The Next Normal - Staying in Touch

The coronavirus pandemic has made caring for a loved one with an illness or disability even more challenging than it usually is.

Since March 2020, it has been nearly impossible in many parts of the country to visit family or friends who live in a nursing home or assisted living facility. In addition, many family members who live in their own homes remain isolated with little opportunity to spend time with the people they love.

Although many states are re-opening, social distancing and wearing a cloth face covering or mask in public continues to be a requirement in most communities. The CDC warns that distancing recommendations should remain in place when people are in public spaces, and exposure to someone who has COVID-19 requires quarantine.
This guide provides options and suggestions for communicating with your loved one and her local caregivers when you cannot be there in person.

Understand the risk of social isolation.

Social isolation can affect your loved one’s health and sense of well-being. It’s essential to maintain and even increase opportunities to be in contact (safely) as much as possible for both of you! Once you have assessed and addressed your loved one’s material needs (e.g., ensuring an ample supply of household items, food, medications, and other care supplies), it’s time to think about ways to stay in contact and help keep each other’s spirits up.

According to research funded by the National Institute on Aging (NIA), loneliness raises stress hormone levels, weakens immune systems, and contributes to inflammation. In the body, loneliness acts like chronic stress. Continue to assess your loved one’s mood and be alert to changes that indicate that the isolation may be causing more serious problems over time.

If you notice mood swings, uncharacteristic outbursts of anger or sadness, lack of motivation, or increased confusion or memory loss, it may be time for your loved one to contact his or her primary care physician and arrange for some support. Telehealth visits are being covered by Medicare to provide additional mental health support during the pandemic.

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 to help nursing homes understand when and how to relax the restrictions they imposed in March 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. 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 directions. 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 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.

Explore high-tech and low-tech options for staying in touch.

Continue to use telephone and video chat applications, such as FaceTime or Skype, to stay in contact if you are unable to visit in person. Consider your loved one’s technical abilities and a combination of communication methods that are appropriate — landline phones, cell phones, tablets, computers, etc. Increase the number and variety of opportunities for staying in touch:

  • Set up a schedule of calls among several family members to reach out to your loved one regularly at different times. If your loved one lives in a facility and has a phone in his or her room, set up a schedule so s/he can plan to be at the phone to receive calls.
  • Involve the kids. If older children and teenagers are interested, encourage them to call on their own to say hello, share school projects, or just hang out for a short time.
  • Explore video calling options, such as FaceTime, Skype, or Zoom. Most of these have free options.
  • Use your smartphone and/or other applications for texting or sharing pictures, such as What’sApp, Instagram, and Facebook Messenger.
  • Consider purchasing a device designed for less “tech-savvy” individuals. Perhaps a smart speaker, with Amazon’s Alexa, Apple’s Siri, or Google Assistant would be helpful, by allowing voice commands instead of requiring typing. Some companies, for example, Consumer Cellular, have phones and tablets with limited options (to be less confusing), large keyboards, and other design features to address hearing, vision, or cognitive challenges. Have any new device delivered first to you so that you can set it up for your loved one in advance.
  • Send a letter or postcard. Cards and letters in the mail are still great to connect with someone you love. Including photos, kids’ artwork, or other mementos can provide comfort. Your loved one gets the opportunity to feel your presence and hear from you each time s/he re-reads your correspondence.

Communicate regularly with care providers.

If you remain unable to visit a loved one who lives in a facility, find out if it is helping residents to make phone calls or facilitating FaceTime or other video chats. If they are not already doing so, request that a daily update be posted on the residence’s website or sent via email or text to let families know the status of the facility and any changes in plans or routines that families should be aware of. If the facility has a resident family council, contact council members and find out how residents’ families might help each other by staying in touch and reporting on what they know or learn.

If your loved one receives help from a home health aide, contact the agency to learn about any changes it anticipates regarding protocols and practices for preventing the spread of the virus. Verify the arrangements available for back-up care if your loved one’s aide is unable to come and provide services.

If you have hired a private home health aide, reinforce the precautions and practices you and your family member put in place at home, such as handwashing, disinfecting surfaces, etc. Create or review the plan if either the aide or your loved one becomes ill from COVID-19 or comes into contact with someone who has developed symptoms of COVID-19 or has come into contact with someone exposed or otherwise at risk.

Manage your anxiety.

Take care of yourself. The current public health emergency is increasing anxiety and worry for everyone. You may find yourself running on empty sooner than usual with the added stress this pandemic has created.

Let go of perfection.

These are not typical times. We can’t necessarily hang on to our typical expectations without causing ourselves and our families undue stress. Now is not the time to expect perfection in all areas of life. The house might be messier than it usually is. Your child might use more screen time than you’d normally allow. You might struggle to balance parenting and caring for your loved one, with your work; some days you’ll feel more competent in one of these areas than you will in the other. And the next day, the balance may skew in the opposite direction. That’s okay.

Like everyone else right now, you’re doing the best that you can. And the best that you can is good enough.

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.

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