Many South LA residents are caring for elderly loved ones in their homes and have real concerns about exposing shut-ins to the coronavirus (COVID-19).
During the coronavirus pandemic, it’s vitally important for caregivers to follow guidelines from the Centers for Disease Control and Prevention (CDC) and to make sure that anyone who enters the house washes their hands immediately. It’s also recommended that caregivers wipe down frequently-touched surfaces in the home. Bleach diluted with water can replace those hard-to-find sanitary wipes.
The LA County DPSS office provides an In Home Support Services (IHSS) program which offers trainings throughout the year for its hired caregivers. They recommend that all caregivers, whether paid or unpaid, continue to practice universal precautions as instructed by the Department of Public Health, visit https://www.cdph.ca.gov/programs.CID/DCDC/Pages?immunization/ncov12019.aspx, as a standard of care while delivering services.
Additionally, the DPSS has issued information to IHSS caregivers on how they may protect themselves and their care recipients, including:
Washing hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
Avoiding touching their eyes, nose, or mouth with unwashed hands. Avoiding close contact with people who are sick. Staying away from work, school, and other people if you become sick with a fever, cough, or respiratory symptoms.
Eliminating or minimizing visitors
According to a statement by James Bolden, DPSS public information officer, “If caregivers do become ill or experience COVID-19 symptoms, they have been advised not to report to their recipient’s home. Instead, they should call the IHSS recipient and let them know they are ill. The recipient and in many cases the relative caregiver, acting as an authorized representative, may contact another provider or the local Personal Assistance Services Council (PASC) to request assistance with finding another provider.”
Bolden said that shopping for food and other shopping/errands are current compensable services within IHSS. To apply for IHSS services call their application line at (888) 944-4477.
The CDC advises caregivers to:
— Contact health care providers to obtain extra necessary medications and stock up on over-the-counter drugs.
— Monitor needed medical supplies related to a loved one’s condition or treatments (oxygen, incontinence, dialysis, wound care) and common supplies such as tissues and cough syrup.
— Purchase enough nonperishable food items so you are prepared to stay home for some time.
Those who have a loved one in a care facility should monitor the situation, ask about the
health of the other residents frequently and know the protocol if there is a coronavirus outbreak.
There are other preparation steps, too, that caregivers can take, including creating backup plans, according to a recent AARP article.
“This is a good time for families to take stock and revisit contingency plans and to identify family and friends to help with such activities as grocery shopping, [and] stockpiling essential items,” says Jennifer Wolff, a professor of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health. “The virus is going to expose and exacerbate the fragile systems that are in place that primarily rely on family and other unpaid caregivers.”
Reschedule wellness appointments
Carla Perissinotto, the associate chief for geriatric clinical programs at the University of California-San Francisco, suggests looking ahead for any regular medical appointments on your loved one’s schedule.
“Look at what can be canceled that is not essential,” she told AARP “because health care environments are where the most sick people are right now.”
If an appointment is necessary, Perissinotto advises using a telephone or video-based system with the doctor, if available.
“If you aren’t used to this technology, see if there is someone in your family or in your community that can help you with that,” she says.
The same technology can relieve any social isolation caregivers and loved ones are experiencing during this time of social distancing. Phone calls, video chats and online conversations can provide welcome connections to friends and relatives.
Visitors to the home are not the only concern. Caregivers themselves must make sure they take safety measures.
“Even if the older adult stays home in a semi-quarantine situation, their caregivers – paid or unpaid – are still out in the community,” says Paula Lester, a geriatric medicine physician at NYU Winthrop Hospital. “The key is to use appropriate precautions.”
Lester advises that older people skip trips to the market if possible, to avoid exposure. Also, if you are doing shopping or other errands for those who need assistance, don’t bring the goods into their home and stick around afterward.
“Help them, but help them in a way that still protects them and yourself,” she recommends. “Leave [items] at the front door, or make online orders for them. That kind of help is really useful and safe.”
Hospice and home health nurses, home care aides and temporary nurses are stepping up protective measures. These include calling patients at home before they visit to see if they or anyone in the household have a fever or other symptoms of COVID-19. They’re also washing hands in front of patients and wearing masks and other protective gear to reduce infections and to make patients more comfortable.
Still, home health providers say they’re seeing some patients turn them away for fear of getting the virus, according to Kaiser Health News.
“It’s been quite a challenge – we’ve had patients discharged from the hospital for a home health referral who have refused to have our caregivers come in,” said Dr. Thomas Schaaf, chief medical officer for Providence St. Joseph’s Home and Community Care division.
Providence nurses visit patients at home, nursing homes and assisted living facilities. Visits are often critical for wound care, to ensure patients are taking their medications and to assess if a patient’s housing is safe to minimize falls and other dangers.
Schaff said his large health system has been trying to move care visits – such as those done by social workers or chaplains – to phone or video conferences.
‘Flying By The Seat Of Our Pants’
Marie Grosh, a nurse practitioner in Cleveland who calls on elderly patients at home, said she has shifted her schedule so that she now sees patients with communicable diseases at the end of her shift to reduce infection risks to others. She’s also stopped visiting patients who need only a checkup and don’t have immediate acute issues.
When visiting patients, she no longer sits down or puts down her bag of medical supplies to reduce the risk of coming in contact with germs or spreading infection.
“I am going from home to home. If I get sick, I can get over it, but I can’t risk taking anything from one home to the next home I am going to,” Grosh said.
“We are all trying and flying by the seat of our pants,” she said of trying to find the best way to keep seeing patients while reducing infection risk.