The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sampling and Recruitment
2.2. Participants
2.3. Data Collection and Analysis
3. Results
3.1. Navigating Care during the Height of Public Health Restrictions
3.1.1. Caregiving Responsibilities
“I have a lot of travel costs because of where I live, and trying to get to her, that would be the biggest thing because, like I kind of said before, I’m like doing all the organizational things, all the bills … like right now we’re kind of trying to sell the house because she’s moved and now it’s just kind of sitting there. Those kind of things end up costing me emotionally along with financially just because there’s like more stuff on my plate, but yeah, the main cost is the kind of travel and having to go back there if there is something, you just have to do in-person. And then obviously, visiting and seeing her because I want to”.(woman, 25 years old, rural, cares for mother who lives with early-onset dementia)
“Definitely, financial issues have happened, in particular with us, we’ve experienced a lot of financial hardships with my dad in terms of him being not able to work anymore. That was prior to the pandemic, but the financial issues were also exacerbated because of my dad’s chronic kidney disease. He needs to use certain medical supplies, like a catheter and a condom catheter and because of that, it has resulted in additional expenses for him. And I’ve had to pay out of pocket for things like the ThickenUp that he uses every day and other types of like diapers and things like that. So I see the financial issues existed prior to the pandemic, but more so now as well and, in particular during the pandemic [in 2020]. I unfortunately lost my job due to the reconstructing of our department and, due to budgeting, that had come to an end. And I sort of was feeling the pressure as well, of not being able to financially support myself and so that did add a level of stress and burden, because of course I was a student at the time and it definitely impacted my mental health. And yeah, that was something I experienced due to the pandemic and so now I feel like I am still trying to navigate that world of being able to, you know, persist and continue to move forward”.(woman, 25 years old, urban, cares for father with complications from a stroke including left hemiplegia)
3.1.2. Changes in Person Being Cared For
3.1.3. Protecting My Family from COVID-19
“And during the pandemic and even until now I’m very, very cautious about the activities that I undertake and how many people I surround myself with and just how I go about my daily life. And so, like, for example in my family, every Friday, we normally do our grocery shopping and normally I would only have like one person in my family go and do it, as opposed to all of us at once, just limit the number of people we were around. And I feel like I’ve become much more vigilant and always like wearing a mask and if I did go out and always like practicing, you know, washing my hands very frequently and always making sure to just stay as far as the distance from people as much as possible. And just like following all those extra precautions, just as anybody else would, but just being very mindful of that”.(woman, 25 years old, urban, cares for father with complications from a stroke including left hemiplegia)
3.2. Neighbourhood and Built Environment during the Pandemic
3.2.1. Benefits and Challenges of Living Outside of the City
3.2.2. Benefits and Challenges of Living in the City
3.3. Perceptions towards COVID-19 and Public Health Restrictions/Efforts
3.3.1. COVID-19 and Public Health Restrictions
3.3.2. Vaccines and Masks
3.3.3. Online Schooling
3.3.4. Feelings towards Re-Opening
3.4. The Impact of Public Health Restrictions on Relationships
3.4.1. Friendships
3.4.2. Family Dynamics
“I feel like having lived in a crowded area almost made [my mental health] worse because we were trying to keep [my grandmother living with dementia] inside all the time which means usually I had to entertain her or talk to her. Also, my grandmother’s dementia is that she has pretty severe hallucinations. She can get really caught up in a fit and sometimes other family members aren’t able to de-escalate her but somehow she is responsive to me”.(woman, 26 years old, urban, cares for grandmother living with dementia).
3.5. Mental Health Challenges of Being a Young Caregiver during a Pandemic
3.5.1. Mental Health
“I think I mentioned this earlier, but my mental health was already kind of low because of the stress of being a student and being a caregiver and so then adding in the stress to the pandemic gave me a lot of—it just worsened what I was going through, because I didn’t have those like outlets. Like I couldn’t just go out to a restaurant and have a nice night out with my friends and just shoot the shit or blow off steam in any way, so it was just like … And even when you were able to do things, it still was not like fully relaxing because you still have to be like, “What are the regulations?”, “Can I even do that thing?”. There were so many levels of steps before you got to the place and then, when you got to the place, you’re only getting like 75% of the experience. So, it just became like no way to let off stress, so just build up the stress and anxiety”.(woman, 25 years old, rural, cares for mother who lives with early-onset dementia)
3.5.2. Coping Strategies
3.5.3. Recreation
3.6. Navigating Formal Services and Supports
3.6.1. Supports Accessed by Young Caregivers
3.6.2. Changes in Formal Services and Support for Person(s) Receiving Care
“Yeah, there was this one community program that [my grandmother] could go to for one day of the week that was no longer running in-person. The program was just one, single day of the week, but it felt really different because usually when she [was] away for that day, everyone gets to relax for the day. But yeah, we didn’t have that during COVID-19 … they started doing half an hour zoom sessions with the people that would go to the program. After a while, my grandmother wasn’t super engaged in it anymore, she would talk or do other things on her own during the program. We still had to watch her very closely when she was doing that. Sometimes I think because they were trying to cater to a broader audience—usually the day program is in Chinese so she can understand what is going on, but this was frequently in English so maybe that’s why she wasn’t as excited about it”.(woman, 26 years old, urban, cares for grandmother living with dementia)
“The main thing that happened is that, right before the pandemic, I was talking to my mom and we were like in the process of exploring her moving into an Assisted Living facility and I pretty much just gotten her to the point where she was like starting to be willing to like actually consider it and then the pandemic happened, and they all shut down. And they obviously weren’t taking people in, so we couldn’t do tours, so it all got put like just on the back burner, and it was like over a year until I felt like I could bring it up again. And then when I did, she didn’t feel like she wanted to do it anymore. And so, I was like even further back from step one so that was really, really, really frustrating and difficult”.(woman, 25 years old, rural, cares for mother who lives with early-onset dementia)
3.7. Recommendations from Young Caregivers and What Would Make Life Easier
“I wish there were more financial resources for young caregivers, and I feel like finding any type of financial help has been so cumbersome and really complicated in terms of different pages and websites and there’s just so much information and organizations out there. Just honestly, I wish there was just a one-stop-shop—have one place, that I could go to just see what was available for young caregivers and having that information be accessible, I think can be really useful. Like you know what would be … like specific home care support, for example, or having you know that resource that would be easy to access”.(woman, 25 years old, urban, cares for father with complications from a stroke including left hemiplegia)
“I guess that one other thing that was kind of weird that I haven’t heard from other people was that I almost was like a secondary caregiver because my mom was so stressed with what was going on and the relationship with my grandmother. [the person we cared for]. Sometimes it was like looking after my mom, too. Or I guess a lot of the times yeah … I did feel like the secondary caregiver role that I felt like I had to take [on] is not necessarily something that I see in the media or hear from other people a lot. I guess looking after a very, very stressed caregiver and how to navigate that too”.(woman, 26 years old, urban, cares for grandmother living with dementia)
4. Discussion
4.1. Strengths and Limitations
4.2. Recommendations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Who Are Young Caregivers? Available online: https://youngcaregivers.ca/who-are-young-caregivers/ (accessed on 17 December 2021).
- McDougall, E.; O’Connor, M.; Howell, J. “Something That Happens at Home and Stays at Home”: An Exploration of the Lived Experience of Young Carers in Western Australia. Health Soc. Care Community 2018, 26, 572–580. [Google Scholar] [CrossRef] [PubMed]
- Burns, C.M.; Abernethy, A.P.; Dal Grande, E.; Currow, D.C. Uncovering an Invisible Network of Direct Caregivers at the End of Life: A Population Study. Palliat. Med. 2013, 27, 608–615. [Google Scholar] [CrossRef] [PubMed]
- Greene, J.; Cohen, D.; Siskowski, C.; Toyinbo, P. The Relationship Between Family Caregiving and the Mental Health of Emerging Young Adult Caregivers. J. Behav. Health Serv. Res. 2017, 44, 551–563. [Google Scholar] [CrossRef] [PubMed]
- Szafran, O.; Torti, J.; Waugh, E.; Duerksen, K. Former Young Carers Reflect on Their Caregiving Experience. CJFY 2016, 8, 129–151. [Google Scholar] [CrossRef]
- Cameron, T.M.; Walker, M.F.; Fisher, R.J. A Qualitative Study Exploring the Lives and Caring Practices of Young Carers of Stroke Survivors. Int. J. Environ. Res. Public Health 2022, 19, 3941. [Google Scholar] [CrossRef] [PubMed]
- Becker, S. Global Perspectives on Children’s Unpaid Caregiving in the Family: Research and Policy on ‘Young Carers’ in the UK, Australia, the USA and Sub-Saharan Africa. Glob. Soc. Policy 2007, 7, 23–50. [Google Scholar] [CrossRef] [Green Version]
- Dearden, C.; Becker, S. Young Carers in the UK, the 2004 Report; Carers UK: London, UK, 2004. [Google Scholar]
- Shifren, K. Early Caregiving and Adult Depression. Gerontology 2001, 41, 188–190. [Google Scholar] [CrossRef]
- A New Resource for Young Caregivers. Available online: https://ontariocaregiver.ca/oco-2020-2021-annual-report/a-new-resource-for-young-caregivers/ (accessed on 14 December 2021).
- Robson, E. Hidden Child Workers: Young Carers in Zimbabwe. Antipode 2004, 36, 227–248. [Google Scholar] [CrossRef]
- Siskowski, C. Young Caregivers: Effect of Family Health Situations on School Performance. J. Sch. Nurs. 2006, 22, 163–169. [Google Scholar] [CrossRef]
- Stamatopoulos, V. The Young Carer Penalty: Exploring the Costs of Caregiving among a Sample of Canadian Youth. Child Youth Serv. 2018, 39, 180–205. [Google Scholar] [CrossRef]
- Chalmers, H.; Lucyk, L. The Impact of Caregiving: Is It Who I Am or What I Do? Relational Child Youth Care Pract. 2012, 25, 37–46. [Google Scholar]
- Lakman, Y.; Chalmers, H.; Sexton, C. Young Carers’ Educational Experiences and Support: A Roadmap for the Development of School Policies to Foster Their Academic Success. Alta. J. Educ. Res. 2017, 63, 63–74. [Google Scholar] [CrossRef]
- Sexton, C. Caregiver Stress: An Exploration of Stressors and Coping Strategies among Young Carers. Master’s Thesis, Brock University, St. Catharines, ON, Canada, 2017. [Google Scholar]
- Breen, A. It’s Time to Care for Our (Young) Carers; Vanier Institute: Ottawa, ON, Canada, 2006. [Google Scholar]
- Anjum, S.; Ullah, R.; Suleman Rana, M.; Ali Khan, H.; Shabir Memon, F.; Ahmed, Y.; Jabeen, S.; Faryal, R. COVID-19 pandemic: A serious threat for public mental health globally. Psychiatr. Danub. 2020, 32, 245–250. [Google Scholar] [CrossRef] [PubMed]
- Ciotti, S.; Moore, S.; Connolly, M.; Newmeyer, T. Roots, Rights and Risk: Canada, Childhood and the COVID-19 Global Pandemic. Can. J. Child Rights 2021, 8, 13–33. [Google Scholar] [CrossRef]
- Ciotti, S.; Moore, S.A.; Connolly, M.; Newmeyer, T. Super-Spreaders or Victims of Circumstance? Childhood in Canadian Media Reporting of the COVID-19 Pandemic: A Critical Content Analysis. Healthcare 2022, 10, 156. [Google Scholar] [CrossRef]
- Nichols, K.R.; Fam, D.; Cook, C.; Pearce, M.; Elliot, G.; Baago, S.; Rockwood, K.; Chow, T.W. When Dementia Is in the House: Needs Assessment Survey for Young Caregivers. Can. J. Neurol. Sci. 2013, 40, 21–28. [Google Scholar] [CrossRef] [Green Version]
- CDC Updates and Shortens Recommended Isolation and Quarantine Period for General Population. Available online: https://www.cdc.gov/media/releases/2021/s1227-isolation-quarantine-guidance.html (accessed on 18 January 2022).
- COVID-19 Daily Epidemiology Update. Available online: https://health-infobase.canada.ca/covid-19/ (accessed on 18 January 2022).
- Grundy, E.; Henretta, J.C. Between Elderly Parents and Adult Children: A New Look at the Intergenerational Care Provided by the ‘Sandwich Generation’. Ageing Soc. 2006, 26, 707–722. [Google Scholar] [CrossRef] [Green Version]
- Miller, D.A. The “Sandwich” Generation: Adult Children of the Aging. Soc. Work 1981, 26, 419–423. [Google Scholar]
- Steiner, A.M.; Fletcher, P.C. Sandwich Generation Caregiving: A Complex and Dynamic Role. J. Adult Dev. 2017, 24, 133–143. [Google Scholar] [CrossRef]
- Kent, E.E.; Ornstein, K.A.; Dionne-Odom, J.N. The Family Caregiving Crisis Meets an Actual Pandemic. J. Pain Symptom Manag. 2020, 60, e66–e69. [Google Scholar] [CrossRef]
- COVID-19: Resources for Seniors and Their Caregivers. Available online: www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/resources-older-adults-caregivers.html (accessed on 29 April 2022).
- More Support for Family Caregivers during COVID-19. Available online: https://news.gov.bc.ca/releases/2020HLTH0141-000763 (accessed on 29 April 2022).
- Silliman Cohen, R.I.; Bosk, E.A. Vulnerable Youth and the COVID-19 Pandemic. Pediatrics 2020, 146, e20201306. [Google Scholar] [CrossRef] [PubMed]
- Efuribe, C.; Barre-Hemingway, M.; Vaghefi, E.; Suleiman, A.B. Coping With the COVID-19 Crisis: A Call for Youth Engagement and the Inclusion of Young People in Matters That Affect Their Lives. J. Adolesc. Health 2020, 67, 16–17. [Google Scholar] [CrossRef]
- Orgilés, M.; Morales, A.; Delvecchio, E.; Mazzeschi, C.; Espada, J.P. Immediate Psychological Effects of the COVID-19 Quarantine in Youth From Italy and Spain. Front. Psychol. 2020, 11, 579038. [Google Scholar] [CrossRef] [PubMed]
- Liang, L.; Ren, H.; Cao, R.; Hu, Y.; Qin, Z.; Li, C.; Mei, S. The Effect of COVID-19 on Youth Mental Health. Psychiatr. Q. 2020, 91, 841–852. [Google Scholar] [CrossRef] [PubMed]
- Rundle, A.G.; Park, Y.; Herbstman, J.B.; Kinsey, E.W.; Wang, Y.C. COVID-19–Related School Closings and Risk of Weight Gain Among Children. Obesity 2020, 28, 1008–1009. [Google Scholar] [CrossRef] [PubMed]
- A Review of Frameworks on the Determinants of Health. Available online: ccsdh.ca/images/uploads/Frameworks_Report_English.pdf (accessed on 29 April 2022).
- Social Determinants of Health. Available online: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1 (accessed on 26 April 2023).
- Crenshaw, K.W. Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine. Univ. Chic. Leg. Forum 1989, 140, 139–168. [Google Scholar]
- Carbado, D.W.; Crenshaw, K.W.; Mays, V.M.; Tomlinson, B. INTERSECTIONALITY: Mapping the Movements of a Theory. Du Bois Rev. 2013, 10, 303–312. [Google Scholar] [CrossRef] [Green Version]
- Caiola, C.; Docherty, S.L.; Relf, M.; Barroso, J. Using an Intersectional Approach to Study the Impact of Social Determinants of Health for African American Mothers Living With HIV. Adv. Nurs. Sci. 2014, 37, 287–298. [Google Scholar] [CrossRef] [Green Version]
- Newman, K.; Chalmers, H.; Berardini, Y.; Wang, A.Z.Y.; Stamatopoulos, V.; Lewis, M. No Young Carer Left Behind: A Two-Phased Study to Understand and Address the Needs of Young Carers from Rural and Urban Communities Before and During Covid-19. CJFY 2022, 14, 124–145. [Google Scholar] [CrossRef]
- Nowell, L.S.; Norris, J.M.; White, D.E.; Moules, N.J. Thematic analysis: Striving to meet the trustworthiness criteria. Int. J. Qual. Methods 2017, 16, 1–13. [Google Scholar] [CrossRef]
- Braun, V.V.; Clarke, G.; Hayfield, N.; Terry, G. Thematic analysis. In Handbook of Research Methods in Health and Social Sciences; Liamputtong, P., Ed.; Springer: Singapore, 2019; pp. 843–860. [Google Scholar]
- Newman, K.; Bookey-Bassett, S.; Wang, A.Z.Y. Exploring Nurses’ Knowledge, Skills and Experience with Young Caregivers. Perspective 2021, 42, 7–15. [Google Scholar]
- Stamatopoulos, V. One million and counting: The hidden army of young carers in Canada. J. Youth Stud. 2015, 18, 809–822. [Google Scholar] [CrossRef]
- Stamatopoulos, V. Supporting young carers: A qualitative review of young carer services in Canada. Int. J. Adolesc. Youth 2016, 21, 178–194. [Google Scholar] [CrossRef]
- Brooks, S.K.; Webster, R.K.; Smith, L.E.; Woodland, L.; Wessely, S.; Greenberg, N.; Rubin, G.J. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020, 395, 912–920. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- de Figueiredo, C.S.; Sandre, P.C.; Portugal, L.C.L.; Mázala-de-Oliveira, T.; da Silva Chagas, L.; Raony, Í.; Ferreira, E.S.; Giestal-de-Araujo, E.; dos Santos, A.A.; Bomfim, P.O.-S. COVID-19 pandemic impact on children and adolescents’ mental health: Biological, environmental, and social factors. Prog. Neuropsychopharmacol. Biol. Psychiatry 2021, 106, 110171. [Google Scholar] [CrossRef]
- Guessoum, S.B.; Lachal, J.; Radjack, R.; Carretier, E.; Minassian, S.; Benoit, L.; Moro, M.R. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res. 2020, 291, 113264. [Google Scholar] [CrossRef]
- Lee, J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc. Health 2020, 4, 421. [Google Scholar] [CrossRef]
- Lindsay, S.; Ahmed, H. School and Employment-Related Barriers for Youth and Young Adults with and without a Disability during the COVID-19 Pandemic in the Greater Toronto Area. Adolescent 2021, 1, 442–460. [Google Scholar] [CrossRef]
- Magson, N.R.; Freeman, J.Y.A.; Rapee, R.M.; Richardson, C.E.; Oar, E.L.; Fardouly, J. Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic. J. Youth Adolesc. 2021, 50, 44–57. [Google Scholar] [CrossRef]
- Lavergne, M.R.; Kephart, G. Examining variations in health within rural Canada. Rural Remote Health 2012, 12, 1848. [Google Scholar] [CrossRef]
- Young, T.K.; Ng, C.; Chatwood, S. Assessing health care in Canada’s North: What can we learn from national and regional surveys? Int. J. Circumpolar Health 2015, 74, 1. [Google Scholar] [CrossRef] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Newman, K.; Chalmers, H.; Wang, A.Z.Y.; Ciotti, S.; Luxmykanthan, L.; Mansell, N. The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada. Int. J. Environ. Res. Public Health 2023, 20, 6410. https://doi.org/10.3390/ijerph20146410
Newman K, Chalmers H, Wang AZY, Ciotti S, Luxmykanthan L, Mansell N. The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada. International Journal of Environmental Research and Public Health. 2023; 20(14):6410. https://doi.org/10.3390/ijerph20146410
Chicago/Turabian StyleNewman, Kristine, Heather Chalmers, Arthur Ze Yu Wang, Sarah Ciotti, Luxmhina Luxmykanthan, and Nicole Mansell. 2023. "The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada" International Journal of Environmental Research and Public Health 20, no. 14: 6410. https://doi.org/10.3390/ijerph20146410
APA StyleNewman, K., Chalmers, H., Wang, A. Z. Y., Ciotti, S., Luxmykanthan, L., & Mansell, N. (2023). The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada. International Journal of Environmental Research and Public Health, 20(14), 6410. https://doi.org/10.3390/ijerph20146410