• Dr Warren Donnellan

How are carers finding control in the chaos of COVID-19?

We all like to be in control. Whenever we're feeling stressed we try to exert some control over the situation so that it feels more manageable. COVID-19 has caused a great deal of stress for the UK's 9 million carers. How are they coping with a situation which is uncertain, unpredictable and, to a large extent, uncontrollable?


COVID-19 is especially problematic for carers. Since the outbreak began, Mobilise, the tech startup run for carers by carers, has been talking to hundreds of people looking after somebody vulnerable. Those conversations indicate that having some control of a situation enables carers to cope and that routines they rely upon are no longer possible in the face of COVID-19.


There's a strong sense coming out of conversations with carers at the moment that advice from national government is either unclear or impossible for them to implement. Some of the questions put to mobilise are: "What happens if I go down?" and "Should I be visiting my elderly parents?"


As a result, carers are taking matters into their own hands but are often struggling to find answers to their questions. They are spending more time focusing on the things that are out of their control, making them increasingly anxious.


These findings chime with the words of Professor Ian Robertson, who in a 2016 article for the Irish Times, said:

'One of the best antidotes to stress in caregivers is a sense of control over some aspects of a life that can often end up revolving completely around the person being cared for'.

What is the science behind control?

Naturally we all differ in our understanding of what is controllable or not controllable. There are two forms of control: internal locus of control, the belief that we make things happen and can determine our situation; and external locus of control, the belief that things happen to us and so are less able to determine our situation.


COVID-19 is tipping the balance for carers away from internal (routine, autonomy, order) towards external local of control (local and national government and the virus itself), which might explain why carers are feeling more stressed and anxious than usual.


Research shows that carers who feel in control of their situation are more likely to have positive perceptions of their caregiving role and have higher levels of psychological resilience and hardiness, which reduces stress and mental health problems. One study found that dementia carers with higher levels of perceived control had fewer symptoms of depression over a one-year period, relative to carers with low perceived control.


According to Robertson (2016), carers who can see their situation as a problem to solve or a challenge to meet, rather than a stress that totally overwhelms them, will find it easier to manage their stress levels. He also noted that practices such as mindfulness, meditation, yoga and relaxation can help carers control their emotional state.


What are carers doing to regain a sense of control during COVID-19?

It is clear from the conversations that carers are having with Mobilise that they are seeking more clarity from local and national governments so that they can continue caregiving. But there are also some clear approaches taken by carers themselves, which enable them to regain a sense of control in the chaos of COVID-19.


Focus on what you can control

Carers are fully aware that they should 'control the controllable' by focusing on things that are within their internal locus of control. They note that by accepting not all things are in their control, they are more able to refocus their energy on finding strategies and tools to care for their loved one(s). Carers also appreciate that the current situation is dynamic and that it won't be like this forever.


Routines

Another important strategy that carers are using to facilitate their sense of control is routine. Although routines have been disrupted by COVID-19, carers are establishing new routines to help them cope, such as pursuing hobbies, interests and daily exercise. This is in line with my own published research that routine is an important facilitator of resilience in older adults caring for a spouse with dementia.


Community

Finally, and perhaps most importantly given the advent of social distancing, carers value support from the online caregiving community, especially on social media and support organisations such as Mobilise.

The challenge for carers is to empower themselves to regain a sense of control in uncertain times, but also for local and national government to do more to help them meet this challenge.

Dr Warren Donnellan is a psychologist and lecturer in lifespan development, health and wellbeing at the University of Liverpool. His research focuses on resilience and dementia care. You can follow his work on Twitter @DrWizWaz.

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