In late June, Presbyterian Senior Services (pssusa.org) in New York City hosted a webinar for caregivers on how to protect yourself and your loved one during this time of covid-19.
Presenters offered guidelines for questions to ask and procedures to follow to prevent transmission of covid-19 to you or your family:
- if you have or need in-home care
- live in an assisted living facility or are moving to assisted living
- for home care services following hospital discharge, and
- for venturing out as businesses open.
Presenters also provided:
- Online covid-19 resources
- A list of equipment needed to collect vital signs for telehealth visits
- Go-Kit packing list with the basics you will need (and want) if you have to take your loved one to the hospital and they are admitted
- In-home covid-19 test kit information
This webinar was recorded and can be viewed at: https://www.youtube.com/watch?v=zcfJ8UaGsZs
Denise Dagan, with Stanford Parkinson’s Community Outreach, listened to the webinar and took notes. See below.
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Caregiver Toolkit in Uncertain Times
Webinar hosted by Presbyterian Senior Services
June 25, 2020
Notes by Denise Dagan, Stanford Parkinson’s Community Outreach
Presenters: Melissa Sheehan and Laura Radensky, LCSW
Mind Set Preparation – Keeping Calm
Keep a mindset of being open to not knowing what is next
Accept continuing risks and take reasonable precautions
– Wearing masks
– Hand washing
– Limiting people coming into our home or ensuring those who come into the home have proper protective equipment.
– Limiting exposure
– Practicing self care (eating well and attending to health issues)
– Err on the side of caution as businesses reopen
– Realize information about covid-19 is an evolving body of knowledge
– Look at good data: Center for Disease Control (cdc.gov), NY State Novel Coronavrius (coronavirus.health.ny.gov), and Johns Hopkins (coronavirus.jhu.edu), Institute for Health Metrics and Evaluation (healthdata.org)
Equipment Preparation at Home
* Ordering personal protective equipment including masks, gloves, hand sanitizer, thermometers. Keep in mind soap and water are recommended over hand sanitizer.
* Higher level of equipment including face shields, gowns, scrubs, N95 and KN95 masks. This equipment should be used by hired care givers working in your home. Expect that N95 masks be reused due to shortages of equipment.
* Equipment to collect vital signs prior to telehealth visits, including:
– blood pressure cuff
– pulse oximeters. Normal blood oxygenation is at least 95%. In many cases, upon arrival at emergency rooms, covid patients’ blood oxygenation levels were in the 70s, 60s, even 50s. Doctors tell patients to visit the hospital if blood oxygenation drops to 93%, or below.
– scales
– thermometer. All staff working in your home taking temperature twice daily. Everyone entering the home should have their temperature taken before entering.
Testing Options
Greater availability of testing options
Possibility now to request COVID-19 tests and antibody testing
Being able to have testing in your home and sent to lab
* LabCorp – Pixel at-home kit
* House calls: doctor visits at home may do covid-19 testing
Accuracy issues and possibility to still be contagious:
* In light of this if you have been exposed or have symptoms, self isolate
* Be extra vigilant about wearing masks hand washing to protect yourself and others
Planning Ahead
Home care, assisted living are still options, but:
* Assisted living has limited visitation, social interaction, entertainment, etc.
* In addition, assisted living facilities are doing twice daily temperature checks, etc.
* There are far fewer covid-19 cases in assisted living facilities. Most senior residential care facility covid cases have been in skilled nursing/nursing homes.
Live-in service and fewer caregivers with home care:
* Just like clients discontinued in-home care due to concerns of catching covid, on-home care workers stopped working as in-home care givers due to:
- self isolating due to personal exposure
- child care while schools are closed
- personal concern over becoming infected or infecting others
* As businesses reopen more caregivers should become available. Some services have changed policies to limit exposure to patients.
Advance Directives, especially the choice of a healthcare proxy since covid-19 is a fast moving disease process. Make sure your advance directive information is available so carers don’t have to go looking for it.
Online cultural options: musueums, opera, music, concerts
The “New Normal”
Ensuring restaurants and other public spaces are accessible and safe
Having 60% (or higher) alcohol wipes available and proper spacing of tables
Preparing ahead to ensure safety
Providing Care to Those Who are Ill
Most home care agencies have N95 and KN95 masks that filter 94% of small particles to provide safe services to clients
Face shields, gowns, and other equipment also provided by agencies
Arranging for workers to stay home if have had contact of are symptomatic at least 14 days and then having testing. Newest guideline requires two negative COVID tests at least 24 hours apart before returning to work
Some agencies particularly with LPN staff will provide care to active COVID clients
Sometimes, aide services were on hold for active COVID clients but skilled services are still provided (nursing, physical, occupational and speech therapies)
Provider Questions
How are staff being tested and monitored for cases?
– And are there any cases among residents and staff?
– Testing of staff and residents should happen weekly.
How is information on any cases being communicated to care partners?
– Testing results should be available to anyone who asks.
– Notification of all involved parties should be communicated (text, email) immediately.
What are the steps being taken to clean and sanitize?
– Should be a robust procedure for cleaning the facility.
– Should be regularly cleaning high touch areas.
– What are they cleaning with?
– Are there check lists for which areas and how often cleaning is done?
– Who’s doing the cleaning?
– How are staff being trained on procedures? Recommend ongoing training on hand washing, sanitizing and procedures for social distancing. Recommend three times weekly in service training on procedures for hand washing, using hand sanitizer, taking temperature at building entry, check list of all personnel entering the building to clear those without fever, exposure or symptoms.
Creating a Go-Kit with what you need in an emergency
- Cell phone
- Charger
- Glasses / hearing aids
- List of phone numbers
- Copy of advance directives
- List of medications (with dosages and times)
- Copy of insurance ID cards
- Small amount of cash or prepaid debit card
- Book
- Pajamas / underwear
- Hairbrush
- Toothbrush / toothpaste
Transitions to Home from Hospital – Resources to Manage
Medicare home care and changes in protocols for care under COVID-19
- Skilled nursing care
- Home care services
- 30 days, but can be extended if need can be shown
What to expect when arranging for private home care
- Some limitations in staff with multiple language skills
- Maintaining a safe environment at home when visitors come in
Know before you go – the New Normal
Call ahead or look at the website of your destination. Does the business have a policy posted online for keeping staff and patrons safe?
Are they conducting daily health checks of their employees?
Are high touch and public areas being regularly sanitized and cleaned?
Is social distancing being observed when possible?
If patrons are waiting, are guidelines marked for social distancing?
Are employees wearing face coverings when appropriate?
Is hand sanitizer readily available?
Are signs displayed about hand hygiene and stopping the virus?
Are employees enforcing masks, social distancing, and stopping unhygienic behaviors?
If everything looks like it did 6 months ago, ask questions!
The AARP recently published a list of things to do when a loved one dies: