was a calculated risk, one that my mother was reluctant to take, but I convinced her it made sense. I’m thankful that we were discharged after a few visits, but the protocols in place progressed from questions on have you traveled out of the country, to waiting in our car for our appointment, to our temperature being taken as soon as we stepped in the hospital doors and the wearing of masks being required. It was scary and I’m thankful that taking that risk did not result in either one of getting sick us.

Now here we are. New Jersey is slowly reopening. We have learned during the last 100+ days that certain precautions work. Washing hands, wearing masks, social isolation and social distancing flattened the curve and helped to mitigate personal risk. But we are not out of the woods yet and my mom, at 88 with her health conditions, is still at great risk. As her caregiver, I need to continue to take precautions so I don’t add to her vulnerability.

But taking a calculated risk at this stage has broadened beyond physical safety to how to stay emotionally healthy. I recognize the toll isolation has taken on mom’s mental health and mine. We find ourselves still in those intentional conversations, but now it includes friends and family as we figure out how to be together and still be safe.

One beautiful weekend I knew mom had to get out of the house. We decided to head to a town about 20 minutes away where a cousin lives to visit with her. We didn’t do the hugs and kisses our Italian family cherishes. Mom and I stayed in the car while our cousin sat outside and we were all masked. It was certainly different, but just felt so good to see a loved one and be out in the fresh air.

With our state opening a bit more, mom and I agree that we are willing to take some additional calculated risks to be able to see people in her home. Visits are with one person at a time, we socially distance either outside or in the living room and we don’t eat at the kitchen table, which does not allow for the six feet distance. Before we get together, we share what we are doing to stay safe, where I might have been that week, like the grocery store, and talk that morning to ensure everyone is feeling well and has not been around someone who has tested positive. Do we miss playing cards with friends? Absolutely. But that would bring us too close together with everyone touching the cards in a way that makes us uncomfortable.

If you are figuring out what calculated risks you are willing to take for your emotional health, then there is a formula to keep in mind. The formula is based on a balance of exposure and time. A high level of exposure means a shorter time to infection. Think crowded beaches or dining in a restaurant with the air conditioner on, and the risk of exposure is higher. If you have a low level of exposure, like being with one person in your home, continuing to wash your hands, are masked and socially distanced from one, another it takes the infection longer to establish. Of course, these numbers vary by person, age and physical health, which is why I call it a calculated risk.

The hardest part of taking a calculated risk is that everyone has a different risk tolerance. This can cause conflict between spouses or family members. Dr. Barry Jacobs does a terrific job in his article tackling this subject. https://www.aarp.org/home-family/friends-family/info-2020/arguing-about-coronavirus-risks.html

If you are interested in learning more about the science behind why some places and events are more likely to spread the coronavirus, Dr. Erin S .Bromage, an Associate Professor of Biology at the University of Massachusetts Dartmouth breaks it down in this article. https://www.erinbromage.com/post/the-risks-know-them-avoid-them

What calculated risks are you willing to take to preserve your physical and mental health during COVID 19? I’d love to hear from you in comments.

Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.

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Deb is available as a caregiver consultant. She will answer the question: “Where do I start?” and find the resources to alleviate your stress. If you would like to invest a half hour to learn how she can help you, please contact her at: deb@advocateformomanddad.com