Covid 19 Protocol

An Infection Control Module:
Understanding Coronavirus

INSTRUCTIONS FOR THE LEANER

If you are studying the ins inservice on your own, please do the following:

  • Read through all the material. You may find it useful to have a highlighting marker nearby as you read. Highlight any information that is new to you or that you feel is especially important.
  • If you have questions about anything you read, please ask your supervisor.
  • Take the quiz. Think about each statement and pick the best answer.
  • Check with your supervisor for the right answers. You need 6 correct to pass!
  • Print your name, write in the date, and then sign your name.
  • Enail in the Know at [email protected]

We hope you enjoy this inservice, prepared by registered nurses especially for caregivers like you!

After finishing this inservice, you will be able to:

  • Describe the new coronavirus (COVID-19) and discuss where it came from.
  • List the signs and symptons of COVID-19.
  • Describe the infection control precautions that should be followed to prevent the spread of COVID-19.
  • List the steps to take if you or one of your clients begins to show symptons of coronavirus.

WHAT’S HAPPENING?

  • Worldwide (as of March 20, 2020) more than 250,000 people have become infected by a new strain of coronavirus
  • More than 10,000 have died
  • Schools, colleges, and places of worship around the world have closed in an effort to contain the virus.
  • Tourism is discouraged to certain countries and tourist hotspots sit eerily quite.
  • Entire countries in Europe are on lockdown.
  • The virus has now infected nearly 15,000. Americans in all 50 states. Over 200 Americans have died.
  • Nursing homes across the US have now shut their doors to visitors.
  • Hundreds of flights have been cancelled and travel between the US and parts of Europe has been banned.
  • Events that attract large gatherings of people are postponed or canceled.
  • Hospitals are preparing to be overrun by the surge in new cases to come.

And unfortunately, it’s propably going to get much worse before it gets better.

Please note:

The guidance in this course is based upon limited information becomes available. We will continue to update the course until COVID-19 is no longer a threat.

WHAT EXACTLY ARE CORONAVIRUS?

Coronaviruses are a family of viruses that can infect both humans and animals. The first human coronavirus popped up in the mid-1960s. To date, there are seven(7) coronaviruses that can infect people.

The newest(2019) coronavirus (aka COVID-19) was first detexted in China in late December, 2019.

You may also hear the virus referred to as “Novel Coronavirus” because:

  • NOVEL = NEW (never seen before).
  • CORONA = CROWN (named for the crown-like-spikes on the virus).

Other coronaviruses you may have heard of include:

  • SARS (Severe Acute Respiratory Syndrome), and
  • MERS (Middle East Respiratory Syndrome)
Where did COVID-19 come from?

Experts believe the newest coronavirus probably began in an animal in China. Both MERS and SARS originated in bats. Many of the first people to become sick from COVID-19 in China either worked or shopped at a live-animal market. So, while the exact source is still unknown, researchers are fairly certain the virus was spread from animals to humans. The virus was then able to transmit from person to person, without animal contact.

Who is at risk for infection?

Older adults who have other medical conditions, such as obesity, heart disease, diabetes, or lung disease continue to be at the highest risk of serious illness from an infection with the COVID-19. But no one is immune.

The CDC just released a new estimate that 20% of cases the require hospitalization are 20 to 44 years old. And 12% of those younger adults require intensive care.

 

THE FACTS

  • The number of active COVID-19 cases grows each day, and it’s likely going to get worse before it gets better.
  • One reason for the increase in cases being diagnosed is the increase in testing. Before the test was widely available, it’s likely people had the infection without even knowing it.
  • There is currently no vaccine or cure for COVID-19, but researchers are working hard to makes these available ASAP.
  • About 81% of people who become infected will have a mild case and fully recover without complications.

WHAT ARE THE SYMPTOMS OF COVID-19?

COVID-19 causes a range of symptoms in those infected. The following symptoms may appear 2-14 days after exposure:

Severity Signs & Symptoms
Asymptomatic No symptoms at all.
Mild Mild cold-like symptoms, such as stuffy or runny nose, cough, sore throat, or achiness. Some people have also reported mild diarrhea.
Severe Fever, cough, shortness of breath, breathing difficulties; may progress to pneunomonia.
Critical Respiratory failure, septic shock, multiple organ dysfunction or failure, and even death.
What should you do if your client shows symptoms?

Contact a doctor right away if you notice any of the symptoms listed above, especially if your client has recently travelled or has been in contact with someon who is known to have the virus.

What should you do if YOU show symptoms?

Caregivers who have signs and symptoms of any respiratory infection should not report to work.

If you develop signs and symptoms while on-the-job:
  • Immediately stop work, put on a face mask, and plan to self-isolate at home;
  • Contact your supervisor so arrangements can be made to cover the client as necessary;
  • Inform your supervisor of all individuals, equipment, and locations you came in contact with; and
  • Contact and follow your local health department recommendations for next steps.

SHOULD YOU WEAR A MASK?

You SHOULD wear a mask if…

  • You are a healthcare worker providing close, personal to clients.
  • You have symptoms of COVID-19.

You SHOULD NOT wear a mask to…

  • Protect yourself from COVID-19 in public places.

The general public is not advised to use face masks for protection against coronavirus.

WHAT DOES SOCIAL DISTANCING REALLY MEAN?

Social distancing, self-quarantine, isolation, and shelter-in-place are all terms commonly used these days. You’ll hear them from politicians, newscasters, and maybe even your own family. But, what do they mean? How are they different?

Here’s a breakdown of what these terms mean to you:

Social distancing – Social distancing is when we purposely increase the space between people. Staying at least six feet away from other people can dicrease your chances of catching COVID-19. Why six feet? Because that is how far the coronavirus droplets can travel when someone near your coughs or sneezes.

Social distancing will not stop the spread of coronavirus, but it can slow it down so that fewer people get sick all at once.

How do you maintain social distance during personal care with clients?

That’s the tricky part. If you provide personal care for clients, you must get closer than 6 feet to interact with them.

Here are a few suggestions:

  • Wash your hands and put on gloves before coming in contact with the client.
  • Wear a mask for close contact with clients, even if you don’t have symptoms. You can still carry and pass the virus to others even if you don’t feel sick.
  • If the client has symptoms, put a mask on the client.
  • Limit talking while in close contact with clients.
  • Turn your head or walk away (if it’s safe to do so) to cough or sneeze
  • Perform personal care quickly and efficiently to minimize the time you are in close contact.
  • Wash your hands after removing gloves.
  • Encourage clients to wash their hands frequently throughout the day
More Terms to Know
  • Self-Quarantine – This is when you voluntarily dtay in your own home to stay away from others for a period of time (such as two weeks) during the outbreak of a contagious disease.

    – If you feel the need to self-quarantine, let your supervisor know. Ask if there are other tasks you may be able to do from home, such as make phone calls to clients or pack supplies for other caregivers.

  • Isolation – Isolation is required for anyone confirmed to have COVID-19. It’s the only way to keep people who are infected with the virus away from those who are not infected. People can be isolated at home if their symptoms are mild. Hospitals have special “isolation rooms” for people who need more care.

    – If you are asked to care for a client in isolation, be sure you understand how to use standard and transmission based precautions. Click here for instructions on putting on and taking of PPE in isolation situations.

  • Shelter-in-Place – Several cities across the US have issued “shelter-in-place” or “stay at home” orders. This means residents in those areas must remain at home unless they have an essential reason for going out. Essential reasons to go out include getting food or medicine and going to work.

    – In the cities where this order is in place, all travel is prohibited. Residents cannot wallk, bike, drive, or use publick transportation unless their travel is considered “essential”.

HOW TO PREVENT SPREADING THE VIRUS

There are two ways to prevent the spread of infection:

  • Prevent yourself from getting sick, and
  • Prevent others from catching the virus from you.
To prevent yourself from getting sick:
  • Wash your hands often with soap and water (preferred), or use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth if your hands aren’t clean.
  • Avoid close contact(within 6 ft.) with anyone who is sick.
  • Avoid crowded places such as sporting events, concerts, or religious gatherings.
  • To keep your immune system strong, get enough rest, eat a balanced diet, and perform some type of exercise each day.
To prevent other from catching the virus from you.
  • Stay home from work, school, and public areas if you’re sick, except for medical visits.
  • If you must leave the house for a medical visit, call the doctor in advance and wear a face mask to protect others with whom you may come in contact.
  • Separate yourself from other people and animals in the home as much as possible. In other words, try to stay in a separate room with the door closed.
  • Cover your mouth and nose with your elbow or tissue when you cough or sneeze. Or use a clean tissue, then throw it away and wash your hands.
  • Clean and disinfect surfaces your touch frequently
  • Avoid sharing dishes, glasses, bedding, and other household items if you’re sick.

HOW DOES IT SPREAD?

There are two ways COVID-19 is spread:

  • Person-to-person: The virus is thought to spread mainly from person-to-person between people who are in close contact with another. Droplets produced when an infected person coughs or sneezes can travel up to 6 feet away. These droplets can land in the mouths or noses (or become inhaled into the lungs) of people who are nearby.
  • Contact with infected surfaces: Droplets from infected person can also land on surfaces or objects. When an uninfected person touches the surface or object thay has the virus on it, then touches their own mouth, nose or eyes, the virus enters the uninfected person.

A study published February 6, 2020 in The Journal of Hospital Infection found that coronaviruses can stay on surfaces such as metal, glass or plastic for as long as nine days.

HOW IS COVID-19 TREATED?

There is currently no specific treatment for COVID-19 infection. Supportive measures are recommended depending on the type and severity of the symptoms. Guidelines are as follows:

Severity Supportive Measures
Asymptomatic
  • Contact a doctor (and follow the doctor’s orders).
  • Follow isolation precautions.
  • Monitor for symptoms.
Mild
  • Contact a doctor (and follow the doctor’s orders).
  • Follow isolation precautions.
  • Monitor for worsening symptoms. The CDC reports, “some observations suggest that respiratory symptoms may worsen in the second week of illness
  • Get plenty of rest and fluids.
  • Tylenol or Motrin can ease discomfort associated with mild, cold-like symptoms.
Severe
  • Get emergency help for difficulty breathing
  • Hospitalization is likely required.
  • Follow isolation precautions.
Critical
  • Life-saving measures are required at this stage.
  • Isolation precautions remain.

HOW TO DISINFECT SURFACES

In homes, the CDC recommends, “routine cleaning or frequently touched surfaces (tables doorknobs, light switches, handles, desks, toilets, faucets, sinks).”

Other recommendations from the CDC include:

  • Wear disposable gloves while cleaning and discard after each use.
  • Prepare a bleach solution to use on hard surfaces by mixing 4 teaspoons bleach per quart or water
Learn More!

See section called “Frequently Asked Questions about Cleaning During the COVID-19 Crisis” later in this lesson for more information.

FAQS ABOUT CLEANING DURING THE COVID-19 CRISIS

Can coronavirus droplets survive on clothing?

  • The World Health Organization remains uncertain about how long the coronavirus lives on surfaces, but initial testing indicates that it may survive on surfaces for a few hours or up to a few days.
  • However, scientists at Harvard found that the virus is more likely to survive on hard services, lke plastic and steel, than on softer ones like slothing fabric. Still, experts suggest that you remove your shoes and change out your work clothes to prevent outside germs from coming into your home.

To combat the virus, what’s the best practice for doing laundry?

  • The CDC recommends washing your own clothes using the warmest appropriate water setting, making sure to dry them completely. They also suggest cleaning and disinfecting clothes hampers. Better yet, if possible, use a disposable bag to line the hamper.
  • When you are on the job, follow standard precautions for handling your client’s laundry. Wear disposable gloves. To reduce the chances of spreading the virus through the air, never shake dirty laundry. Be sure to remove your gloves properly (to avoid axposure to germs) and throw them out after each use. Then wash your hands.

Does it matter what type of soap I use to wash my hands?

  • Fortunately, no, the type of soap does not matter. And, remember, since COVID-19 is a virus, there is no advantage to using antibacterial hand soap. The most important thing is to wash your hands for atleast 20 seconds so that the combination of the soap and the friction of your hands rubbing together disrupts the germs.

I always have my cell phone with me when I care for clients. Do I need to clean it?

  • Yes, experts recommended that you clean your cell phone regularly. Since you can’t use soap and water on a phone, they recommended something like a Clorox or ethanol wipe – something with atleast 70% alcohol. Be sure to clean the back and sides as well… but avoid the ports.
  • However, DO NOT use a wipe that contains bleach as it may ruin the surface of your phone. If your are unable to find wipes, try filling a spray bottle with rubbing alcoholo. Spray the phone carefully, avoiding getting any liquid in the ports. Whatever cleaner you use, just make sure it has time to sit and work its magic before you wipe it off with a signle use cloth.

NOTE:

Your best bet to protect your phone from harsh cleaners may be to first put a screen protector on your screen.

MORE FAQS ABOUT CLEANING DURING THE COVID-19 CRISIS

Is there a difference between cleaning and disinfecting?

  • Yes! Cleaning removes germs, dirt, and impurities from surfaces, lessening the risk of spreading infection by reducing the number of germs. However, cleaning does not kill germs.Disinfecting involves using chemicals to kill germs on surfaces.

    Your best bet to lower infection spread is to first clean a surface and then follow up by disinfecting it.

    For clients who are isolating at home (and in your own home), the CDC suggests cleaning and disinfecting high-touch surfaces daily in household common areas. These items include counters, tablets, hard-backed chairs, doorknobs, light switches, remotes, handles (such as the refrigerator and microwave handles), desks, toilets, and sinks.

What products can I use to disinfect surfaces in my client’s homes (or my own home)?

  • Firt, remember your standard precautions. Wear gloves while cleaning and disinfecting client areas. When you are finished, remove them properly, dispose of them, and wash your hands. NOTE: At home you don’t have gloves, be sure to wash your hands before and after you clean.If surfaces are dirty, CLEAN them first by scrubbing with soap/detergent and water. Then, if possible, Disinfect. You can use a diluted bleach solution, and alcohol solution with at least 701% alcohol or one of these CDC-approved disinfectants:www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf (In general, look for sprays or wipes that promise to kill 99.9 percent of germs). Be sure to follow the manufacturer;s instructions on the container.

    You can prepare a bleach solution by mixing 4 teaspoons of bleach to one quart of water. However, please remember to:

    • Check the expiration date on the bottle of bleach. If it has expired, it will not be effective against the coronavirus.
    • Ask your client or a family member if any househo surface will be harmed by bleach, For example, some laminate countertops will discolor if cleaned with bleach.
    • Never mix household bleach with ammonia or any other cleanser, including vinegar. It may create a poisonous gas.
    • Be sure to label the bleach solution container and keep it away from children adults with dementia or Alzheimer’s disease.

MANAGING ANXIETY AND FEAR OVER COVID-19

The COVID-19 scare has many people on edge. And all of its effective on society, such as schools closing, the stock market crash, and declared states of emergency can cause extreme anxiety.

Non-stop coverage in the media, misinformation on social media, and the general uncertainty of where all this is going can make matters worse.

  • Experts advise that anxiety is a normal protective human response. It’s when your brain scans your body and the environment for potential threats so that you can get prepared to react, if necessary.

The problem is that stress and anxiety can easily spiral into panic. Panic is NOT productive.

  • For people who already suffer from anxiety, the loudest message coming through is that everyone is powerless to an invisible threat that the potential to a devastate individuals, families, and even entire communities. This fear can lead to irrational behaviors such as fixating on handwashing or wearing a mask when it’s not necessary to do so.
  • On the other side of the spectrum, there are those who refuse to see the virus as a threat at all. They may block it out completely, downplay the risk, and even ignore basice advice to wash hands and avoid public gatherings.
  • Both of these are stress-related responses. And neither is productive. Problems can arise when stress spirals out of control and leaves a preson to obsess over protective measures – or ignore them altogether.

The healthiest response lies somewhere in the middle of these two extremes!

If you, or someone you know seems to suffer from one of these stress responses, here are five easy steps that can help stress and anxiety at a healthy level:

  1. Try to stay “in the moment.” Anxiety can spiral out of control when your mind begins to predict catastrophic future events. Just know that all you can do is take measure to protect yourself from what is happening right now. You can’t predict the future.
  2. Stay informed but know when to turn off the news (and log out of social media). It’s important to stay up-to-date and know the facts. You should tune in for that. But there’s a point at which news and social media stop being helpful. You could spend hours listening to headlines or scrolling tweets for alerts, but none of that maker you any safer.
  3. Get prepared. Don’t feel silly, weak, or embarrassed to follow reasonable safety advice from trusted sources. In fact, feeling prepared can give you a sense of control, which can also decrease anxiety.
  4. Practice self-care. Get a good night’s sleep. Eat a balanced diet. And get a little bit of exercise each day. These things help boost your immune system and can help decrease anxiety as well.
  5. Reach out for help if you need it. There is no shame in reaching out to a friend, family member, your doctor, or even a mental health expert if you feel your anxiety spiraling out of control. Help is available. You are not alone.

MYTHS & FACTS SURROUNDINGS COVID-19

MYTH: You should stay away from people of Asian descent because they are more likely to have the virus.

FACT: Anyone, no matter their ethnicity, can become infexted by COVID-19.

MYTH: Products shipped from China may contain the virus.

FACT: It’s not likely that the virus could survive that long on a package, especially after it goes through the extreme temperature changes that occur during an international flight.

MYTH: A face mask will protect you from COVID-19.

FACT: Professional, tight-fitting respirators (such as the N95 mask) can protect health care workers as they care for infected patients. In the general public, a lightweight disposable surgical mask will not protect you from the virus. They don’t fit tightly and may allow tiny infected droplets to get into the nose, mouth or eyes.

MYTH: A coronavirus test costs $3,000 in the United States.

FACT: The U.S Food and Drug Administration has authorized the use of two tests – one from the Centers for Disease Control and Prevention and one from the New York State Department of Public Health – and neither agency charges patients for the test.

MYTH: Spraying alcohol or chlorine on your body can kill the new coronavirus.

FACT: Spraying alcohol or chlorine on your body canot kill viruses that have entered your body. These chemicals can also be harmful to clothes, skin, or mucous membranes such as eyes or mouth.

MYTH: Vaccines against the flu and pneunomonia can protect you against new coronavirus.

FACT: Neither the yearly vaccine against the flue nor the pneumococcal vaccine against pneunomonia provide protection against the new coronavirus.

SUDDENLY, YOU’RE A CAREGIVER…

Like many family members across the country, you may find yourself caring for a loved one who normally benefits from the services of a professional caregiver. Perhaps, due to the coronavirus:

YOU ARE WORKING FROM HOME.

You may have requested that home care services be paused since you are at home with your loved one all day anyway.

THE AGENCY IS SHORT ON CAREGIVERS.

Home care agencies are feeling the pinch because many caregivers have children who are now out of school, severely limiting their work schedules.

YOUR LOVED ONE IS CAUTIOUS ABOUT ANYONE VISITING.

Your loved one (or you) may be restricting visitors to the home in an effort to reduce the spread of infection.

IT CAN BE DIFFICULT TO STEP INTO THE SHOES OF A CAREGIVER!

You may suddenly be responsible for your loved one’s:

  • Personal care, including bathing, mouth care, grooming,Dressing, and toileting.
  • Mobility, such as encouraging daily “strolls” around the house, range of motion exercises, or simply changing positions in bed.
  • Transferring the person from the bed to a chair to a commode…and back again.
  • Diet, including any special diet prescribed by the physician or a nutritionist.
  • Health and wellness…watching for any changes in the person’s condition and/or symptoms of the coronavirus.

Over the next few pages, we’ll provide some tips and resources to guide you through caring for your loved one during the coronavirus crisis.

BASIC CARE TIPS FOR FAMILY CAREGIVERS

START WITH THE CARE PLAN

If your loved has been under the care of a professional caregiver through an agency, you should have access to the care plan that was developed just for him or her. In most states, a copy of the Care Plan must be left in home. If you are unable to locate it, reach out to the agency to request a copy.

WHAT’S IN THE CARE PLAN?

The care plan should list all the task the caregiver does for or with your loved one. Examples of tasks may include helping with bathing, preparing meals, and housing duties. Try to keep the same schedules as the caregiver, if possible. The situation may be stressful for your loved one. Keeping a connsistent schedule can ease some anxiety.

HELPING WITH PERSONAL CARE

Bathing Tips

Bathing is important bacaus it prevents infections, controls body odor, promotes comfort and stimulates circulation. Depending on your loved ones’s abilities and care plan, you may give a:

  • Bed Baths. This type of bath is for people who can no longer get ou of bed/
    • How do you do it? Gather all the supplies and place them within reach of the bed. Close any doors or windows to avoid drafts. To ensure both warmth and privacy, cover the person with a light contton blanket. Uncove, wash, and dry only a small part of the body at a time.
  • Tub Bath. This type of bath is only for people with good posture, balance and mental alertness.

    • What do you need to know? Dont attent to help anyone in or out of a tub unless you feel secure about your ability and/or you have the proper equipment (like a lift or slide board).
  • Shower. A shower is best for people who are “independent”. It can be done standing or by using a shower chair, if available

    • Best Practice: Be sure to place a rubber mat on the shower floor – but dont’t cover the drain opening. Stand close by, while still providing privacy.
Mouth Care

Having a healthy mouth helps your loved one feel better, have a healthier appetite and eat more balanced diet. Here are a few ways you may need to help:

  • Encourage or Remind: Your loved one may just need a reminder to brush his teeth or take care of his dentures independently. Remind him or her to brush at least once a day using a soft toothbrush. It even better to brush after every meal!
  • Set-up Supplies If your loved one has mobility problems, you may need to set up and arrange her toothbrush, toothpaste, water and towel within easy reach. if more help needed, wet the tootbrush with water and put the toothpaste on the toothbrush. Provide a basin for the person to spit.
  • Perform the Task for the Person. Someone who is confused, completely immobilem in a coma, or in the end stage of life will need you to perform the oral care task for him. An unconscious person may need oral care every 2 hours. Gently swab the teeth, gums, inside of cheeks and tongue with a soft brush or a “toothette” if available.
  • Denture Care. Dentures need to be removed from the mouth, rinsed, brushed with a denture brush and dentures paste and soaked overnight.
Toiletting Tips

There’s no way around this one! Everyone has to eliminate! Depending on your loved one’s abilities and care plan, toiletting may involve:

  • Clearing a Safe Path For people who are independent and mobile, your only involvement in toiletting may be to make sure the path to the bathroom is clear and clutter free.

    Good Ideas!

    Remove any area rugs that slide or move. Make sure there are no electrical cords crossing the path. Leave a nightlight on at night to light the way from the bedroom to the bathroom.

  • Using a Urinal (for men): Urinals are a handy option for immobile males.

    Best Practice:

    If possible, encourage your loved one to sit on the side of the bed to use the urinal.

  • Helping with a Bedside Commode: If your loved one can get out of the bed with or without help, a bedside commode may be used.

    Best Practice

    Keep the commode near the bed and clean it after each use to eliminate unpleasant odors. Adjust the legs of the commode so that the user’s feet plant firmly on the ground during elimination.

Dressing and Grooming Tips

For people who have physical or mental impairments, dressing and grooming task are often difficult to manage alone. That’s where you come in. You can help your loved one feel good about his or her apperance by:

  • Healping to Choose Clothing: Encourage your love one to choose what to wear, if able, to preserve independce and control.
  • Laying Out the Clothing. If your loved one has a diagnosis of dementia or alzheimer’s disease, he or she may have trouble making choices. In this case, you might limit choices to just two items or choose the clothing and lay it out for the person.
  • Assisting with Dressing: Peole with physical impairments, like paralysis after a stroke or stiff joints from arthritis, may need you to assist with dressing. Best choices are items with elastic waistband and no buttons or zippers.
Helpful Hair Care Tips

It can be particularly upsetting fo an adult child to see his or her mother with a wild-bedhead-hairdo, especially if, in the past, she was a stylish woman who always took special care of her appearance. How can you help with your loved one’s hair?

Here are few tips:

  • Most people only need their hair washed once a week. Dry Shampoos are a good option for individual who are less mobile.
  • If your loved one spends a lot of time lying on her hair in bed, then use a silk pillow case or try having her sleep in a hair net to minimize tangles.
  • Women with long hair may need a shorter hairstyle. If a shorter cut is not an option, then braids or abun can help tame a wild style!

HELPING WITH MOBILITY

Ambulating (Walking)

Ambulate means to walk. Ambulating keeps people active and improves muscle tone and strength. It can also slow down the process of bone density loss. Other benefits of ambulation include better digestion, circulation, self-esteem and greater independence.

Every time you get your loved one up and moving, it’s important to follow these basic safety guidelines:

  • Always clear the walking path of area rugs, furniture, wires and clutter before getting your loved one up to ambulate.
  • Allow the person to sit on the edge of the bed and dangle his or her feet for a few minutes before standing. This will minimize the dizziness the person may have as a result of rising too quickly.
  • Be sure he or she has socks and nonskid shoes on before ambulating. Does your loved one have a “weak side” and use a cane or a walker? If so, walk on the client’s weak side, and slightly behind him or her.
Range of Motion Exercises

You know the old saying use it or lose it’? That’s what it’s like with mobility. People who keep moving maintain mobility. Those that stop, lose it.

One way to maintain mobility is by doing range of motion exercises. People who have full range of motion have the strength, balance and coordination to move in many different ways.

You may want to try some very gentle joint rotation exercises.

  • Joint rotations are performed to help warm and loosen up the joints.
  • These are slow circular movements, performed in both clockwise and counterclockwise directions.
  • This rotating motion is usually the best way to prepare for other forms of exercise—including range of motion and walking.

Remember to exercise each joint … shoulder, elbow, wrist and fingers! Rotate each joint, very gently, both clockwise and counter clockwise.

Helping Your Loved One Remain Flexible
  • A fun way to exercise the wrist and finger joints is to have your loved one make shadow puppets. (Remember how to do that? Make your hands into shapes that show up as shadows on the wall.)
  • Another way to exercise hand and finger joints is to have the person squeeze a washcloth or sponge while soaking their hands in a basin of warm water. This is especially good for people who have arthritis in their hands.
  • Movement that occurs during daily activities helps keep joints flexible. For example, Mrs. Taylor uses her shoulder, elbow, wrist and finger joints to brush her hair every day. If your loved one is independent and/or active in their personal care, they’ll have a better chance of staying flexible.
Frequent Position Changes

If your loved one has limited mobility, is or uses wheelchair, its important to assist with frequent changes of throughout the day. This helps prevent putting too much pressure on the honey areas of the body…such as the ones pictured here:

  • The physician may have ordered that your loved one change position at a specific frequency. If not, the best practice is that he or she around every two hours.
  • If your loved one spends a lot of time in bed, consider using the “turn dock” system. The dock (pictured below) serves as a reminder that at each two-hour interval, your loved one should be m-positioned according to the position indicated on the dock. For example, from 12:00to 2:00the person should be positioned on his or her back; from 200 to 41)0 on the right side; and so forth.
  • Post the graphic below in a highly visible spot, then follow the dock so you know what positions were used and when the cycle can be repeated.
  • Use pillows and pads to help position your loved one comfortably in their bed or chair. Place extra pillows so that they minimize pressure on bony parts of the body.
  • If your loved one uses a wheelchair, remind him or her to sit upright. Sitting with good posture will allow the person to switch positions with greater ease.
  • Encourage your loved one to shat positions every 15 minutes- if able. Position changes am very important for preventing pressure ulcers.
  • Does your loved one have an issue with incontinence? If so, try to keep the person as dry and clean as possible. It is extremely important to stay dry to prevent pressure ulcers. Wet skin can become brittle, making it tear mom easily. Soiled or wet clothing can rub against the skin, creating an ulcer.
  • If your loved one has an adjustable bed, make sure the incline is as !owes possible. The straighter a person sits up in bed, the mom pressure there is on the tailbone and lower back.

PERFORMING SAFE TRANSFERS

Helping your loved one move from one place to another may be one of the most dangerous tasks you’ll have to perform. Both of you could get hurt. Here are TEN important tips you can follow to keep your loved one and yourself safe while doing this job!

TIP 1:Think before you act! Before you start, go through the entire transfer in your mind.lRead through the steps at the bottom of this page.

TIP 2: Get help if you need it. Be realistic about what you can do safely on your own. Use transfer equipment or a mechanical lift if available. Ask for help, rf help is available.

TIP 3: Set the stage. Clear the path where you plan to stand or walk with your loved one. If you are moving the person to a wheelchair, place the wheelchair close by and lock the wheels.

TIP 4: Balance it out. Stand so that your weight is centered over your feet with feet shoulder-width apart. Don’t lock’ your knees.

TIP 5: lighten it up! Pull in your abdominal muscles and tighten your buttocks to support your lower back.

TIP 6: Use your BIG muscles! Bend your knees to help you keep your balance during a transfer. If you need to bend forward, bend from the hips, not from the waist.

TIP 7: Don’t do the Twist! Plan your transfer so that you don’t have to twist your body. Twisting your lower back puts you at risk for muscle strain or even a more serious back injury.

TIP 8: Get close! Keeping the person close to you helps you use your large muscle groups to do the work and prevents straining the smaller arm and back muscles.

TIP 9: Take a breath test! If you can’t lift and breathe at the same time, the person is too heavy for you. Get help if help is available.

TIP 10: Encourage participation! The most important tip of all is to encourage your loved one to help as much as possible during the transfer! This will give him the opportunity to use his muscles and joints-and possibly regain some mobility in the future.

HOW DO YOU DO IT?

TRANSFER YOUR LOVED ONE FROM BED TO CHAIR
  1. Help your loved one sit on the side of the bed.
  2. Put on non-skid slippers or shoes.
  3. Position the chair near the bed. If the person has a weak side, place the chair on the stronger side. If the chair has wheels, be sure to lock them.
  4. Now, support your loved one’s knees by putting your knees right in front of them.
  5. And, keep his feet from sliding by putting your feet in front of his feet. DO NOT LOCK YOUR KNEES!
  6. Ask your loved one to lean forward and push off the bed at the count of three. It’s vaay for him to hold onto your shoulders or waist, but never your neck!
  7. Once the person is standing, turn your body, along with his toward the chair.
  8. Make sum the chair seat touches the back of his legs before he begins to sit. Ask him to mach back for the armrests, if able.
  9. Lower your loved one slowly to the chair seat without rounding your back.
What About This Special Diet?

Has a physician or dietician ordered a special diet for your loved one? If so, this is known as a therapeutic diet and it is considered a medical treatment—just like checking vital signs. The food your loved one eats is just as important as the medications he or she takes!

COMMON THERAPEUTIC DIETS

A LOW FAT DIET

A doctor might prescribe a low fat diet if your loved one has heart disease, diabetes, is overweight or has trouble digesting fats. People on a low fat diet should eat:

  • Lots of fruits and vegetables.
  • Small portions of meat.
  • A bowl of oatmeal instead of a muffin.
  • Steamed vegetables instead of French fries.
  • Low fat milk instead of whole milk.
  • Yogurt instead of sour cream.
  • Skinless, baked chicken instead of fried.
A HIGH FIBER DIET

Your loved one might be prescribed a high fiber diet if he or she has heart disease, is overweight, suffers from constipation or has a high risk for colon cancer. People on a high fiber diet should eat:

  • Whole grains like brown rice and whole wheat bread.
  • Fresh vegetables and fruits.
  • Dried beans like lentils, split peas, and black-eyed peas.
  • An apple (4 grams of fiber) instead of applesauce (1.5 grams).
  • A cup of brown rice (3.5 grams of fiber) instead of noodles (1.8 grams).
  • Oatmeal 14 grams of fiber) instead of corn flakes (1 gram).
  • Baked beans (7 grams of fiber) instead of green beans (2 grams).
A RENAL DIET

Has the doctor prescribed a renal diet for your loved one? It could be because of kidney disease, dialysis, or another condition that is a fleeting the kidneys, like diabetes or an infection.

  • No two renal diets are the same. This is because a renal diet is developed individually for people depending on their weight and severity of their kidney damage. Please consult with the physician or nutritionist for details.
  • Offer the specific number of calories to be eaten every day, as outlined in the diet order.
  • Limit the amount of sodium (salt) so the body doesn’t hold onto fluids and swell up.
  • Limit fluids since too much fluid makes the kidneys work overtime.
A LOW SODIUM DIET

If your loved one has high blood pressure, has had a stroke, or has a lot of edema (fluid often showing up as swelling around the ankles), the doctor may have ordered a low sodium diet. People on a low sodium diet should eat:

  • Lots of fresh fruits and vegetables.
  • Small servings of meat, poultry, fish, dairy products, and eggs—because these foods have more sodium.
  • Very little canned and processed food—because these are the highest in sodium. (Lots of foods have sodium added during processing. These include cheese, bacon, sausage, ham, pickles, and sauerkraut.)
  • No salty foods like chips, popcorn, pretzels, and crackers.

COVID-19 TESTING

Coronavirus Disease (COVID-19) is caused by the SARS-CoV-2 virus. As of now, scientists all over the world are still working on potential treatments and vaccines.

For now, there are two main types of tests to determine if you have been infected with the SARS-CoV- 2 virus.

  1. Diagnostic test.Swabs from the back of the nose, mouth, or lower respiratory tract will be taken as samples for this type of analysis. FDA-authorized diagnostic tests for SARS-CoV-2 are highly accurate for finding a current infection.
  2. Antibody test.For this type of test, clinicians will use a blood sample to look for the antibodies made by the previous infection of the SARS-CoV-2 virus. The making of antibodies usually takes 1-3 weeks. For now, health authorities do not know how much protection the antibodies might provide or how long this protection might last. Serology or antibody tests have limited ability to diagnose COVID-19 and sometimes are not accurate. It should not be used alone to diagnose COVID-19.
How to get tested?

Testing sites may be available at your doctor’s office, urgent care center, pharmacy, or other healthcare clinics. Talk to your physician for further instructions and recommendations.

To find testing sites in your area, visit the website Virginia COVID-19 Testing Sites.

What to do after you get tested?

If you test positive for COVID-19 and are only experiencing mild symptoms, you can rest at home and isolate yourself from others. If you are experiencing difficulty breathing, call your physician right away for hospitalization.

Learn more about the safety measures you can follow to protect yourself and your community if you are sick with COVID-19.

If you test negative for COVID-19, it does not mean that you are not infected. It may be that you were probably not infected at the time your sample was taken, or you were very early in your infection when you were tested, and that you could test positive later.

It is best to do quarantine for 14 days from the day of the exposure to protect those around you. If you develop symptoms later, you will need to get another test.

For more information, please visit:
www.vdh.virginia.gov
www.cdc.gov