Tag Archives: coronavirus

Nursing homes on the front line of coronavirus outbreak

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Photo by Gabriella Fabbri/Freeimages

Anyone who has ever spent time in a nursing home, whether as a resident, employee or family member, know how easily communicable diseases and infections can spread in such an environment. This includes everything from the common cold to C. diff. The coronavirus is proving to be no exception.

A nursing home in Washington state is considered to be an epicenter for the coronavirus outbreak in the state and in the country. More than 20 residents have died, half of the current residents have tested positive for coronavirus and over 35 percent of staff did not report to work this week because they exhibited symptoms, The Washington Post reported. Those staff members that do come to work are risking their own health for substandard wages. Their desire to continue providing care for the residents during a national health crisis is admirable, but we must do more to support them.

While younger people may only experience mild symptoms with a coronavirus infection, our elders are most susceptible to experiencing severe symptoms that require hospitalization. As government officials and talking heads argue who is responsible for this country’s handling of the coronavirus outbreak, nursing homes across the country are facing a major challenge and the lives of our elder loved ones are at risk.

It’s no wonder why nursing homes are breeding grounds for such an outbreak. You have a community of older people, many with underlying health conditions that can lead to a weaker immune system. Some may have cognitive challenges that make such simple guidance as “wash your hands” difficult to follow. Nursing homes under normal conditions are typically understaffed. Infection control and cleaning protocols may get overlooked or shortcuts may be taken by harried staff or by the corporate office looking to maximize profit.

The coronavirus outbreak may prompt nursing homes to take actions that will help protect residents from a variety of diseases and infections. The spotlight is on them and they may finally be held accountable for deficiencies in care. (The Department of Justice recently launched a National Nursing Home Initiative that will enhance civil and criminal penalties for nursing home companies who provide substandard care.)

The CDC has prepared guidelines for nursing home staff and management to follow in preparing for coronavirus at their facilities. Some other steps nursing homes are taking to limit infection risk:

  • Barring most visitors: While this may seem cruel, it is necessary to limit the risk of infection that visitors pose to residents. Facilities are encouraging residents to use technology, such as Skype calls and the FaceTime app to stay in touch with residents. Phone calls are also encouraged.
  • Limiting or temporary canceling group activities: Limiting the infection risk associated with large gatherings is an important component of infection control.
  • Increased sanitizing of shared surfaces: Any surfaces or objects used by more than one staff member or resident should receive frequent sanitizing.
  • For facilities with confirmed coronavirus cases: Additional steps must be taken, including isolating those who test positive, have meals delivered to rooms versus serving meals in a cafeteria setting, and ensuring staff where proper protective gear when interacting with residents.

If you have a loved one in a nursing home, remain vigilant and ask about what plans the facility has in place to address the coronavirus epidemic. Don’t be afraid to speak up and contact your local health officials if you feel that a facility is not providing the level of care it needs to in order to keep residents safe.

And if you know someone who works in a care center, make sure to reach out to them to show how much you appreciate them. Do whatever you can to support them.

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What dementia caregivers need to know about the coronavirus

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Managing the health of our loved ones with dementia is difficult enough even when we are dealing with the annual flu season. This year has ushered in a new coronavirus, which is causing an outbreak of serious respiratory disease that began in China and has now spread across the globe, including in the U.S. While 24/7 news coverage has caused some to panic and others to go into denial, caregivers should be concerned about the coronavirus, as they would with any virus which is highly contagious and has a higher mortality rate in older populations and those with compromised immune systems.

Here are some tips for caregivers of those with dementia as they encounter a world which has been disrupted by the coronavirus. (Disclaimer: I am not a medical professional. If you have any questions surrounding the coronavirus, please consult a physician.)

  • Symptoms: Those with dementia often can’t clearly express how they are feeling. Their caregivers must be vigilant in tracking any changes in their physical health. According to the CDC, there are 3  main symptoms associated with coronavirus: fever, cough, and shortness of breath. Emergency symptoms include difficulty breathing, chest pain, new confusion separate from dementia, and bluish lips or face.
  • How it spreads: The CDC believes that the coronavirus spreads easily, primarily by person-to-person contact. The CDC recommends not touching your face, covering your mouth when sneezing or coughing, frequent hand washing, and frequent disinfecting of commonly used surfaces and objects. Caregivers will want to pay special attention to their own health, and make contingency plans now for who will take care of your loved one if you contract the coronavirus.
  • For those with dementia who are diagnosed with coronavirus: If they have a mild case that does not require hospitalization, you will want to keep them isolated at home, separate from other family members. Those with dementia are often sensitive to any changes in their routine, so you may need to get creative in explaining these changes to your loved one. Use your best judgment, but it may  be best to avoid potentially frightening words like “quarantine.” Try to involve your loved one in tasks they enjoy, such as puzzles, crafts, or listening to music or watching TV. Keep your loved one comfortable and monitor for any spikes in symptoms; unless it’s an emergency, call ahead if you need to visit the doctor.
  • Keep public outings to a minimum: You may want to keep public outings to a minimum until the coronavirus outbreak is under control in your community. It can be a challenge to manage the movements of those with dementia in public settings and they may not comprehend or forget instructions such as hand washing.
  • What about facemasks? The CDC does not recommend facemasks for those who are healthy. For those with coronavirus and their caregivers, facemasks are recommended. It may be a challenge to keep a facemask on a person with dementia, which is why it’s so important for caregivers to wear masks and to isolate those who are ill so they cannot spread the disease.
  • What can caregivers do to prepare? Plan now for a potential outbreak in your community. Stock up on supplies, including food, hygiene, and basic medical supplies. Make sure prescriptions are filled. If your loved one is used to attending activities such as adult day care, create alternative activities at home. Make a contingency plan in case you become sick. Contact your support network and develop a specific coronavirus plan. Reach out to public health agencies in your area for further aid.

It is too early to know how much of an outbreak of coronavirus we will experience in the U.S. I do think it’s going to get worse before it gets better. And if history is any indicator, there may be additional outbreaks that arise in future seasons, so caregivers should remain vigilant even if there is a lull in the summer. Take proper precautions for your loved one with dementia and yourself, and we should be able to weather this storm.

Next week, I’ll discuss the challenges that nursing homes are facing in trying to prevent coronavirus outbreaks in their communities.

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