Caring for patient at home

I am taking this opportunity to thank everyone working round the clock, a person who is filling oxygen in the manufacturing plant to the tanker, ambulance, train drivers, volunteers on ground, pharmacy staffs, funeral site staffs, cleaning staffs, police, armed forces, administration and You - all those caring for someone. Words are not enough for all of you there, nurses, doctors, all hospital staffs, citizens of different countries who have kept India in your thoughts and every country that has stepped in unconditionally to help.

A year ago I published an article for care homes, long term cares and hospitals when Coronavirus pandemic outbreak happened for first time in countries. While we have seen the first phase and second phase getting over in many countries around the world, few other countries still have certain major hotspots while vaccine efforts are underway.

India after a successful first wave could never thought and imagine that this virus strain with its mutations would reel the country and bring it to what it is today. As India is gasping for Oxygen, with efforts and help pouring in from inside and outside country there are many many COVID-19 patients who are at home.

As I am writing this, there are so many of us who are fighting against this virus- a full blown war against a pandemic never seen before, lost many, still many at home and while there are others in ICU. I just couldn’t stop myself but writing this, for in spite of all awareness I feel there is still scope for more that one can do at individual level when it comes to minimizing spread and adopting infection control measures. I want to let you all know that, those of you who did not contact this virus must consider lucky and must take all precautions come what may. I am also urging others whose family members are affected and undergoing treatment they must also take utmost care and follow all infection control practices. I have worked in multiple Health care organizations and have volunteered to work for covid units and have seen and experienced it very closely. Please note that my outlook towards infection control has changed and has garner more seriousness over last few years. Anyways, here are few suggestions on practices that you must follow.

1) Masking is Key: I have observed many folks, while talking they would lower their mask or would wear below chin so that they can talk clearly or breadth the air. Please stop doing this; you are putting yourself at big risk. Then, there are others esp. when they speak to media few donot keep enough social distance or lower mask. You must know that the microphone you speak to may have been within one feet distance and carries the germs and may not have been sanitized after every interview.

— Wear mask even at home covering your face when you are around family members.

— Breathe in open or remove mask when you are close to window or at roof.

— Wear face mask covering face. If you have option wear double mask when near a Covid affected patient/clinic or hospital.

— Donot touch or remove any area of mask except the ear string.

— Change masks. (Surgical masks must be discarded immediately after use, should be used once at best for 6 — 10 hours or if appears to be soiled)

— If you sneeze into the mask ideally you must change the mask.

— Cloth Masks: If you are using cloth masks, ensure you clean it at least once in 2 — 3 days. Best to have couple of masks so that you donot use the same one daily at least until the pandemic is over.

— Donot exchange or use another family members mask.

2)  A. Social Distancing outside: Wherever possible practice social distance of at least 3 feet. I can understand where there is a high population density it is hard to practice it, but I have seen folks not following this even when they can outside when they are standing in a queue either for vaccination or buying drugs.

B. In a home environment, try to maintain a distance while caring for patient if you are providing food or giving med where the patient can manage on own. If the patient cannot or where the home is small with limited options, then ensure you cover yourself well, wear mask, cover with some face protection before caring. You must change the dress immediately after such care.

3)  Caring for Patient at home: You must ensure that in addition to above you follow the following and take precautions. At times, given our regular habit or tendency we may remove the mask and keep it on a table or for that reason anywhere in house – A strict No. You have to be mindful in every act of yours when you are caring for a patient/family member at home or in community.

— Have a separate waste disposable bag.

— Keep it at a designated place in house only. Donot mix this with regular garbage bag.

— After removing mask and gloves, throw it into the waste disposal bag meant for COVID only.and not into your regular garbage bag.

— Always wear full PPE before visiting the patient and cover yourself well. If you donot have body PPE kit, you can use dress or something that covers you well.

— The PPE should be disposed off immediately after you come out from the patient’s room or after care. The outer dress layer should be kept separately in a designated area for separate laundry and must not be mixed with your regular wears or regular laundry of other members of family.

4)  Hand Hygiene/Coughing/Sneezing: DONOT sneeze or cough into your hand, this is a common practice in many countries and so is in India. ALWAYS turn your face and sneeze into your hand below shoulder. ALWAYS today, tomorrow and in future. Make it a habit.

Wash hands well before and after care and when you touch something in your house, use sanitizer, soap and clean the soap even after use.

5)  Sanitize Wallet, Phone, Key Chain, Glasses: Often ignored or easily forgotten as mind is not tuned to do these with other visible or larger scheme of infection control.

6) T ouching Eye/Ears/Face: Avoid touching your eyes, ears, face. If you have to make it a point to wash your hands before or use a sanitizer.
 
7) Mask, Gloves, PPE Disposals : Ensure that you dispose these off into the covid waste bag. Donot throw or keep it anywhere for that reason even for a second.

8)  Home Sanitization : This is key when you have a patient at home. Donot touch any wall or any part of the house after care or after coming from outside. Sanitize the door knobs/any area you touch.

9)  Footwear, Shoes: Segregate your shoes and keep at a particular place only. The footwear used for caring the patient should be kept at designated place only.

10)  Utensils: All utensils must be separated from the one that is used by the patient. Those should be left in the patient room only.

11)  Rooms: Patient should be kept in a separate room with separate bath. If house is small and this is not available, you need to be all the more careful in your infection control practices. Layout of where you sleep and where the patient sleeps need to be planned with enough distancing.

12)  Keep a hand sanitizer with you when you go out if you can.

13)  Mental Health: Most importantly, take care of yourself. This is a very stressful time. Avoid media. I should say stop following them. Many are sensationalizing, creating panic and increasing anxiety. Read something if you want to or watch something that you like or meditate or practice breathing. It helps.

14)  Medicines: I was checking on one of my relative about her health who is fine. During my conversation she mentioned that she is thinking to get oxygen cylinder and Remdesivir and keep it ready at home. Request you not to hoard anything at this point if you are fine, there are people who are battling for life who need it more than us. You need not have to presume and stress yourself. Follow Doctors/Nurse advice.

15)  Stress, Anxiety and Citizenship behaviors: Everyone is going through enormous amount of stress now. Please know that everyone is concerned, caring or trying a save a life at this point in time. Be patient, respectful to everyone, help each other. I know it’s difficult at times when you realize things are no more in anyone’s control but we all are going through this together in different ways.

This too shall pass….We will defeat this and emerge stronger. Be kind, take good care, stay safe and most importantly united!

Strength to you!

Disclaimer:

This pandemic has thrown us in a constantly evolving situation. Things change quickly, what is applicable today may not be so in next few days. Keep yourself up-to-date. These are my individual experiences and views. Please follow your respective municipal/state/province/country specific health guidelines and orders.