Before the caregiver visit
Rondello: All presume that the home is a safe place to be, that it is protective. An individual's home is meant to be a sanctuary from the outside world, and in the midst of a pandemic, that refuge must be biologically secure as well. For that reason, we need to do everything in our power to preserve the safety of the home. That starts by limiting both the number of people going in and out and the number of times they do it. However, there are some essential services that must be done in the home, such as caregiving.
An individual’s home is meant to be a sanctuary from the outside world, and in the midst of a pandemic, that refuge must be biologically secure as well.
Fichtenbaum: Older adults should first check with caretakers/aides through their home care company if they have a policy of screening staff for COVID-19 symptoms or exposure each day prior to a visit. If you hire someone directly, call them the day before and ask about symptoms like fever, cough, sneezing or runny nose. Ask if they have been exposed to someone with COVID-19 in the past two weeks. If yes to either, it's probably best to avoid the visit. Whenever the caretaker arrives, make sure they wash their hands thoroughly for 30 seconds with soap and water before any care is completed. Remind them not to touch their face, mouth, nose or eyes while in the home.
Rondello: To some extent this is a numbers game. It is nearly impossible to get your risk down to zero, so the next best thing is to minimize your risk as best as you can. Every time someone comes into your home from the outside, that risk goes up a little bit higher. You do not need to live as a hermit and avoid all human contact, but you do need to make smart choices.
Whenever the caretaker arrives, make sure they wash their hands thoroughly for 30 seconds with soap and water before any care is completed.
During the caregiver visit
Rondello: The caregiver should wear gloves around the patient, and both the patient and caregiver should cover any coughs or sneezes (followed by hand rewashing). For those responsibilities that don't require close proximity, like doing laundry or preparing meals, the rules of social distancing apply. For instance, the caregiver and patient should maintain a 6-foot distance from each other.
The caretaker should ask the older adult if they feel any symptoms of the virus and provide a one-page laminated sheet for them which lists the symptoms, a number to call and other important information.
Brown: The caretaker should also be careful to touch as few surfaces as possible. Physical distancing and not touching surfaces may not be possible in situations where dressing, cleaning or assisting older adults with exercise are among the activities. In that case, PPE [personal protective equipment, such as gloves and masks] should be used. Additionally, the caretaker should ask the older adult if they feel any symptoms of the virus and provide a one-page laminated sheet for them which lists the symptoms, a number to call and other important information. If they have a thermometer, that is a good tool to measure potential fever. Also, ask if they have enough soap, toilet paper — and if they have mobility issues, hand sanitizer.
Sansoni: If the caretaker is caring for someone diagnosed with or showing signs of Alzheimer's or another form of dementia, the caretaker should do all of the cleaning and store all cleaning products, including liquid laundry packets, up, out of sight and out of reach in a locked closet or cabinet when not in use.