Easing COVID-19 Restrictions Will Provide Relief for Caregivers
It’s finally happening. We’re digging our way out of a very long and dark tunnel as the U.S. begins to drop COVID-19 restrictions, mainly mask mandates. Also, deaths from the disease have declined here, and fewer people are falling ill from it. As of this writing, more than 61% of U.S. adults have received at least one COVID-19 vaccine dose, and nearly 50% are fully vaccinated.
Aside from a collective sigh of relief, can we also take a minute to express gratefulness? Life may be slowly on its way back to normal. The pandemic has been particularly challenging for those trying to keep a loved one safe. Imagine repeatedly explaining the importance of wearing a mask to someone who doesn’t have the capacity to remember it. There’s a fine line between encouraging and badgering someone to do what’s best for them.
Wearing a mask may have prevented COVID-19 from being passed from one person to another. Still, for persons with hearing disorders or cognitive issues, who often depend on facial cues, the mandate inhibited communication skills and understanding.
A weary caregiver recently inquired if there was a way to keep a mask on a person with Alzheimer’s disease. The person within her care constantly removed it. The answer was no. Like the rest of us, they would have to badger their loved one as gently as possible. For more than a year, caregivers have cajoled their loved ones into stopping doing this or that.
“Wear the mask.”
“Don’t touch your face.”
“Don’t touch anything or anybody.”
“Don’t hug your grandkids.”
No wonder we’re breathing more easily, and not simply because the masks are coming off. We’re finally in the position to change our message and tone. The grandkids can embrace their fully vaccinated grandparents, who can now scratch their nose without being reprimanded.
These may appear like small things. Compared to the devastation COVID-19 has left in its wake, they are infinitesimal. However, if you’re a caregiver that’s harangued a spouse, mother, or father with Alzheimer’s disease about wearing a mask, you get it. You’re likely grateful for the U.S. Centers for Disease Control and Prevention’s latest recommendation for masks.
Telemedicine is great until it isn’t
As dementia progresses, it becomes more challenging to get out and about. Taking a loved one with Alzheimer’s to their doctors’ appointments is daunting, even on a good day. Thankfully, most healthcare providers quickly pivoted to meet the needs of their patients with telemedicine during the pandemic.
Televisits were the perfect solution for patients and their weary caregivers — until they weren’t. Telemedicine is a beautiful tool, and it’s mind-boggling that it took a pandemic for many healthcare providers to realize its usefulness.
However, a televisit can only go so far. There’s something to be said for a hands-on appointment. The doctor can’t take a person’s vital signs during a televisit. It is difficult to assess the patient’s demeanor and physical appearance, such as their coloring, which can provide clues. A person appears on screen differently than they would in person.
During a televisit, the healthcare provider primarily relies on how the patient says they feel. The doctor can’t palpate a painful area to discover abnormalities. Telemedicine is a great alternative when it’s the only alternative, but there comes a time when it’s necessary to see the patient in person, face-to-face.
Now that the country is moving forward and hopefully distancing itself from COVID-19, patients can go back to in-person doctors’ appointments. However, it would be nice to continue making the choice available. In the late stages of Alzheimer’s disease, patients are often unable to make the physical trip to the doctor’s office.
The pandemic added to the isolation that was already a close and unwelcome companion for caregivers and people with dementia. As mentioned earlier, it’s not easy to go anywhere, but sans COVID-19, we can still take an occasional walk in a park, eat out, or have family members come over to visit. These options came to a screeching halt during the pandemic, but now, we can get back out there with caution.
Let’s take a minute to assess where we were as a nation this time last year in terms of the pandemic and choose to have a grateful heart. At the same time, we must remember and pray for countries that are less fortunate than ours. India, for instance, is in the throes of the pandemic, with many lives lost and still threatened.
Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Alzheimer’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Alzheimer’s disease.
SAN DIEGO (KUSI) – The Comprehensive Care for Alzheimer’s Act has the potential to streamline today’s complicated health care maze for people living with dementia and their caregivers according to Katie Croskrey, Executive Director of Alzheimer’s Association San Diego/Imperial Chapter.
Croskrey joined Good Evening San Diego to explain the bill.
The bipartisan bill is expected to reduce medical complications for these patients by creating a new way to fund dementia care through Medicare.
Alzheimer’s disease is a devastating diagnosis, and as the disease progresses it becomes increasingly challenging for sufferers to manage the myriad of emotions and situations they encounter throughout the course of any given day. Thus, when an Alzheimer’s sufferer experiences a tremendous loss, such as the death of a spouse or loved one, it can seem like a monumental task for caregivers to help them cope with their grief.
The experience of grief and bereavement is unique to every individual and can depend largely on how far their disease has progressed. People in the earlier stages of dementia may have an easier time understanding the loss that has occurred and even retaining the information, with occasional bouts of forgetfulness.
Image via Flickr by Julie Jordan Scott
Caregivers of people in the later stages of Alzheimer’s disease or other dementia often struggle with communicating regarding the death of a loved one, fearing that the care recipient may not comprehend the loss or may soon forget after the conversation. In fact, this is a common occurrence, leaving caregivers to wonder whether they should remind the person they care for that their loved one has passed on when they speak of her repeatedly as though she is still living. Multiple experts have offered advice on handling these sensitive situations, but ultimately, caregivers must approach every situation individually based on the person’s cognitive status, previous behaviors and conversations, and the individual’s personality and behaviors.
It’s important to recognize that even if a person with Alzheimer’s disease seemingly does not comprehend the loss, they may exhibit common behaviors associated with grief and bereavement and may retain an understanding of what has occurred. Often, these people are able to communicate their understanding of the loss during lucid moments, while during periods of forgetfulness, they may speak of loved ones who have passed on as though they are still with us.
There is one certainty in helping an individual with Alzheimer’s disease cope with the loss of a loved one, and that is that it is most assuredly a challenging and complicated process. We’ve put together a comprehensive resource, including tips, information, and advice from a variety of reputable organizations and sources, to help caregivers navigate the complex maze of helping a person with Alzheimer’s cope with the death of a loved one.
Coping with the Range of Emotions in Alzheimer’s Caregiving
Caring for a person with Alzheimer’s disease can be particularly emotionally challenging, resulting in a range of emotions for both the caregiver and the care recipient. The following tips and resources provide helpful advice for coping with the myriad of emotions encountered by Alzheimer’s caregivers, particularly when facing loss.
Image via Flickr by Michael Havens
Caring for a person with Alzheimer’s disease comes with both challenges and rewards. This article outlines the challenges and rewards of caring for a person with Alzheimer’s disease and offers information about support resources for caregivers.
Behavior problems can be a very real concern. This article discusses things like wandering, aggressiveness, hallucinations, and difficulties with sleeping or eating, along with tips to help caregivers manage these issues.
Memory loss is one of the most common – and most frustrating – symptoms associated with the early stages of Alzheimer’s disease. This resource from WebMD offers tips for caregivers to help people with Alzheimer’s disease cope with memory loss.
There are some special considerations and tips for reducing challenges during day-to-day care. Whether you live with someone who is suffering from Alzheimer’s disease or caring for a person with Alzheimer’s who does not reside with you, this article provides helpful information to help you best care for a person suffering from Alzheimer’s disease. Likewise, this article offers helpful links to information on maintaining a sense of normalcy in day-to-day life.
Stress and anxiety are common for people with Alzheimer’s disease. These emotions are often attributable to frustration due to memory loss, a loss of ability to do things they could once do independently, and the overall experience of grieving for what has been lost in relationships and daily activities. This resource from the National Institute on Aging offers links to helpful information for managing stress and anxiety, coping with grief and feelings of loss, and more, for both caregivers and individuals suffering from Alzheimer’s disease.
Learning to recognize signs of frustration in yourself helps you to be proactive about managing your stress. This resource, from Caregiver.org, offers helpful scenarios and alternative statements to control self-doubt, frustration, and other emotions common among Alzheimer’s caregivers.
Understanding the Grieving Process and Stages of Grief
Before you can help a person with Alzheimer’s cope with the loss of a loved one, it’s important to understand how the grieving process works and the various stages of grief individuals typically experience. Still, the grieving process is unique to every individual, so be sure to respect individual differences.
Image via Flickr by 30datgarmedanal
Extreme feelings of grief typically subside within six months following the loss of a loved one. However, some individuals may struggle for several years to resume a sense of normalcy. This article describes the general process of grief and complicated grief.
Bereavement is the state of grieving over the loss of a loved one. This resource from the American Cancer Society explains the difference between grief and bereavement as well as the various stages of grief.
Grief is typically thought of as having five stages: denial, anger, bargaining, depression, and acceptance. This article from Grief.com outlines the five stages of grief as conceptualized by Elizabeth Kubler-Ross.
Other models define grief as having seven stages, a similar model to the 5-stage model that breaks down some of the original five stages into more complex experiences. This article outlines the seven-stage model of grief.
The five stages of grief are universal and experienced by people from all corners of the world and from all walks of life. This article discusses the five stages of grief and explains how these emotions represent stages experienced by anyone experiencing a loss.
Understanding How Loss and Bereavement Affect a Person with Dementia
When caring for a person with Alzheimer’s disease, it’s important to understand how various circumstances and events may impact them. The following resources and information are useful for gaining clarity on how loss and bereavement may impact the individual for whom you’re caring.
Image via Flickr by Alan Cleaver
Every person’s experience will be unique. Not every person with Alzheimer’s handles grief and loss in the same way. This is true of all individuals, whether the person is suffering from Alzheimer’s disease or not. This article describes the importance of person-centered care to adapt to the individual’s needs.
“Bereavement at the death of a friend or relative with dementia is a unique and complex situation that everyone will cope with in their own way.” This article outlines the experiences of grief, loss, and bereavement that a person diagnosed with Alzheimer’s disease may experience, both after their own diagnosis and following the death of a friend or loved one.
Every day is different following the death of a spouse or loved one for a person with Alzheimer’s disease. Not only is the grieving process different for each individual, but as Carol Bradley Bursack explains in this article at ElderCareLink, the grieving process and the emotions experienced can change from day to day.
It’s not uncommon for a person with Alzheimer’s disease or dementia to not recall the death of a loved one. In fact, some Alzheimer’s sufferers still speak as though their loved ones are living years following a death. This resource includes the perspectives and advice of several families and caregivers who have dealt with similar situations.
The reaction of a person with dementia to grief is largely affected by their cognitive understanding of what has happened to their loved one. For this reason, grief may be far more complicated for a person with Alzheimer’s disease or dementia than it may be for a healthy person free of diseases or illnesses affecting cognition.
The loss of a family pet can lead to substantial grief for a person with Alzheimer’s disease, as well. This article offers tips for helping a person with Alzheimer’s disease cope following the loss of a beloved pet.
Breaking the News and Communication Tips
Many times, caregivers are tasked with breaking the news of the passing of a loved one to a person suffering with Alzheimer’s disease. The following tips and resources provide valuable advice for having these initial sensitive conversations and communicating with people with Alzheimer’s disease following the recent passing of a loved one.
Image via Flickr by Borya
Should you tell a person with Alzheimer’s disease about the death of a loved one? If so, who should be the person to communicate the news, and how should it be handled? These are just a few of the questions plaguing caregivers’ minds when a care recipient loses a loved one. This article addresses how to best answer these questions and handle the communication of bad news.
When the situation involves the passing of a spouse, telling the surviving spouse, even when that person has Alzheimer’s disease, is an absolute must. Carol Bradley Bursack shares her experience when placing her dad in foster care, while her mother, who had dementia, shared a room with him in the nursing home.
There are some strategies that can help a person with Alzheimer’s disease more easily take in new information, such as keeping the information as simple as possible or breaking it down into smaller bits of information or steps. This article offers some helpful tips for aiding a person with Alzheimer’s disease in taking in new information through context and various communication strategies.
Your approach to sharing the news and helping a person with Alzheimer’s disease cope with the passing of a loved one will vary based on how advanced the individual’s disease is. As this article points out, there are multiple stages of Alzheimer’s disease and dementia. A person in the earlier stages of Alzheimer’s disease may cope more readily with such a loss, while in some cases, the loss can complicate the individual’s disease progression.
A person with Alzheimer’s disease deserves the dignity of being told of the passing of a loved one. Regardless of how difficult the situation may be, many experts agree that any individual with Alzheimer’s disease has the same right to learn of the passing of a loved one. This article explains the position of one recognized expert on Alzheimer’s caregiving, Carol Bradley Bursack.
There are several tips and strategies to help caregivers communicate more effectively with a person with Alzheimer’s disease. This article outlines ten tips for communicating with a person with Alzheimer’s disease or dementia, such as getting the person’s attention first and asking simple, answerable questions.
Caregivers of persons with Alzheimer’s disease encounter many unique and challenging communication scenarios. This article covers many of the possible scenarios caregivers may face, along with tips for addressing these situations. One such scenario is how to handle it when a person with Alzheimer’s disease states and/or believes that a deceased loved one is not only living, but came to visit that day.
When communicating the death of a loved one to a person with Alzheimer’s disease, it’s recommended that only one person break the news to avoid confusion. This article offers helpful information and advice for communicating the death of a loved one to a person with Alzheimer’s disease or dementia.
Handling Forgetfulness When Caring for a Person with Alzheimer’s Disease
One of the biggest challenges faced by many Alzheimer’s caregivers following the loss of a loved one is that the care recipient may forget that their spouse, parent, or other loved one has passed. These situations prove particularly challenging for caregivers in determining how to best communicate throughout these conversations.
Image via Flickr by Marjan Lavarevski
People with Alzheimer’s disease don’t always have to be grounded in reality. As this article points out, reminding a person with Alzheimer’s disease that her spouse or parent has passed away is also a reminder of the pain of that loss.
When the person you are caring for repeatedly forgets about their loved one’s passing and asks for him, it’s difficult to navigate these situations. This article offers some advice for finding the right balance between telling the person you’re caring for a lie and having to relive your own grief each time she asks about her loved one.
Sometimes, a “therapeutic lie” is acceptable, and may even be preferred in some cases. This discussion centers on the benefits of occasionally using this technique to avoid causing undue stress or pain for a person with Alzheimer’s disease.
Some experts advise against reminding a person with Alzheimer’s disease that a loved one has passed. This article outlines five things you should never say to an individual with Alzheimer’s disease, including reminding her that her loved one has passed on. As this article explains, if the person does not believe you, they may become angry with you; if they do believe you, they will experience grief and loss all over again. And ultimately, the information may not be retained, so you may encounter the same situation again tomorrow. However, this is dependent on the person as well as his disease process.
Habilitation Therapy is an approach that gives the highest value to the well-being of the person suffering with Alzheimer’s disease. This approach, outlined in this resource, recognizes that whatever the individual correctly or incorrectly believes to be true is, in fact, the reality in which the individual is living. Habilitation Therapy approaches these situations by understanding what the person is experiencing and respecting it, never negating it.
How to Handle Bereavement Activities When Caring for a Person with Alzheimer’s Disease
In addition to the possibility that a person with Alzheimer’s disease may experience memory loss resulting in forgetfulness about a loved one’s passing, every Alzheimer’s sufferer is unique in how she experiences grief and handles bereavement. The following tips and resources offer helpful advice for coping with situations such as attending funerals and other bereavement activities.
Image via Flickr by Arthur (Ted) LaBar
An Alzheimer’s sufferer may opt not to attend a loved one’s funeral. Again, every individual handles grief and loss differently. This resource contains helpful responses from Alzheimer’s caregivers surrounding the communication of the death of a loved one and how to handle situations, such as the individual choosing not to attend a funeral.
When determining whether a person with Alzheimer’s disease should attend the funeral of a loved one, there are several considerations to weigh. This article offers advice for handling different situations when a person has dementia, such as attending church and attendance at the funerals of loved ones.
Taking a person with Alzheimer’s disease to the funeral of a loved one is an individual choice based on behavior and cultural preferences, but can sometimes help the individual process the loss. This resource offers tips for communicating the death of a loved one to a person with Alzheimer’s disease and recommends activities and approaches that can help both you and the person for whom you are caring cope with the loss.
A person with Alzheimer’s disease or dementia may exhibit behaviors that demonstrate the pain of their loss, even though they don’t appear to have a cognitive understanding of the loss. As this article explains, it’s not uncommon for a person with Alzheimer’s disease to seemingly not comprehend that a loved one has passed, yet display common bereavement behaviors such as sleepiness, a lack of motivation, a lack of appetite, and other common symptoms of grief.
It can be helpful to redirect conversations following the death of a loved one to pleasant memories, playing music that brings back fond memories, or sharing stories about the person who has passed to help a person with Alzheimer’s cope with grief. This article offers several suggestions for easing the grieving process for a person with Alzheimer’s disease, as well as helpful insights on how a person with Alzheimer’s may experience grief.
While helping a person with Alzheimer’s disease cope with the death of a loved one is certainly not easy, it can be quite rewarding. When you employ strategies that help the person you’re caring for transition from a state of grief, despair, and possibly anger and frustration to one of comfort and nostalgia, it can help you feel accomplished as a caregiver as well as help you manage your own complicated emotions that accompany caring for a person with Alzheimer’s disease.
April 4, 2021, at 9:00 a.m.
U.S. News & World Report
6 Steps to Reduce Caregiver Stress
SUNDAY, April 4, 2021 (HealthDay News)
Caring for a loved one with Alzheimer’s disease can be mentally and physically exhausting, so you should take steps to manage and reduce stress, according to the Alzheimer’s Foundation of America.
“Finding ways to manage and reduce stress is of paramount importance for every Alzheimer’s caregiver. Untreated stress can lead to physical, mental and emotional caregiver burnout,” Jennifer Reeder, director of educational and social services, said in a foundation news release.
The foundation offers the following six tips to help caregivers enhance their stress-coping skills:
Be adaptable and positive. Your attitude influences stress levels for both you and your loved one. Being able to “go with the flow” will help both of you stay relaxed. If you get aggravated or agitated, odds are that your loved one will, too. Try to adjust to situations in constructive ways.
Deal with what you can control. Remember that some things are out of your control, such as the coronavirus pandemic. What you can control is how you respond and react to these outside factors.
Set realistic goals and take it slow. Everything can’t be resolved immediately and it doesn’t need to be, so don’t have unrealistic expectations. Set priorities and practical goals, do your best to achieve them, and take things one day at a time.
Take care of your health. Too little rest, poor diet and lack of exercise can worsen stress and cause other health problems. Try to get enough sleep, eat right, drink plenty of water and be active. You can’t provide good care if you don’t look after yourself.
Clear your mind. Exercise, yoga, meditation, listening to music and deep breathing can help relax your mind and reduce stress. Identify what works for you and do it on a regular basis.
Share your feelings. Talking with family members, trusted friends or a professional can also help relieve stress.
The U.S. National Institute on Aging has more about Alzheimer’s caregiving.
SOURCE: Alzheimer’s Foundation of America, news release, March 30, 2021
Copyright © 2021 HealthDay. All rights reserved.
Tags: Alzheimer’s disease, psychology, stress
This is the first set of public health recommendations for fully vaccinated people. This guidance will be updated and expanded based on the level of community spread of SARS-CoV-2, the proportion of the population that is fully vaccinated, and the rapidly evolving science on COVID-19 vaccines.
For the purposes of this guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or ≥2 weeks after they have received a single-dose vaccine (Johnson and Johnson [J&J]/Janssen ).†
The following recommendations apply to non-healthcare settings.
Fully vaccinated people can:
- Visit with other fully vaccinated people indoors without wearing masks or physical distancing
- Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
- Refrain from quarantine and testing following a known exposure if asymptomatic
For now, fully vaccinated people should continue to:
- Take precautions in public like wearing a well-fitted mask and physical distancing
- Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
- Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
- Avoid medium- and large-sized in-person gatherings
- Get tested if experiencing COVID-19 symptoms
- Follow guidance issued by individual employers
- Follow CDC and health department travel requirements and recommendations
- Recommendations for Visiting with Others in Private Settings
- Recommendations for Isolation, Quarantine and Testing
Currently authorized vaccines in the United States are highly effective at protecting vaccinated people against symptomatic and severe COVID-19. Additionally, a growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to transmit SARS-CoV-2 to others. How long vaccine protection lasts and how much vaccines protect against emerging SARS-CoV-2 variants are still under investigation. Until more is known and vaccination coverage increases, some prevention measures will continue to be necessary for all people, regardless of vaccination status. However, the benefits of reducing social isolation and relaxing some measures such as quarantine requirements may outweigh the residual risk of fully vaccinated people becoming ill with COVID-19 or transmitting SARS-CoV-2 to others. Additionally, taking steps towards relaxing certain measures for vaccinated persons may help improve COVID-19 vaccine acceptance and uptake. Therefore, there are several activities that fully vaccinated people can resume now, at low risk to themselves, while being mindful of the potential risk of transmitting the virus to others.
For the purposes of this guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or ≥2 weeks after they have received a single-dose vaccine (Johnson and Johnson [J&J]/Janssen).† This guidance applies to all fully vaccinated people. However, people should discuss with their provider if they have any questions about their individual situation, such as immunocompromising conditions or other concerns.
This guidance provides recommendations for fully vaccinated people, including:
- How fully vaccinated people can safely visit with each other or with unvaccinated people in private settings
- How fully vaccinated people should approach isolation, quarantine, and testing
In public spaces, fully vaccinated people should continue to follow guidance to protect themselves and others, including wearing a well-fitted mask, physical distancing (at least 6 feet), avoiding crowds, avoiding poorly ventilated spaces, covering coughs and sneezes, washing hands often, and following any applicable workplace or school guidance. Fully vaccinated people should still watch for symptoms of COVID-19, especially following an exposure to someone with suspected or confirmed COVID-19. If symptoms develop, all people – regardless of vaccination status – should isolate and be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated.
CDC will continue to evaluate and update public health recommendations for vaccinated people as more information, including on new variants, becomes available. Further information on evidence and considerations related to these recommendations is available in the new Science Brief.
Visits or small gatherings likely represent minimal risk to fully vaccinated people. Medium or large-sized gatherings and those including unvaccinated people from multiple households increase the risk of SARS-CoV-2 transmission. Though the risk of disease may be minimal to the fully vaccinated person themselves, they should be mindful of their potential risk of transmitting the virus to others if they become infected, especially if they are visiting with unvaccinated people at increased risk for severe illness from COVID-19 or who have unvaccinated people at increased risk for severe disease in their own households. Fully vaccinated people should not visit or attend a gathering if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms, regardless of vaccination status of the other people at the gathering.
Indoor visits between fully vaccinated people who do not wear masks or physically distance from one another are likely low risk. For example, if you are fully vaccinated, it is likely a low risk for you to invite other fully vaccinated friends to dinner inside your private residence.
Indoor visits between fully vaccinated people and unvaccinated people who do not wear masks or physically distance from one another are likely low risk for the vaccinated people.
Therefore, the level of precautions taken should be determined by the characteristics of the unvaccinated people, who remain unprotected against COVID-19.
Vaccinated people visiting with unvaccinated people from a single household that does not have individuals at risk of severe COVID-19
If the unvaccinated people are from a single household that does not have individuals at risk of severe COVID-19, they can visit with fully vaccinated people indoors, without anyone wearing masks, with a low risk of SARS-CoV-2 transmission. For example, fully vaccinated grandparents can visit indoors with their unvaccinated healthy daughter and her healthy children without wearing masks or physical distancing, provided none of the unvaccinated family members are at risk of severe COVID-19.
Vaccinated people visiting with unvaccinated people from a single household that has individuals at risk of severe COVID-19
If any of the unvaccinated people or their household members are at increased risk of severe COVID-19, all attendees should take precautions including wearing a well-fitted mask, staying at least 6 feet away from others, and visiting outdoors or in a well-ventilated space.
For example, if a fully vaccinated individual visits with an unvaccinated friend who is seventy years old and therefore at risk of severe disease, the visit should take place outdoors, wearing well-fitted masks, and maintaining physical distance (at least 6 feet).
Vaccinated people visiting with unvaccinated people from multiple households at the same time
If the unvaccinated people come from multiple households, there is a higher risk of SARS-CoV-2 transmission among them. Therefore, all people involved should take precautions including wearing a well-fitted mask, staying at least 6 feet away from others, and visiting outdoors or in a well-ventilated space.
Continuing the example from above, if fully vaccinated grandparents are visiting with their unvaccinated daughter and her children and the daughter’s unvaccinated neighbors also come over, the visit should then take place outdoors, wearing well-fitted masks, and maintaining physical distance (at least 6 feet). This is due to the risk the two unvaccinated households pose to one another.
All people, regardless of vaccination status, should adhere to current guidance to avoid medium- or large-sized in-person gatherings and to follow any applicable local guidance restricting the size of gatherings. If they choose to participate, fully vaccinated people should continue to adhere to prevention measures that reduce spread, including wearing a well-fitted mask, maintaining physical distance from others, and washing hands frequently.
Risk of SARS-CoV-2 infection during public social activities such as dining indoors at a restaurant or going to the gym is lower for fully vaccinated people. However, precautions should still be taken as transmission risk in these settings is higher and likely increases with the number of unvaccinated people present. Thus, fully vaccinated people engaging in social activities in public settings should continue to follow all guidance for these settings including wearing a well-fitted mask, maintaining physical distance (at least 6 feet), avoiding crowds, avoiding poorly ventilated spaces, covering coughs and sneezes, and washing hands frequently.
At this time, CDC is not updating our travel recommendations and requirements.
The following recommendations apply to non-healthcare settings.
Although the risk that fully vaccinated people could become infected with COVID-19 is low, any fully vaccinated person who experiences symptoms consistent with COVID-19 should isolate themselves from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated. The symptomatic fully vaccinated person should inform their healthcare provider of their vaccination status at the time of presentation to care.
Fully vaccinated people with no COVID-like symptoms do not need to quarantine or be tested following an exposure to someone with suspected or confirmed COVID-19, as their risk of infection is low.
Fully vaccinated people who do not quarantine should still monitor for symptoms of COVID-19 for 14 days following an exposure. If they experience symptoms, they should isolate themselves from others, be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated, and inform their health care provider of their vaccination status at the time of presentation to care.
Fully vaccinated residents of non-healthcare congregate settings (e.g., correctional and detention facilities, group homes) should continue to quarantine for 14 days and be tested for SARS-CoV-2 following an exposure to someone with suspected or confirmed COVID-19. This is because residential congregate settings may face high turnover of residents, a higher risk of transmission, and challenges in maintaining recommended physical distancing.
Fully vaccinated employees of non-healthcare congregate settings and other high-density workplaces (e.g., meat and poultry processing and manufacturing plants) with no COVID-like symptoms do not need to quarantine following an exposure; however testing following an exposure and through routine workplace screening programs (if present) is still recommended.
†This guidance applies to COVID-19 vaccines currently authorized for emergency use by the Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson and Johnson [J&J]/Janssen COVID-19 vaccines. Considerations for applying this guidance to vaccines that are not FDA-authorized include whether the vaccine product has received emergency approval from the World Health Organization or authorization from a national regulatory agency.
COVID-19 Caregiver Tip Sheets
COVID-19 is disrupting routines and turning care for someone with dementia into a potential nightmare for families. Below please find four tip sheets to help caregivers manage those living with dementia during these difficult times.
If you want to talk to someone about these issues or any other challenges you are facing during this difficult time, please call our Helpline at 844-435-7259 and ask to speak to our dementia experts, our care counselors.
COVID-19: Activities to do at Home
During the COVID-19 Safer at Home order, older adults are being asked to stay indoors to lower risk of exposure. Many things are changing fast and we are being forced to adapt quickly. Staying home might be easier said than done.
To help organize your days, we have put together lists of activities to do at home with someone who has a diagnosis of Alzheimer’s or another dementia, regardless of their stage in this journey.
Additional COVID-19 Guidance for Caregivers of People Living with Dementia in Community Settings
Caring for People Living with Dementia in Long-term Care Facilities (LTCFs): For information on how to care for people living with dementia in LTCFs including nursing homes, skilled nursing facilities, and assisted living facilities with memory care units/wings, please see CDC guidance for preparing these facilities for COVID-19.
Older adults and people with serious underlying medical conditions are at higher risk for severe illness from COVID-19, according to public health and clinical experts.1–2 Among adults with confirmed COVID-19, those aged 65 years and older are more likely to be hospitalized, to be admitted for intensive care, and to die. In fact, 8 out of 10 deaths associated with COVID-19 in the United States have been among adults aged 65 years and older.1–2
Older adults also have the highest rates of dementia. An estimated six million adults have some form of dementia, including Alzheimer’s disease, the most common type of dementia.3
Given the risks that older adults face from both COVID-19 and dementia, CDC is providing this additional guidance to caregivers of adults with Alzheimer’s disease and other types of dementia to reduce the spread of COVID-19 and to help them manage their patients’ physical and mental wellbeing as well as their own wellbeing. Not all people living with dementia require caregivers. Therefore, the degree of assistance a person needs will depend on the extent that their dementia has progressed. For people living with dementia, changes in behavior or worsening symptoms of dementia should be evaluated because they can be an indication of worsening stress and anxiety as well as COVID-19 or other infections.
If you care for someone living with dementia, it’s important that you know what you can do to protect yourself and others during the COVID-19 pandemic and what additional steps you can take to protect your loved one:
- Know when you need to seek medical attention for your loved one.
- If your loved one has advanced dementia and needs to be hospitalized for COVID-19, make sure hospital staff know that your in-person assistance might be required to communicate important health information and emergency support. Here are several important issues to consider:
- Be prepared to be in a healthcare setting with your loved one. Be prepared to use personal protective measures as recommended by the hospital staff if you are in the room with your loved one.
- Be aware that you and healthcare providers may face difficulties caring for your loved one because he or she:
- May not cooperate with care and may not follow personal protective measures such as wearing a mask or practicing social distancing
- May refuse diagnostic procedures
- Incorporate CDC guidance into your daily routine and the daily routine of your loved one:
- Wear masks8 and make sure that others wear them.
- Do NOT place a mask on anyone who has trouble breathing, is unconscious, is incapacitated, or is unable to remove the mask without assistance.
- Wash hands often.
- Cover coughs and sneezes with a tissue.
- Avoid touching eyes, nose, and mouth with unwashed hands.
- Clean and disinfect frequently touched surfaces.
- Wear masks8 and make sure that others wear them.
Caregivers: Be Aware of the Symptoms for COVID-19
The first step in caring for people living with dementia in any setting is to understand that changes in behavior or worsening symptoms of dementia should be evaluated because they can be an indication of COVID-19 infection or worsening stress and anxiety. Not everyone with COVID-19 has symptoms, but when people with dementia do have COVID-19 symptoms,4 they can include the following:
- Increased agitation
- Increased confusion
- Sudden sadness
- Difficulty breathing
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
Caregivers Can Be First Responders Under Stress: Know How to Take Care of Yourself
As a caregiver,9 you provide care to people who need some degree of ongoing assistance with everyday tasks on a regular basis. During this pandemic, you may also be a first responder, providing the first line of response and defense to your loved one living with dementia. First responders often experience stress due to heavy workloads, fatigue, and other situations that come with an emergency. There are important steps you should take during and after an emergency event to help manage and cope with stress.10 To take care of others, you must be feeling well and thinking clearly. Here are some tips on how to take care of yourself:
- Eat a healthy diet, avoid using drugs and alcohol, and get plenty of sleep and regular exercise to help reduce stress and anxiety. Activities as simple as taking a walk, stretching, and deep breathing can help relieve stress.
- Establish and maintain a routine. Try to eat meals at regular times, and put yourself on a sleep schedule to ensure you get enough rest. Include a positive or fun activity in your schedule that you can look forward to each day or week. If possible, schedule exercise into your daily routine.
- Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting. If you want to stay up-to-date on the pandemic, visit CDC’s website for the latest recommendations on what you can do to protect yourself and those you care for.
- Make time to unwind. Try to do activities you enjoy.
- Connect with others. Reach out to family and friends. Talking to someone you trust about your concerns and feelings can help.
- Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
- Find a local support group. Support groups provide a safe place for you to find comfort in knowing you are not alone.
- Have a backup caregiver. In case you become sick with COVID-19, a backup caregiver will ensure that your loved one continues to receive care. You can focus on caring for yourself.7
- Razzaghi, et al. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Early Release. 2020; 69
- Centers for Disease Control and Prevention. Coronavirus Disease 2019: Older Adults. 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
- Centers for Disease Control and Prevention. Alzheimer’s Disease. 2019. https://www.cdc.gov/aging/aginginfo/alzheimers.htm
- Centers for Disease Control and Prevention. Coronavirus Disease 2019: Symptoms of Coronavirus. 2020. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
- Centers for Disease Control and Prevention. Coronavirus Disease 2019: Preparing for COVID-19: Long-Term Care Facilities, Nursing Homes. 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html
- Centers for Disease Control and Prevention. Coronavirus Disease 2019: How to Protect Yourself & Others. 2020. https://www.cdc.gov//coronavirus/2019-ncov/prevent-getting-sick/prevention.html
- Centers for Disease Control and Prevention. What to Do If You Are Sick. 2020. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
- Centers for Disease Control and Prevention. Use of Masks to Help Slow the Spread of COVID-19. 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
- Centers for Disease Control and Prevention. Caregiving: Who are caregivers? 2019. https://www.cdc.gov/aging/caregiving/index.htm
- Centers for Disease Control and Prevention. Coronavirus Disease 2019: Stress and Coping. 2020. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html