“Are you going to get busy living or are you going to get busy dying?” Traumatic stressors in older adult–caregiver dyads during COVID-19 social scarcity in the USA

BACKGROUND: The 2022 US National Strategy to Support Caregivers emphasises the importance of understanding trauma as part of caregiving relationships. However, this focus has not been applied to understanding caregiving during social scarcity such as COVID-19 from a dyadic older adult-caregiver perspectives. METHODS: = 22), this qualitative thematic study explored how social scarcity impacted caregiving relationships, and whether there was evidence of traumatic stress in shared experiences. Dyads represented parent-child, relatives, and friend relationships aside from spouses. RESULTS: Three themes were identified: (1) interactional micro-injuries and micro-adaptations; (2) nested troubles: present challenges and old wounds; and (3) eudaemonic deprivation-a perception of the erosion of order, meaning and purpose. Stressors were described as continuous fear, losses, grief, loneliness, loss of meaning, and disruptive feelings of anxiety impacting caregiving relationships. DISCUSSION: Older adults demonstrated keener, sharper experiences of losses, and generally expressed self-focused distress whereas caregivers expressed generally adaptive and dyad-oriented responses. Powerlessness was a feature of traumatic stress reflected among older adults, and it was responsibility among caregivers. The study underscores the importance of trauma-informed support in caregiving at a time of involuntary and prolonged exposure to social scarcity.