PANDEMIC

While many have warned about the potential for the COVID-19 pandemic to overwhelm our Canadian health care system, few have considered the widespread impact this will have on family caregivers. Even before the COVID-19 pandemic, nearly one-third of all Canadian adults were providing unpaid care to a family member or friend with a long-term health condition or disability. Though largely unrecognized, these family caregivers were spending nearly 20 hours per week on caregiving responsibilities, and providing as much as 75 per cent of all direct home and community care services in Canada. While family caregivers have been traditionally relied upon for emotional support and basic assistance, many are now expected to perform medical and nursing tasks that are increasingly complex. This includes managing medications, performing wound care, and even operating durable medical equipment like ventilators and oxygen therapy. As Canada prepares for the increasing number of COVID-19 cases, we need to consider family caregiving as a key component of overall healthcare system planning. With more than 80 per cent of people infected with COVID-19 experiencing only mild symptoms, the majority of COVID-19 patients will be managed supportively in the community by family caregivers. This increased need for caregiving will be challenged by necessary social distancing measures including restrictive visiting policies to nursing, retirement homes and now hospitals, and the fact that family caregivers may fall ill from COVID-19. The COVID-19 pandemic will also challenge the existing demands of family caregivers, as non-essential medical services close and obtaining provisions is proving difficult. We have the potential for both an enormous deficit in Canadian caregiving and for a much more complex and demanding role—we need to act now. At present, less than ten per cent of all family caregivers receive any training related to their caregiving responsibilities. The Public Health Agency of Canada has released guidelines for caregivers on how to care for a person with COVID-19 at home. While a helpful start, the guidelines are limited to infection control precautions and most family caregivers cannot secure the recommended medical supplies like masks and gloves. Family caregivers also need to be included as core members of our healthcare teams, by providing them with the specific training, equipment, psychological support and ongoing communication required to provide care for COVID-19 patients at home. As virtual health care options are being increasingly leveraged during the COVID-19 pandemic, there are opportunities for this technology to support caregivers who may need to provide enhanced care to their care recipients for pre-existing chronic diseases – many of which also increase the risk of serious COVID-19 infection.