Caring for Older Adults with Depression Receiving Electroconvulsive Therapy (ECT) During the 2020 Pandemic

Introduction Caregivers are essential in providing valuable patient information to medical providers, such as recent changes in health, family history, previous hospitalizations, and medication reactions. Caring for elderly patients with a mental illness, in particular, is a unique and challenging job that may lead to caregiver stress and inability to provide proper care. As a result, patients with stressed caregivers are at increased risk of elder neglect and abuse. With limited available research investigating caregiver burden among those caring for patients receiving ECT and the new life challenges presented by the 2020 pandemic, it is more important than ever to take a closer look at the caregivers’ experiences. Methods Emory's Wesley Woods Geriatric Hospital is one of the busiest ECT services in the country with around 2000 treatments completed every year. In this study, researchers are expecting to enroll and interview 25 caregivers of patients receiving ECT using the Zarit Caregiver Burden Interview. This assessment includes 22 questions assessing the nature and frequency of caregiver emotions when caring for their dependents in order to examine the impact of the patient's condition on caregiver wellbeing. The score ranges from 0 (no burden) to 88 (severe burden) and the questions cover information about the caregivers’ current emotional state and struggles. Other objective assessments completed with ECT patients are BDI (Beck Depression Inventory), BDI Suicide, Sheehan Disability Scale, ECCA (Electrocompulsive Cognitive Assessment), GAD-7 (Generalized Anxiety Disorder Scale), and CGI (Clinical Global Impression). The purpose of these interviews is to investigate whether the higher severity of depression in patients correlates with higher levels of caregiver burden and whether the pandemic contributed to caregiver burden. Results The Zarit Caregiver Burden Interview has been administered on five patients (n=5) currently undergoing ECT for depressive symptoms. Additional patients are being interviewed in the ECT suite and further data collected will be presented at the 2021 AAGP Annual Meeting. Conclusions As the world adjusts to life in the COVID-19 era, caregivers face new challenges in providing care for vulnerable, at-risk populations. Caregivers of patients receiving ECT facilitate frequent COVID testing and limited visitation policies while continuing to provide care and emotional support to patients with advanced age and a mental illness. The main focus of the medical team is typically on patients; however, caregivers fill an essential role in the care of our geriatric patients receiving ECT and it is equally as important to be mindful of caregivers’ experiences in order to catch and potentially prevent serious consequences resulting from caregiver burnout. Administrating the Zarit Caregiver Burden Interview can help providers look at the degree of burden in caregivers of patients receiving ECT for depressive symptoms and provide better caregiving strategies during the 2020 pandemic. Funding Not Applicable