Coronavirus & What Caregivers Need to Know

As the months unfold, we continue to learn more about how the coronavirus pandemic will change the way we live and work.

Older woman walking with walker

If you are a caregiver, the challenges of helping your loved one continue to evolve. Whether your friend or family member lives independently or in an assisted living facility or nursing home, new knowledge and new guidelines for precautions and care are emerging.

This guide contains links to reliable sources and updates the information from experts, such as the Centers for Disease Control (CDC), on recommended precautions and patient care if you or your loved one becomes ill with COVID-19, as well as The Centers for Medicare and Medicaid Services’ new guidance on visiting restrictions in nursing homes as parts of the country re-open the economy.

Torchlight does not provide medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice because of something you read on Torchlight. If you think you may have a medical emergency, call your doctor or dial 911.

Get the facts from reliable sources.

Information about the coronavirus and COVID-19 is still changing frequently. Stories about the spread of the virus and the COVID-19 infection remain headlines in the news and active on social media sites.

Unfortunately, not all sources of information provide accurate and timely intelligence and advice. Follow these recommendations when choosing where to get your information:

Take recommended precautions.

Current data indicate that older individuals, people with chronic conditions, such as diabetes, severe asthma, heart, lung, kidney disease, or obesity, and individuals with compromised immune systems seem to be at higher risk for developing a serious case of COVID-19.

There is still a lot to be learned about how this virus behaves.  The CDC states that “COVID-19 most commonly spreads between people who are in close contact with one another (within about 6 feet, or 2 arm lengths). It spreads through respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes.”. (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.)

Since COVID-19 is transmitted by close contact with infected individuals and possible contact with surfaces, everyone is advised to take precautions to limit exposure to and spreading of the virus. Studies have suggested that COVID-19 may be spread by people before they show symptoms and become ill as well as by people who never develop any symptoms at all.

The CDC recommends that you:

  • Stay at home as much as possible.
  • Cover your mouth and nose with a cloth face cover if/when you must go out in public. (Children under the age of two and anyone who has trouble breathing, is unconscious, or would have difficulty removing it should not use a mask.)
  • Wash your cloth mask after each use, either by hand with a bleach solution or in your washing machine. Air dry completely or on your dryer’s highest setting.
  • Do not use a facemask meant for a healthcare worker. These are still in short supply.
  • Keep a distance of at least six feet between you and other people if you are out in public, even if you are wearing a mask.
  • Stay away from anyone who is sick or has been exposed to the virus.
  • Avoid using public transportation, if possible, including taxis or ride-sharing services.
  • Wash your hands often with soap and warm water for at least 20 seconds, especially after going out of the house into the community. If soap and water are not available, use a hand sanitizer that contains at least 60 percent alcohol.
  • Avoid touching your eyes, nose, and mouth — key entry points for transmitting viruses.
  • Clean and disinfect objects and surfaces that are touched frequently (e.g., mobile devices and telephones, door handles, faucets, microwave controls).
  • Cover coughs and sneezes with a tissue or the inside of your elbow. Throw used tissues in the trash, and wash your hands immediately.
  • Make sure you/your loved one has access to several weeks of your prescription drugs, over-the-counter medications, supplies, and food, in case you need to stay home for two or more weeks.
  • Create a plan to care for your loved one, if you or other caregivers involved become ill or unavailable.

It’s a good idea to have a two-week supply of the following items at home, especially if someone in your home is at greater risk of severe illness:

  • Masks (only needed if ill or caring for someone who is ill)
  • Disposable gloves
  • Laundry detergent
  • Hand soap
  • Trash bags
  • Prescription drugs
  • Over-the-counter medications
  • Groceries (non-perishable is best)
  • Infant supplies, such as formula, diapers, wipes, and baby food
  • Pet food or other pet supplies

If your loved one uses items, such as adult incontinence supplies, chucks, diabetic skin care products, or any other specialty items, consider getting extras to have readily on hand.

Learn what to do if you or a loved one gets sick.

The symptoms of COVID-19 infection can include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Note that this is not a complete list of symptoms.

If you or your loved one develops these symptoms, call your doctor. The CDC recommends that you stay at home, except to get medical care. The doctor will recommend whether you should remain recovering in isolation at home, need to be seen in the office, or should go to the hospital for care.

Many insurance companies (and Medicare) now allow members, during the pandemic, to use their health insurance for telemedicine appointments as they would for in-person visits.

Most people will experience a mild form of COVID-19. If you or your loved one is sick, the CDC recommends that you:

  • Stay home. Most people will experience COVID-19 as a mild illness and should remain isolated at home while they are ill.
  • Avoid close contact with others. If you are not able to be isolated in your home, keep a physical distance of six feet from other household members and stay in well-ventilated areas.
  • Avoid going out in public. Don’t go to work, school, church or other public areas where people gather.
  • Avoid public transit. Don’t use public transportation, ridesharing (such as Uber or Lyft), or taxis, if at all possible.
  • Provide yourself with plenty of rest and supportive care.

Get medical help immediately if you or your loved one has any of the following symptoms:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

Consider these guidelines if you need to care for someone in your home with confirmed or suspected COVID-19:

  • Stay in contact with the doctor to determine if your loved one needs professional medical care or when s/he can come out of quarantine or isolation.
  • Isolate the patient, if possible, with a separate room and bathroom during quarantine. Do not share eating utensils, cups, and other items.
  • Wear disposable gloves and a mask while providing care and handling the patient’s clothing, linens, etc. Remove gloves and mask and dispose of in a lined trash container. Gloves and masks should be used once and then disposed of. These items are typically not designed for multi-use. See instructions for putting on and taking off protective gear ( link: https://cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf).
  • After providing care and removing protective gear, wash hands with soap and warm water for at least 20 seconds.
  • Clean and disinfect surfaces that are touched frequently during care.
  • Wash the patient’s towels, wash cloths, bedding, and clothing as directed and dry on your clothes dryer’s highest setting.

Review CMS’s nursing home guidelines for screening visitors.

On May 18, 2020, the Centers for Medicare & Medicaid Services (CMS) published a document, Nursing Home Reopening Recommendations Frequently Asked Questions (link https://www.cms.gov/files/document/covid-nursing-home-reopening-recommendation-faqs.pdf) to help nursing homes understand when and how to relax the restrictions they imposed in March (link CMS Memorandum 3/4/2020: Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes Ref: QSO-20-14-NH, updated 3/13/2020 (https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf). The new guidelines suggest the following:

Nursing homes should continue to follow CMS and CDC guidance for preventing the transmission of COVID-19. In addition, they should follow state and local direction. Because nursing home residents are especially vulnerable, CMS does not recommend opening facilities to visitors (except for compassionate care situations) until phase three when:

  • There have been no new, nursing home onset COVID-19 cases in the nursing home for 28 days (through phases one and two).
  • The nursing home is not experiencing staff shortages.
  • The nursing home has adequate supplies of personal protective equipment and essential cleaning and disinfection supplies to care for residents.
  • The nursing home has adequate access to testing for COVID-19.
  • Referral hospital(s) have bed capacity on wards and intensive care units.

If your loved one lives in a nursing home, call or check the facility’s website to understand if they are allowing visitors and what restrictions apply. Expect changes to be gradual. For example, homes may start by allowing outdoor visits with social distancing and masks, visits by appointment only, or visiting only when enough staff are available to help manage the use of available visiting areas.

Assisted living facilities do not fall under federal regulation. Their response to the coronavirus will likely reflect their state regulations and recommendations. If your loved one lives in an assisted living facility, check its website, or call to understand the precautions being taken to prevent the spread of the virus and learn about any new measures regarding visitors. It’s likely that these facilities will be making changes similar to nursing homes as required by their state governments.

Continue to take advantage of telephone and video chat applications, such as FaceTime to stay in contact with a loved one if you are unable to visit in person.

Review Medicare changes during the coronavirus pandemic.

If your loved one has Medicare health insurance coverage, be aware that Medicare has made temporary changes to help people get the care they need more easily. Find the full list and description of adjustments on Medicare’s website (link: https://www.medicare.gov/medicare-coronavirus).

Key changes to Medicare coverage include the following:

  • Medicare covers lab tests for COVID-19. There are no out-of-pocket costs.
  • Medicare covers all medically necessary hospitalizations, including the need to stay in the hospital under quarantine.
  • Part D Medicare prescription plans will cover a COVID-19 vaccine, if and when one becomes available.
  • Medicare has temporarily expanded its coverage of telehealth services to help people interact with doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers more easily. Telemedicine includes a range of services from brief “virtual” check-ins, e-visits to online patient portals, or other more extensive telehealth services, especially in rural areas. Usual coinsurance and deductibles apply, but Medicare reports that many providers are lowering their fees for these services.

If your loved one has a Medicare Advantage Plan (Medicare Part C), you have access to the same benefits listed above. Check with your loved one’s advantage plan, if applicable, about changes to coverage and costs and find out how it is accommodating telehealth visits.

Check your back-up plan in case you are unable to care for your loved one.

If you are the primary caregiver for your loved one, plan for the possibility that you, your loved one, or someone else in your family may become ill.

Talk to your manager and/or employer to create a shared understanding of your caregiving responsibilities — especially if you are an essential worker, facing the requirement to work onsite.

Many employers have adjusted their policies around attendance, telecommuting, paid time off, and scheduling when and where it is feasible to do so. Make sure you stay informed about the actions your employer is recommending, as plans for re-opening offices are underway in many parts of the country.

Create a list of your loved one’s medications, pharmacy, physicians, and any special needs, if another family member needs to take over for you. Include contact information for any outside services your loved one depends on.

Determine who will care for your loved one if you become ill or quarantined. Share all necessary documents with the alternate caregiver(s).

Torchlight does not provide medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice because of something you read on Torchlight. If you think you may have a medical emergency, call your doctor or dial 911.

Torchlight does not endorse the organizations or technologies mentioned in this document, but offers their information as a sample of the kinds of materials and services that are available.

Contact Torchlight at support@torchlight.care for more information.