En español | Denise Brown already has bought the gin and the chocolate.
It's part of her parents’ wish to stay comfortable in the time of coronavirus.
They don't have COVID-19. But they're 88 and 85, so death is not outside the realm of possibility. And their caregiver daughter wants to have a plan.
'Every worry has a plan'
"I like to say, every worry has a plan,” says Brown, who lives 10 minutes from her parents in the Chicago area. “And if we're making plans, we're in action. And that makes us feel like something is within our control during a situation that's very much out of our control."
Brown, an author, speaker and founder of Caregiving.com, is one of millions of caregivers dealing with the uncertainty and fear of harm amid the COVID-19 pandemic. She hears from families who are terrified that they will somehow expose their older relatives to the virus and cause them to get sick.
Some feel constrained about leaving the house for fear they will bring the virus back home with them. Others are now reluctant to allow home health aides into their homes for the same reason.
"I know I can do everything within my power, and something can still happen that I don't want to happen,” Brown says. “I think it's trying to find that place where you say, ‘I think I've done everything’ and still not have regrets that you could have done more.
"That's the big question for us, right? Could I have done more?” she asks.
Tips to keep illness at bay
- Wash your hands
- Wipe down surfaces
- Clean your phone
- Keep door handles clean
- Wipe down your purse or wallet
- Maintain a distance of 6 feet from other people
- Avoid gatherings
- Avoid hugs and kisses
- Stay home if you're even mildly sick
- Sleep 7 to 9 hours to keep your immune system strong
- Get outside and exercise
- Limit news and social media
The real dangers
Swati Gaur, M.D., a geriatrician in Gainesville, Georgia, understands the anxiety — and the risks. The real danger is that we're dealing with a deadly disease, she says.
"In people 80 years or over, what we are seeing is the case fatality rate is about 18 percent, and that is 1 in 5,” says Gaur, medical director of New Horizons Nursing Facilities with the Northeast Georgia Health System. She is the chief executive officer of Care Advances Through Technology, a technology innovation company, and also works on a national infection advisory committee that's knee-deep in analyzing COVID-19 and advising people about how to handle it.
Clean your phone
With her own kids and parents, “we are zero hugging and kissing” for the time being, Gaur says. And “we'll postpone all of the birthday parties until a time when we are far, far away from this epidemic."
She wears clothes that can be washed easily and cleans her phone, showers and changes clothes when she returns home from work.
"I was trying to give an analogy to my kids and today to the staff, and I said: ‘It's like paint. You splatter the paint, and then the paint stays there until you clean it off.’ So, think about it that way,” she says. “Remember, a virus, it is a hard-to-kill thing. Make sure that you're actually cleaning it off."
It may sound harsh to say you could be the one to bring a deadly virus to a loved one, but it's not an overreaction, Gaur says.
"I think my outlook is realistic,” she says. “It's the responsibility of every single person in the United States to be engaged and do their part. The only way we can keep our parents safe is when we all do our part. That is why it is so important for us all to work together."
Turn fear into action
Elizabeth Eckstrom, M.D., lead geriatrician at Oregon Health & Science University in Portland, says COVID-19 seems to be transmitted via droplets, and that's why hygiene is so important.
"I am telling people, ‘Just turn that fear into washing your hands.’ “
Even if you know you are practicing good hygiene, it's OK to question others who come into your home, she says.
"My best recommendation would be to follow the guidance for long-term care facilities,” she says. “So have a little set-up stand at your front door. Check their temperature when they come in.
"Have them wash their hands really well as soon as they come in, and before they touch anything in your house. You turn the water on for them and make sure they wash their hands super well,” Eckstrom says. “Ask them if they've had any cough or fever. If they do, don't let them in the door.
"Say, ‘I'm so sorry, I need to send you back. We can't have anyone who's had a cough or a fever in the last two weeks. Those are the cardinal symptoms,’ “ she says.
Get back to basics
Connie Steed, president of the Association for Professionals in Infection Control and Epidemiology and director of infection prevention at Prisma Health in South Carolina, says she wishes she had a magic bullet for calming people's fears.
"Everybody just needs to take a deep breath and really think about the basic things that can be done that can prevent the spread of any infections,” says Steed, who has a background in nursing and has worked in infection prevention for 35 years.
That means washing hands, keeping surfaces clean and keeping our hands away from our faces.
"This is all basic, basic stuff that we don't pay attention to when everything is normal,” she says. “Right now, things aren't normal, so it's important for us to have heightened awareness about how important that stuff is."
Balance the risks
For caregivers, dealing with COVID-19 is about balancing risks, says Kate Tulenko, M.D., CEO of Corvus Health, a global health-workforce-services firm based in Alexandria, Virginia.
The danger comes not only from the virus itself but from other associated risks — such as hospitals becoming overwhelmed with severely ill people, or all of this anxiety putting a strain on seniors’ mental health, she says. She urges people to look beyond the short term to see past this health crisis.
"You know, people have been posting things like Shakespeare wrote King Lear while being isolated against the bubonic plague. I think Newton did some of his best work under isolation, so trying to see the silver lining — take the positive side, keep busy,” she says.
"And for some people, stay off the news and stay off social media. It's just whipping a lot of people up in a frenzy,” Tulenko says. “Decide your plan of action, that you are going to self-isolate, and stick to it. Don't check the news every 5 minutes. It's just going to get you anxious."
Maintain your sanity
Olivia Kate Cerrone, a writer in Boston, just penned an essay about caring for her terminally ill father during the coronavirus outbreak in the Washington Post's online publication, The Lily. When people shared it online, many people in the same situation responded.
"I wrote the piece because I felt that many folks might feel isolated or a heightened sense of anxiety in addition to just keeping up with normal life,” she says. She wanted to articulate the nuances of the situation — and what you can do to find some kind of sanity in a situation that often feels like you have no control.
For Cerrone and her mother, routines, lists, even meditation and yard work keep them grounded in this chaotic time. Cerrone likes to try to think of ways to be present with her 76-year-old father, even if it means simply watching his favorite TV show with him.
"It's so important to take everything moment by moment, day by day, and try to be as present as possible because we don't have all the control in the world, and it can be very scary,” she says. “But if we take things and think, OK, what do I have to do right now? What's immediate? That can really help someone feel grounded and not so overwhelmed."