Your New Role: Caregiver
As a caregiver, you have the responsibility of taking care of a family member, a friend, or patient with COVID-19. Follow this advice to take care of yourself and others. Everyone’s circumstance is different. You may also be working, working from home, self-employed, or not working at all. Caregivers may likely have other responsibilities such as caring for other adults, children, pets. This post will offer guidance from an occupational therapist’s perspective for taking care of a COVID-19 patient in home quarantine.
Monitor for Symptoms
- Know and monitor for the latest COVID-19 symptoms.
- More importantly, monitor for symptoms that get worse.
- A case of COVID-19 changes from mild to moderate when the patient develops shortness of breath.
- For most people, symptoms last a few days, and people usually feel better after a week.
- Follow the doctor’s recommendations for care.
- Know when to call the doctor vs. visit an emergency room.
- *Some symptoms include*
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake or stay awake
- Bluish lips or face
Designate a Quarantine Room
- The best plan is to have the patient remain quarantined in a room, preferably with their own restroom and shower.
- Except for a medical emergency, patients that remain symptomatic should remain quarantined in the room as long as recommended by the CDC.
- Patients should have a reliable method of communication, e.g., cell phone, charger, laptop.
- Caregivers can assist with bringing food, fluids, medicine, and laundry.
- List of items patient should have:
- Phone & charger
- Pulse Oximeter
- Warm Blankets
Clean High-Touch Surfaces
- In your home, it may be inevitable that some commonly touched surfaces need to be shared. This may include doorknobs, handrails, light switches, handlebars for refrigerators, faucets, toilet flush handles, and toilet seats.
- Reflect on what surfaces are touched most frequently in your home and write this down on the to-clean list.
- Clean these surfaces with disinfectants frequently.
- If you must touch this surface, do not touch your face and wash your hands or use hand sanitizer immediately.
- Pro-Tip: Use sticky notes to distinguish where the patient and other family members should touch.
Minimize Aerosolized Spaces
- The best way to avoid infection is to minimize exposure to aerosolized spaces.
- What are aerosolized spaces? When a patient coughs or sneezes (some reports of even talking), it is possible that the virus is expelled and becomes suspended in the air for several seconds or more – even after they have left the room. When a family member breathes this air and enough virus is inhaled, they could become infected. This is an area of debate for research, but it is best to take maximum precautions to avoid infection of family members.
- Wait a certain period, the longer the better before entering this space. Before entering this space, don a N95 or better face mask as well as eye protection such as goggles. A regular face mask or cloth mask likely would still allow the aerosolized particles to pass through the barrier, however a N95 offers additional protection.
- Wear gloves when working in this space and after you dispose of them, wash your hands.
- Minimize the time spent in the aerosolized space.
- Opening windows will help with airflow and minimize exposure.
- If you have an HVAC system, you may want to reconsider using it if it is designed to recirculate air which could cross-contaminate rooms.
- Plan ahead about why you and the patient are in the space and problem solve how you can reduce future time spent in this space if possible.
- Of course, some spaces such as only have one restroom would make this more difficult compared to having multiple restrooms.
- Most homes only have 1 kitchen, and this is most likely the space that must be shared. Perhaps you can arrange for the patient to not utilize the kitchen and have them eat meals in their room instead.
Visitors, Children & Pets
- Avoid having visitors over.
- For special circumstances, you can arrange for an outside “window” visit; virtual screen-time methods would be ideal.
- The research is still uncertain about whether children and pets can get and transmit the disease. It is best to be overly cautious and limit their exposure to the “sick” space and COVID-19 patient as well.
- Pets should be arranged to be taken care of by other caregivers.
- Pregnant caregivers should avoid cleaning litter boxes (toxoplasmosis).
- Provide adequate lighting (night lights) for nighttime bathroom use.
- Lock doors and windows at night.
- Clear pathways in case of fire or medical emergency.
- Have a backup plan for someone to take care of pets and children.
Finances and Future Planning
- You may want to consider discussing who the decision-maker will be, code status (resuscitation orders), and management of finances. COVID-19 can take a quick course for older patients with comorbidities.
- It is best to be prepared than to be caught off guard – especially if the patient takes a turn for the worse and is unable to make medical and financial decisions.
- With the patient’s permission, assist them in filing for unemployment insurance (through the employer, the State, or both) and other benefits they are eligible for (short-term disability, leave of absence).
- Find out if the employer requires that the patient must exhaust their PTO.
- If the patient got infected at work, they may have a worker’s compensation case.
- Find out what benefits the patient has, then call HR for guidance on their behalf. Most claims can now be filed online, but you should call first to learn about available options.
- If applicable, found out about the patient’s return to work requirements. This likely would involve two negative COVID-19 tests, a telehealth visit with a doctor, and their note allowing the patient back to work. This will need to be cleared with HR or employee health as well as the patient’s supervisor.
- Timeframes may be a minimum of 2 weeks being symptom-free before being allowed back to work, but each employer may have specific requirements.
- As a caregiver, you may be eligible for benefits if you miss time from work as well. These benefits may be offered by your employer, the state, both, and possibly federally. Things with COVID-19 are constantly changing so this will require some research as we cannot detail that in this post.
COVID-19 can be a very stressful and anxious time. The mental health of both you and the patient can be important. As you can imagine, being quarantined to a single space for a long time can cause anxiety and depression due to social isolation. Check-in with the patient for signs and risks – including suicide ideation.
- National suicide prevention hotline – 1-800-273-8255
- Remove items that can be used for self-harm such as knives, sharps, and firearms from the patient’s reach.
- Check-in frequently with the patient.
- CBT (cognitive behavioral therapy) can be an effective tool to help with negative thoughts. CBT-i can also be useful for disrupted sleep and insomnia.
- If you find yourself or the patient going down a path of negative thoughts, use the STOP technique.
- S – Stop and pause a moment.
- T – Take a breath. In & Out – notice your breathing.
- O – Observe your thoughts and what you are reacting to.
- P – Pull back into perspective. Don’t believe in everything you think. Take a helicopter view. What is another way of looking at this situation? Practice what works. It will pass.
- Other useful ways to manage stress:
- Play relaxing music.
- Use Distractions: games, movies, coloring books, knitting.
- Play social games (Laptop, Mobile, iPad, Video game consoles) with the patient even if you are in different rooms.
- Bond with the patient – have a nice conversation.
COVID-19 is a stressful time for the patient and caregiver. Plan ahead, follow the plan, and stay positive by managing both your own and the patient’s mental health.
Stay safe everyone!