The Caring Corner®
The Caring Corner – Home Care for a Loved One in the Era of COVID-19
In the current period of COVID-19, families are reconsidering the benefits of sending mom or dad to a care facility. On one hand, in communities, you get socialization oriented toward their needs. You get an administrative staff that provides a certain degree of 24/7 monitoring and assistance. Depending on the community, you may also get hands on care and nursing assistance. Many communities and facilities provide a pleasant environment for the elder individual and peace of mind for their family members. However, nursing homes in the Chapel Hill and Durham area have reported cases of Coronavirus. And now that we are starting to loosen the stay-at-home guidelines, we can expect community transmission of the virus to increase. The inevitable outcome is that any place where there are more contacts between people taking place, that the risks of contracting the disease will be higher.
Many people have suggested that disease transmission will decline in the warmer summer months. So far, there is modest evidence, at best, to suggest that this is the case. The virus has spread widely in tropical countries such as Ecuador and Brazil where it is summer virtually year-round. The greatest likelihood is that disease transmission will continue to be a significant risk until a vaccine has been developed
In this period of uncertainty, it makes sense to keep mom and dad at home. Many people are not aware that you can create sound, healthy environments for them at home and provide the need care with caregivers. Your parents will enjoy being in their own home and retaining a greater sense of individuality and independence.
The following are guidelines to consider if you elect to provide home care for your mom or dad. They apply to yourself, loved ones and paid caregivers.
Limit contact of your loved one with the outside world. Have as few caregivers as possible. If it is feasible to staff your care plan with one person instead of two or three, do that. Be upfront about your expectations regarding the other social contacts these caregivers may have when they leave your parents. Are they homebodies living quiet lives? Do they have many other clients? Do they have jobs in senior facilities or other places where human contact is high and disease transmission is more likely? Many families successfully provide care themselves and supplement with just one or two skilled caregivers.
Everyone in contact with your parents should themselves be healthy and free of symptoms. Many home care agencies have software that requires caregivers to confirm their lack of symptoms on a daily basis before they clock into a shift. While this is self-reported, and you might conclude that a caregiver will report falsely in order to keep her job, the opposite is more likely to be the case. Caregivers are part of the essential services community and are extremely conscious of the fact that their movement in the community increases their exposure. Currently, in the Chapel Hill – Durham area, it is not possible to get a COVID-19 test unless you are in a high priority category, such as a medical worker in a hospital or are exhibiting symptoms. For the time being self-reporting and taking temperatures is the best screen we have.
Consider your parents’ home a clean, hygienic environment. Upon entering, remove your shoes, wash your hands and wipe down cell phones with sanitary wipes. Consider wiping down groceries and other items brought in from the outside. This video, http://bit.ly/FoodBuys, offers great suggestions for how to handle purchased items. The video suggests placing your groceries on a counter inside your kitchen and having a clean area and a dirty area. You can also achieve the same effect by wiping down individual items as you remove them from your car and bring them into your home. In this case the “hygienic environment” starts as soon as an item is removed from the car.
Hand washing is another critical element of the hygiene process. People often use the rule-of-thumb that they sing the Happy Birthday song while they wash their hands. While this is a useful guideline, it misses some critical steps. Complete hand hygiene includes vigorous scrubbing above the wrist joint, scrubbing between the fingers and scrubbing the fingertips. This is a great video that demonstrates proper hand washing technique https://www.youtube.com/watch?v=-1Hub6Ps_cc&t=4s
People often ask what procedures caregivers follow during COVID-19. In large part, aside from the use of face masks, current CDC guidelines for COVID-19 are the same as what the homecare industry has always practiced for the seasonal flu. Caregivers should wash hands upon entering the client’s home and frequently after contact with any surface that may be contaminated. If a caregiver has flu-like symptoms (fever, cough, etc.) she should not go to work. The caregiver should let their client (your or your loved ones) know and allow you to decide if you want them there. If the caregiver is provided by an agency, that company can provide a replacement caregiver, if you wish.
One thing that has not been common practice with the flu is the use of face masks. These reduce the chance that the wearer contaminates people around them with airborne particles. All caregivers should wear masks when they are with their clients, unless the client asks them to remove it.
