Stroke Family Caregiving and the COVID-19 Pandemic

HomeStrokeVol. 52, No. 4Stroke Family Caregiving and the COVID-19 Pandemic Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessEditorialPDF/EPUBStroke PandemicImpact Future Directions Tamilyn Bakas Patricia Commiskey BakasTamilyn Correspondence to: Bakas, PhD, RN, Professor Jane E. Procter Endowed Chair, University of Cincinnati College Nursing, 3110 Vine St, Hall 231, PO Box 210038, Cincinnati, OH 45221-0038. Email E-mail Address: [email protected] https://orcid.org/0000-0002-3235-5012 (T.B.). Search for more papers by this author CommiskeyPatricia https://orcid.org/0000-0001-6376-4698 Department Neurology, Vanderbilt Medical Center, Nashville, TN (P.C.). Originally published16 Feb 2021https://doi.org/10.1161/STROKEAHA.120.033525Stroke. 2021;52:1415–1417This article is a commentary on followingQualitative Study Chinese Stroke Caregivers’ Experience During PandemicOther version(s) articleYou are viewing most recent version article. Previous versions: February 16, 2021: Ahead Print See related article, p 1407Worldwide, over 104 million people have had stroke, with an estimated 7 in United States.1 Inpatient rehabilitation skilled care often required, although stroke provided family members following discharge home. caregivers many unmet needs, including limited education training, as well access services resources.2 high prevalence depressive symptoms (40%) anxiety (21%),3 experience considerable life changes from providing care.2,4 These include time friends, reduced finances, decreased energy, poor emotional physical health.2,4 The coronavirus disease 2019 (COVID-19) pandemic has further complicated lives their ability provide care.Impact CaregiversIn edition Stroke, Lee et al5 reported underlying impact Hong Kong May 2020 through June when day center were suspended. Despite few limitations (eg, underrepresentation male spousal, adult child, affluent caregivers), rigorous qualitative interpretive description guideline was used data analysis. Interviews 25 revealed additional workload caregivers, 24-hour assuming role therapist. Caregivers declines survivor mobility, some survivors becoming dependent. survivors’ relationships became strained, increasing risk verbal abuse. worsening exhaustion psychological distress, along added stress sanitizing worry about exposing COVID-19. these challenges, insisted that they would continue expressed need information training improve skills exercises.5Another study 11 admitted inpatient unit States April 2020.6 Due pandemic, institution implemented no visitor policy, except discharge. As result, concerns loved ones’ absence. uncertainty progress missed opportunities observe therapy sessions nursing helped them effective after Fear recurrent safety home major concerns. receiving updates health staff, communicating difficult those impaired speech or cognitive problems, leading increased caregiver stress. Findings underscored scheduled phone videoconference calls during rehabilitation, all team members, therapists, nurses, physicians.6Optimal recovery depends quality coordinated, team-based across multiple nodes acute in-hospital postdischarge recovery.7,8 resulted substantive multilevel impacts availability hospital staff beds other resources like rehabilitation.8,9 Institutional restrictions eliminated hospitalization, social isolation patients caregivers.6,9 one facility reserved until discharge,6 which escalated needs prior research.2 Differential utilization technology hampered patients’ be seen virtually outpatient follow-up.9 findings raised concerns, having take therapist, reporting less mobility dependency among survivors. Widespread unemployment underemployment stressed patient caregivers’ care.9 Increased stress, specifically due pandemic,5,6 certain add existing depression, anxiety, negative changes.2–4 global both mental health,5,6,9 caregiver’s needed at pandemic.5,6,9 Interventions now than ever support, follow-up unprecedented times.Interventions Support PandemicSystematic reviews dyad interventions importance focused psychoeducation (ie, provision information), support interactions peers), skill building processes such problem solving, goal setting, providers, management, assist survivor).10,11 combine strongest evidence improving outcomes.10,11 poses challenges caregivers,5,6 underscoring enhanced adapt ongoing context care. While there found literature regarding peer interventions,10,11 online groups may help combat imposed pandemic.6,9 Because exhibit diverse tailored individualized recommended size fits interventions.10,11 Most delivered face-to-face telephone; although, web-based increasing.10,11 accelerated move toward videoconferencing approaches,9,12 families accustomed it; still, lack use it.13 Simply mailing paper copies materials telephone nurses providers better suited technologically savvy caregivers.13 Experts warned who normally discharged directly home,9 necessitating remote caregivers.9 Follow-up become even urgent pandemic.5,6,9ConclusionsQualitative studies emerging detail caregivers.5,6 Sutter-Leve al6 focus intervention experiences pandemic. Assessment tools identify resulting pandemic,2,4,10,11,14 especially transitioning home.6,14 Evidence-based programs urgently psychoeducation, skill-building strategies beyond.10,11 Multiple delivery modes meet varied levels,13 so can recovery, themselves. hidden casualties despite systematic caused. education, capacity, combined build health, must ensure effectively challenging time.Sources FundingNone.Disclosures None.FootnotesThe opinions not necessarily editors American Heart Association.For Sources Funding Disclosures, see page 1417.Correspondence tamilyn.[email protected]eduReferences1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, al; behalf Association Council Epidemiology Prevention Statistics Committee Committee. statistics – update: report Association.Circulation. 2020; 141:e139–e596. doi: 10.1161/CIR.0000000000000757LinkGoogle Scholar2. 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Temporary emergency guidance US centers pandemic: Association/American Leadership.Stroke. 51:1910–1912. 10.1161/STROKEAHA.120.030023Google Scholar9. Leira EC, Russman AN, Biller J, Brown DL, Bushnell CD, Caso Chamorro Creutzfeldt Cruz-Flores Elkind MSV, al. Preserving potential issues solutions.Neurology. 95:124–133. 10.1212/WNL.0000000000009713Google Scholar10. Clark PC, Kelly-Hayes King RB, Lutz BJ, Miller EL; Cardiovascular Nursing Council. Evidence interventions: statement healthcare professionals Association.Stroke. 2014; 45:2836–2852. 10.1161/STR.0000000000000033LinkGoogle Scholar11. McCarthy ET. Update state Dyad interventions.Stroke. 48:e122–e125. 10.1161/STROKEAHA.117.016052LinkGoogle Scholar12. Markus HS, Brainin M. stroke—a Global World Organization perspective.Int J Stroke. 15:361–364. 10.1177/1747493020923472Google Scholar13. MJ, Israel Brehm Dunning Rota EL. Adapting assessment kit telehealth preferences caregivers.Res Nurs Health. 44:81–91. 10.1002/nur.22075Google Scholar14. Camicia Harvath AT, Joseph JG. Using preparedness transition instrument predischarge: uncertainty, anticipation, cues action.Rehabil Nurs. 46:33–42. 10.1097/rnj.0000000000000267Google Scholar eLetters(0)eLetters should relate recently published journal forum unpublished data. Comments reviewed appropriate tone language. peer-reviewed. Acceptable comments posted website only. issue indexed PubMed. longer 500 words will only online. References 10. Authors cited comment invited reply, appropriate.Comments feedback Scientific Statements Guidelines directed Manuscript Oversight via its page.Sign In Submit Response This Article Back top Next FiguresReferencesRelatedDetailsCited By Masuku Khumalo G Shabangu N (2022) effects persons aphasia: A scoping review, South African Journal Communication Disorders, 10.4102/sajcd.v69i2.920, 69:2 Stacy K T Life Changes From Pandemic, Neuroscience 10.1097/JNN.0000000000000654, 54:4, (159-164), Online publication date: 1-Aug-2022. M E Systematic Review Interventions, 53:6, (2093-2102), 1-Jun-2022.Related articlesQualitative PandemicJung Jae Lee, 2021;52:1407-1414 2021Vol Issue 4 Advertisement InformationMetrics © 2021 Association, Inc.https://doi.org/10.1161/STROKEAHA.120.033525PMID: 33588603 publishedFebruary KeywordsEditorialsCOVID-19survivorshealth resourcesrehabilitationfamily caregiversstrokePDF download SubjectsCerebrovascular Disease/Stroke