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Informal caregiving during the pandemic has presented unique challenges for family caregivers that may have impacted both health compromising behaviors such as sleep disturbance and overall mental health. Research suggests that two-thirds of who experience sleep disturbance during the course of their caregiving career, and this may be associated with an increased risk of depression. Sleep disturbances are particularly prevalent among dementia caregivers. It is unclear how the pandemic has affected these associations. Thus, guided by Pearlin’s stress process model, the current study aims to investigate the possible linkages between sleep disturbances, dementia care, and depressive symptoms during the pandemic using national data on Medicare beneficiaries and their care partners .
Method
The current study used Round 11 of National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) (N=1,455; 418 Black caregivers, 926 Non-Hispanic White caregivers, and 111 Hispanic caregivers). We used OLS regression to investigate the moderating effects of interrupted sleep due to providing care by dementia care, controlling for background factors, primary stressors (help with ADL & IADL, in person visit), and secondary stressors (overwhelmed with care and family disagreement due to care).
Results
Most caregivers were adult children (70%) and female (70%), and over 60% of caregivers experienced more than one chronic condition (M=1.6, SD=1.4). During the pandemic, caregivers who experienced interrupted sleep due to caregiving were more likely to report significantly higher levels of depressive symptoms. Caregivers who reported feeling overwhelmed with their care responsibilities, provided in-person visits during the COVID-19 period were more likely to report elevated depressive symptoms. While Black-identified caregivers reported elevated depressive symptoms relative to non-Hispanic White caregivers, there was no significant interaction between dementia care and interrupted sleep due to caregiving for depressive symptoms.
Conclusion and Implications
During the pandemic, individuals who had difficulty sleeping due to care were more prone to reporting significantly elevated levels depression, consistent with previous research. The findings suggest that service providers should prioritize providing support and resources to help caregivers manage the challenges associated with caregiving, such as experiencing interrupted sleep, which may have long-lasting effects on their health, including managing their own chronic diseases and cognitive health. Service providers should be aware of the elevated health and care burden disparities experienced by caregivers from racial and ethnic minoritized populations during the pandemic. Future research should utilize community-based participatory research and provide suggestions for culturally responsive and accessible intervention strategies. Service community should better support caregivers and improve their overall well-being, while also reducing the risk of negative health outcomes associated with caregiving during the times of crisis such as the COVID-19 pandemic.