“I had a long talk with my 80-year-old mother about taking precautions against catching the omicron variant,” a friend said to me last week. “But when I spoke with her the next day, she said she had just come back from playing canasta with her girlfriends at the senior center.”
My friend was aggravated and afraid. Didn’t her mom understand, she wondered, how wildly contagious this variant is? Doesn’t she care that, as an older person, she is most prone to its harmful effects? But my friend also knew her mom had recently read that some public health experts now believe Americans should learn to live as normally as possible with COVID-19. And she was aware that her mother felt that socializing with friends was more important than being careful at this point in her life.
As omicron surges in some parts of the country and begins to abate in others, such family situations have become increasingly common. Even after nearly two years of living with the uncertainty of the pandemic, caregivers and care recipients are still struggling to determine the right way to live safely. There are compelling arguments on each side of the debate:
- Because family caregivers by definition feel responsible for protecting care recipients, they have good reason to err on the side of caution. Faced with an unrelentingly contagious variant, many feel bound to encourage older adults to stay home, or to keep them home if they reside together. They also tend to stay home themselves to reduce their chances of contracting the virus and then infecting their loved ones.
- But even before the start of the pandemic, abundant research showed that socially isolated older adults suffer more medical and psychological problems. There is also recent research that omicron poses far fewer health risks to those who are vaccinated. If responsible family caregivers follow the same dictum as physicians to “first, do no harm,” then is keeping care recipients at home really the best choice to avoid hurting them?
No caregiver wants to make a “wrong” decision and afterward feel pierced by guilt and shame. But all the choices before them bear some risk. Here are some considerations for carefully weighing the available options to make your choice:
Don’t wait for clarity
We all want the pandemic to be declared over so that we can hug one another in spontaneous celebration in New York’s Times Square like a modern-age V-Day. But will any authority actually make such a declaration? The virus that has bedeviled the world with its mutations and multiple ways of attacking the body isn’t likely to disappear like wartime hostilities. The best-case scenario that experts hypothesize is that it will one day become endemic — that is, it continues to circulate, like the annual flu virus, but doesn’t cause alarming rates of hospitalizations and deaths. That may take years, not months, though. In my opinion as a clinical psychologist (not a medical expert), trying to wait for that day to come may damage mental and physical health. It is better for caregiver and care recipient morale to consider a return to normal activities sooner rather than later.
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Weigh your family’s risk factors
Even if the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC) announced the official end to COVID-19, caregivers would still need to consider the unique circumstances of their own families. They’d do well to literally make a list of the variables that affect whether the pandemic is over for them. Those variables include:
- Care recipient’s health. Some older adults are more fragile or immunosuppressed than others. They may always need to avoid congregating in large groups in public spaces. Ask your loved one’s doctor for guidance but keep in mind that physicians, too, are struggling to determine the most prudent course for every patient.
- Local conditions, such as virus prevalence and vaccination rates. Some neighborhoods, cities or whole states pose greater risks to medically compromised older adults than others. That local context must always be taken into account regardless of national or international progress on ending the pandemic.
- Proneness to cabin fever. Being socially isolated for long periods of time leads most of us to feel restless, irritable and lonely. Detrimental long-term mental and physical health consequences often follow. But not all caregivers and care recipients chafe at being cooped up. Each family needs to judge its degree of distress caused by lack of social interaction.
- Risk tolerance. Some caregivers are more comfortable than others with taking chances. Even if their loved ones become sick, they will cite the importance of living in the world, rather than existing apart from it, as justification for their decisions. Each caregiver must reflect on her or his tolerance for risk and susceptibility to guilt.
Valuing good intentions
Caregivers tend to critique themselves based on outcomes, not their loving intentions. But no caregiver has complete control over whether a care recipient thrives or declines. Whether dealing with omicron or any other health risk to our loved ones, we get the best information, make our best decision on the basis of it, and give our best effort. We then hope for the best. That’s as good as any family caregiver could manage before this awful pandemic. That’s as good as any family caregiver can manage now as it lingers indefinitely.
Barry J. Jacobs, a clinical psychologist, family therapist and health care consultant, is the coauthor of Love and Meaning After 50: The 10 Challenges to Great Relationships — and How to Overcome Them and AARP Meditations for Caregivers. Follow him on Twitter and Facebook.