Whether it’s caring for a spouse, parent or child, caregiving always presents stresses and challenges.
With the added stress of trying to maintain a routine and cleanliness with the pandemic, it may cause caregivers to feel more isolated and anxious, which can lead to caregiver stress and depression, said Yvette Lugo, director for the Area Agency on Aging.
“There has been a lot of expression of loneliness and the difficulties that can come with caregiving,” Lugo said. “When we think about caregiving in general, more often than not — caring for a loved one becomes your world. So all the things you used to do before you became a family caregiver have either all gone away — or they are not as important to you. So now, with the stay in place orders, it’s giving caregivers more of a sense of loneliness because they can’t get out.”
Throughout this pandemic, city leaders and health-care providers have encouraged vulnerable populations, ages 60 and above or those with underlying health conditions, to stay at home to minimize their exposure.
The Rio Grande Area Agency on Aging provides several services to caregivers such as providing information on their loved ones’ caregiving needs, referrals to appropriate agencies and care coordination.
The agency’s respite program allows caregivers to take some time away by having their loved ones go to a contracted home care agency. Many families have stopped using respite services during the pandemic, Lugo said.
“We do have several clients that are declining that because of the fear of having a stranger come into the home, so we are trying to work through that,” Lugo said. “But that’s a huge concern.”
Each day, Olga Cereceres, 63, takes care of her father, Ramon Cereceres, 92, who has Alzheimer’s. Olga said she’s noticed a change in him since the pandemic began.
“My dad is doing OK but he does get frustrated and he becomes irritated,” she said. “But otherwise he’s doing well. I mean, he forgets things sometimes but that’s what we are dealing with. Sometimes he doesn’t recognize me, he’ll call me his sister’s name, or sometime he confuses me with my mother — or sometimes he just forgets.”
Olga said during the pandemic, she is limiting her interaction with others and has stopped being a caregiver for someone else. “It’s been hard, with his illness and getting supplies, but there’s nothing else we can do but keep going. He’s my father.”
Manny Carbajal, alternate administrator at HomeWatch Caregivers, said the agency has been busier than ever since the pandemic began. The agency serves more than 700 clients and providers.
Carbajal attributes the spike to family members who are concerned for their elderly parents or other family members, but can’t be there for them due to concerns about COVID-19.
For those who are concerned about having a stranger in their home, Carbajal said the agency is taking precautions and providing their employees with personal protective equipment.
“We have what’s called HomeWatch University and it’s a continued education for our providers,” Carbajal said. “It consists of courses about diabetes, high blood pressure and now training on COVID-19. We do provide them with gloves, the KN95 masks as well — and of course we must take universal precautions and we monitor them and if they present any symptoms. We ask that they let us know right away so they don’t risk infecting the client as well.”
HomeWatch Caregivers is texting clients each day as a screening measure.
“We’ve been asking the basic screening questions — have you been in contact with anyone with COVID-19? Have you traveled out of the area? Have you had symptoms?” Carbajal said. “And if they answer yes to any of those questions we keep track of those every day and we require further evaluation to see if they can be tested.”
If a client tests positive for COVID-19, the agency will send out a provider equipped with personal protective equipment, but appropriate precautions are taken and the client must quarantine themselves after being sent home from the hospital.
Even before the pandemic, many caregivers limited their social outings, which at times could result in feelings of isolation, said Thelma Diaz, community outreach specialist for the Rio Grande Area Agency on Aging.
Diaz provides caregiver education and training classes to family members in El Paso. She said for caregivers, the loved one they care for becomes the priority, and everything else — including opportunities to socialize with friends or other family members — may fall to the wayside. That can cause stress, depression or anxiety.
Diaz coaches families on how to avoid such pitfalls. “You can’t control others, and you can’t control what’s going on in the world – you can only control yourself and the way you feel about things,” she said.
Since the pandemic, the agency has followed up with the caregivers with a weekly phone call.
Diaz said one of the issues that the caregivers are currently dealing with is loneliness and nervousness.
“I’ve seen where a lot of couples, where maybe the wife is the caregiver to the husband, or vice versa, they’re together in the home, but there is a sense of loneliness because they are not seeing their kids anymore,” Diaz said. “You aren’t going out like you used to — perhaps to church, or to go have breakfast — so it’s been tough on them just being in the house.”
Diaz advises that caregivers call their children, friends or neighbors more frequently to ward off feelings of loneliness. She also advises that caregivers who have loved ones with dementia or Alzheimer’s provide them with small tasks to complete.
Maria Ramirez, 72, said she’s very worried for her five children who all have to work. Maria’s daughter, Susana Ramirez, cares for her and brings her groceries and other supplies she may need.
“It (the pandemic) has affected my anxiety,” Maria Ramirez said. “I am more anxious and worried about myself and how much I have to take care of myself to stay healthy. Even before this I was a homebody. The most I would do would go to Walmart, because I live about 5 minutes from it. I would go almost every day. And now, I don’t go anywhere.”
Diaz said during check-ins with caregivers, they mention that they are sad or nervous about the pandemic. She recommends that caregivers limit watching the news to once or twice a day at most.
Other concerns Diaz has come across include daughters who are finding that their parents aren’t abiding by the Centers for Disease Control and Prevention guidelines, or are going out without a face covering.
“The one concern I have dealt with more is that husbands don’t abide by the rules and they tend to get in the car and they go do whatever they are going to do, and they are not wearing their masks and are coming home and not washing their hands,” Diaz said. “The daughters tell us that their mother is very sick – so there are arguments that happen with their dad.”
Marine veteran Adrian Morales, 46, and his wife Alexandra Morales, 45, are trying to stay busy. Adrian suffers from seizures, post-traumatic stress disorder, back problems, insomnia and sleep apnea.
“With his condition, we really can’t go out too much,” Alexandra Morales said. “So, we started making soaps and that has helped me and it helps him physically and mentally and that’s how we cope.”
Because of her husband’s condition, Alexandra Morales decided to stop working in December so she could care for her husband. She admits it was an adjustment and there were times when she felt she had not accomplished anything for that day.
“I think the challenge with the adjustment was more for me,” she said. “I was the one working and coming and going and then it just stopped. I would cry because I would get frustrated. And when I stopped working, I felt like I had a lot of time but the whole day would pass by and I didn’t do anything before I knew it the day was over.”
Adrian Morales said the months of staying at home since the pandemic began are nothing new for him. It’s something he’s experienced since his health began to decline eight years ago.
“You know, it’s been quarantine since 2012,” he said. “I don’t go out unless I have somebody with me because of my seizures. I’m not able to go to the gym. I’m not able to go hunting. I’m not able to go fishing. I’m not able to do a lot of things. They don’t want me to walk around the block by myself. So for me it really hasn’t been a big change. It’s just trying to stay calm and cool because of her and her parents.”
The key in dealing with feeling isolated or frustrated, Adrian Morales said, is remaining calm.
“We really can’t get scared of the pandemic,” he said. “We can’t get all into it. We have my in-laws and they are older and they are already in their 70s and you know this virus is attacking that age group the hardest. So, we have to keep a cool head and not get all nervous and everything else for them.”
Contact the Rio Grande Area Agency on Aging for more information about services and supports available:
(915) 533-0998 or (800-333-7082; or visit http://www.riocog.org/aging-services/
For more information on the El Paso VA Health Care System Caregiver Support program and Caregiver Services contact: (915) 564-6100 or (915) 564-7522. You also can visit https://www.caregiver.va.gov/
Cover photo: María Ramírez, right, discusses her concerns about the coronavirus pandemic while sitting on her porch with her daughter and grandson. She has not seen her other child, who lives in Juárez, since the stay-at-home orders and border restrictions went into effect in March. (Corrie Boudreaux/El Paso Matters)