Original Study
Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada

https://doi.org/10.1016/j.jamda.2022.12.017Get rights and content
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open access

Abstract

Objectives

To examine the prevalence of coping behaviors during the first 2 waves of the COVID-19 pandemic among caregivers of assisted living residents and variation in these behaviors by caregiver gender and mental health.

Design

Cross-sectional and longitudinal survey.

Setting and Participants

Family/friend caregivers of assisted living residents in Alberta and British Columbia.

Methods

A web-based survey, conducted twice (October 28, 2020 to March 31, 2021 and July 12, 2021 to September 7, 2021) on the same cohort obtained data on caregiver sociodemographic characteristics, anxiety and depressive symptoms, and coping behaviors [seeking counselling, starting a psychotropic drug (sedative, anxiolytic, antidepressant), starting or increasing alcohol, tobacco and/or cannabis consumption] during pandemic waves 1 and 2. Descriptive analyses and multivariable (modified) Poisson regression models identified caregiver correlates of each coping behavior.

Results

Among the 673 caregivers surveyed at baseline, most were women (77%), White (90%) and age ≥55 years (81%). Alcohol (16.5%) and psychotropic drug (13.3%) use were the most prevalent coping behaviors reported during the initial wave, followed by smoking and/or cannabis use (8.0%), and counseling (7.4%). Among the longitudinal sample (n = 386), only alcohol use showed a significantly lower prevalence during the second wave (11.7% vs 15.1%, P = .02). During both waves, coping behaviors did not vary significantly by gender, however, psychotropic drug and substance use were significantly more prevalent among caregivers with baseline anxiety and depressive symptoms, including in models adjusted for confounders [eg, anxiety: adjusted risk ratio = 3.87 (95% CI 2.50-6.00] for psychotropic use, 1.87 (1.28-2.73) for alcohol use, 2.21 (1.26-3.88) for smoking/cannabis use).

Conclusions and Implications

Assisted living caregivers experiencing anxiety or depressive symptoms during the pandemic were more likely to engage in drug and substance use, potentially maladaptive responses. Public health and assisted living home initiatives that identify caregiver mental health needs and provide targeted support during crises are required to mitigate declines in their health.

Keywords

Assisted living
caregivers
COVID-19
coping behaviors
mental health

Cited by (0)

This work was funded by an Alberta Innovates National Partnered R&I Initiatives Grant (#202100518), and an Establishment Grant and Professorship in Continuing Care Policy Research awarded to MH by the Faculty of Nursing, University of Alberta.

The COVCARES-AB/BC study was funded by an Alberta Innovates National Partnered R&I Initiatives Grant (#202100518), and an Establishment Grant and Professorship in Continuing Care Policy Research awarded to MH by the Faculty of Nursing, University of Alberta.

This study was reviewed and received ethics approval by the Health Research Ethics Board at the University of Alberta (Pro00101048), University of Calgary Conjoint Health Research Ethics Board (REB20-1544), Human Research Ethics Board at the University of British Columbia (H20-01732) and University of Waterloo Human Research Ethics Committee (ORE#42494). Operational approvals from participating assisted living homes were obtained, where required. All participants provided written informed consent.

Consent for publication: Not applicable.

All study data and analytical output are held on a secure server at the University of Alberta as per relevant Ethics Committees’ guidelines. As such, all study datasets are not publicly available. Access is restricted to approved study investigators and research associates. Aggregate data and relevant statistical code are available from the primary investigators on reasonable request. For additional information regarding the availability of data contact Dr. Colleen Maxwell, email: [email protected].

Author contributions: Study concept and design (CJM, MH); acquisition, analysis, or interpretation of data (all authors); drafting of initial manuscript (CJM, LD, ER); critical revision of manuscript for important intellectual content (all authors); statistical analysis (JA, CJM); administrative, technical, or material support (KC); supervision (CJM). All authors provided approval for the final manuscript submitted and agree to be accountable for all aspects of the work.

The authors declare no conflicts of interest.