Caregiver questions about coronavirus

We've gotten many questions from caregivers about how to reduce risk and protect older adults from coronavirus (COVID-19).

To help you make informed senior care decisions, we've put together this page to answer top questions about specific caregiving situations.

** We'll keep updating this page as we get more questions and as we're able to provide thoughtful, informed answers. **

For information about COVID-19 recommendations, how to reduce risk of spreading, symptoms, and much more, refer to our article: Coronavirus and Seniors: Everything You Need to Know.

Should older adults have visitors during this time?

No. Everyone, and especially seniors, should try to interact with as few people as possible. Keep all interactions to the bare minimum.

Reducing the number of people an older adult comes into contact with reduces the amount of germs that they're exposed to. That reduces the risk that they'll become infected with COVID-19.

Now, it's becoming very clear that everyone needs to take this seriously in order to slow disease spread.

Across the U.S., schools and non-essential businesses are being closed and counties are issuing mandatory "shelter in place" orders that require everyone to stay in their homes.

Hopefully, these changes to public life make it easier to politely, but firmly tell visitors that, out of caution, you're following CDC or local government instructions and limiting your older adult's contact with people as much as possible.

However, the goal isn't to isolate your older adult.

You may want to arrange phone calls or video calls so your older adults can "virtually" enjoy the company of family and friends.

What precautions should I take when I'm visiting an older adult's home?

Similar to seasonal flu, COVID-19 is passed between people through coughing, sneezing, or close contact like touching or shaking hands.

It can also be transmitted by touching a surface with the virus on it and then touching the eyes, nose, or mouth without washing hands.

When you enter your older adult's home, you'll have potentially come into contact with the virus while you were out and should take precautions to reduce the risk of transmitting the virus to them.

Is your visit necessary?

First, make sure your visit is essential. For example, you might live with your older adult or regularly go to their home to care for them.

But if it's not necessary for you to see your older adult at this time, protect their health by postponing your visit until local health officials say it's safe.

Instead, you could call them on the phone or visit once to set up video calling so you'll be able to "see" each other regularly.

Or if you're dropping something off for them, consider leaving it on their doorstep or just inside their door.

Follow basic CDC recommendations

Generally, you should follow the CDC's recommendations for high risk individuals like seniors.

That includes diligent and proper handwashing for 20 seconds, not touching your face, and cleaning high touch surfaces like your mobile phone, faucet knobs, doorknobs, and countertops. Refer to the CDC site for the full list of recommendations.

Additional ideas to reduce viruses brought into an older adult's home

We also share additional suggestions on what you could do to reduce the amount of germs coming into the home.

This doesn't mean that you need to or have to put all of these ideas into practice. They're meant to give you ideas and help you become more aware of how germs could potentially spread.

Everyone needs to decide for themselves which precautions they feel are reasonable and necessary.

Beyond practicing good hygiene and following CDC recommendations for high risk individuals, there are no clear cut right or wrong actions.

In addition to CDC recommendations, you might consider:

• Wash your face, hands, and forearms

• Clean your mobile phone with a 70% alcohol wipe or put it away before washing hands and don't touch it again

• Remove shoes and/or wear indoor shoes or slippers

• While there, wash hands every 30 to 60 minutes – moisturize after washing to prevent cracking skin

• If you might be sick (even if it's a mild cold), wear a disposable mask and disposable gloves

• Put your bags in an out of the way corner or near the door, limiting their contact with the rest of the home

• Remove all rings and bracelets (before washing hands) and don't wear them while in the house – in case virus particles could be hiding in nooks and crannies

• Do a full change of clothing – being careful not to touch the outside of the clothing when removing it

• Pull back your hair to reduce the likelihood that you'll need to touch it or that it would brush against your older adult

• Take a shower (wash your hair too) and change clothes

• When reasonable, stay a few feet away from your older adult and avoid physical contact

When I bring purchases into the home, like food or household supplies, do I need to sanitize them before putting them away or using them?

According to the CDC, proper hand hygiene is the most important thing in reducing the spread of COVID-19.

However, items from stores have been touched by many people and could potentially carry the virus, which can live for up to 3 days on surfaces like plastic and steel.

Items that have been packed or delivered by grocery services have also been handled by other people.

Then, when you handle the item or outer packaging later at home, lingering germs could be transferred to your hands.

"If people are concerned about the risk, they could wipe down packages with disinfectant wipes and wash their hands," said Dr. Linsey Marr, an expert in the transmission of viruses by aerosol at Virginia Tech.

This article from Consumer Reports contains useful information from infectious disease experts and specific suggestions on how to clean and disinfect groceries and other household goods that you've purchased or had delivered.

For most items and surfaces, washing with soap and water can break apart the COVID-19 virus' cell walls and kills it.

Scenarios covered in the Consumer Reports article include:

• Washing nonporous containers

• Washing hands, counters, and any other surfaces that were touched while cleaning and putting groceries away

• Washing produce with soap and water

When I receive packages, do they need to be sanitized?

This New York Times article writes that "a new study, published on 3/17/20 in the New England Journal of Medicine, suggests that the virus doesn't survive more than a few hours on packages."

However, packages are also handled by a delivery person, who could potentially transfer "fresh" virus particles to the package when they're delivering it.

What's the proper technique for washing my hands to reduce the spread of infection?

This brief video from Johns Hopkins Medical shows the World Health Organization's (WHO) method for proper hand washing.

The CDC recommends washing for at least 20 seconds (sing the Happy Birthday song twice).

The only suggestion we'd add to the video's technique is to wash faucet knobs with soap and water so you can safely turn the water on and off as needed. Keeping the water running the entire time wastes a lot of water.

You may also want to remove all hand and wrist jewelry in situations where you're especially concerned about transferring germs to high-risk individuals.

You may also want to print out this helpful WHO poster on proper handwashing technique and post it next to sinks as a helpful reminder.

How do I disinfect my older adult's home to prevent the spread of viruses?

At home, the CDC recommends that people practice routine cleaning of frequently touched surfaces with household cleaners and EPA-registered disinfectants that are appropriate for the surface, following label instructions.

Those "high-touch" surfaces include, but aren't limited to:

• Toilets

• Faucets

• Sinks

• Doorknobs

• Light switches

• Tables

• Countertops

• Cabinet and drawer handles

• Desks

I care for two separate people, in two separate locations. How can I safely provide care and not transmit viruses between them or from myself?

It's great to be extra cautious when caring for two separate high-risk individuals.

The goal is to reduce the amount of potential germs that you're bringing into each of their homes or living spaces.

To reduce the risk of transmitting the virus to them or between them, we'd suggest following the CDC's recommendations for high-risk individuals and consider adding some of the ideas in the answer to question #2 above.

For example, if you're seeing two separate people on the same day, you may want to do a full change of clothing before seeing the 2nd person. If they're especially high-risk, you could consider taking a full shower as well.

As we mentioned in the answer to question #2 above, the precautions that you choose to take will depend on your assessment of the risk and the feasibility of taking those precautions.

There are no clear cut "right or wrong" actions to take except to follow the CDC's recommendations for high-risk individuals.

My older adult is in a nursing home or assisted living community that has been locked down – no visitors are allowed. How can I keep in touch with them and make sure they're not scared or lonely?

This is a tough issue that many people are struggling with right now.

Some care communities have promised to help residents use computers or tablets to communicate with family, but haven't yet done so.

Realistically, your means of communication will be limited by what your older adult is currently capable of and what the facility allows.

In general, just do the best that you can. Use whatever means of communication that is currently available until a better means becomes available.

And periodically check in with the facility to make sure your older adult is doing well and find out when they'll be arranging video communication.

We've included suggestions for various situations:

Video calls on a computer

For example, if your older adult can use a computer, consider doing a Zoom video call with them.

Zoom offers free options and once you get set up, you could send a "meeting invitation" link by email so they can easily get into the video call. They're also offering extra support and tutorials to help people use their service – here.

Zoom works equally well on mobile devices, we mention it here because we think it's the easiest way to get someone into a video call if they don't already use video calling apps or software.

Video calls on a mobile phone

Aside from FaceTime on Apple iPhones, additional free video calling services for mobile devices and computers include: Skype (iPhone / Android), Google Hangouts (iPhone / Android), Google Duo (iPhone / Android)

Talk on the telephone

If your older adult uses a landline telephone, get to know their regular daily schedule so you can call when they're likely to be in their room.

Drop off letters or care packages

If their care community won't allow visitors and your older adult isn't able to use a phone or computer, find out if you can drop off letters or packages for them.

If this is allowed, you could put together a bag of basic supplies, favorite snacks, or comfort items and drop it off for them. And to remind them that they're loved and missed, you could include special photos or a handwritten letter.

If it's feasible, you could even ask family and friends to send letters for them to you via email so you can print them out and add them to your older adult's care package.

If you choose this option, remember to wash your hands for at least 20 seconds using the WHO method before handling anything that you'll be giving to your older adult.

With older adults at high risk, it's better to be safe than sorry. So we'd recommend thoroughly cleaning all the items you'll be including in the care package so they won't accidentally pick up any germs from those items – see our cleaning suggestions in question #3 above.

Even though a NEJM study suggests that the virus only survives for a few hours on packages, the virus can live on some surfaces for up to 3 days (like plastic bags or containers).

Are grocery stores dedicating certain hours in which high-risk individuals (like seniors) can shop without crowds?

Yes. We're happy to see that grocery stores across the U.S. are dedicating certain shopping hours for seniors and people with underlying health conditions that compromise their immune system.

High-risk individuals like seniors must avoid crowds in order to reduce their exposure to COVID-19. But they also need to buy food and other essential supplies.

Major grocery chains like Walmart, Target, Albertsons, Safeway, Whole Foods, and Dollar General have responded to these needs by either opening earlier or reserving certain days or hours for high-risk shoppers.

This USA Today article has a full list of the markets they're aware of who are offering this service.

And if your local store isn't on the list, consider giving them a call to find out if they plan to offer dedicated shopping hours.

Is the COVID-19 virus airborne? Can I get infected by using the elevator in our building?

When someone who is infected with COVID-19 coughs or sneezes, tiny droplets that contain the virus fly out of their noses and mouths and into the air. (That's why we're supposed to cough or sneeze into our elbow)

According to the New York Times, "When the virus becomes suspended in droplets smaller than 5 micrometers – known as aerosols – it can stay suspended for about a half-hour, researchers said, before drifting down and settling on surfaces where it can linger for hours."

But the article also notes, "The virus does not linger in the air at high enough levels to be a risk to most people who are not physically near an infected person. But the procedures health care workers use to care for infected patients are likely to generate aerosols."

So for the average person, it's not likely that you'll pick up the virus from the air, especially if you keep a safe distance from other people – about 6 feet. The greater risk is to health care professionals who are caring for sick patients.

The risks of using the elevator is an interesting question.

According to STAT News, "'If it could easily exist as an aerosol, we would be seeing much greater levels of transmission,' said epidemiologist Michael LeVasseur of Drexel University. 'And we would be seeing a different pattern in who's getting infected. With droplet spread, it's mostly to close contacts. But if a virus easily exists as an aerosol, you could get it from people you share an elevator with.' According to the Centers for Disease Control and Prevention, that is not happening."

However, elevators are small, enclosed spaces. So, following the general CDC recommendations for social distancing, it would be best to avoid riding in elevators with other people.

The most important thing is to not touch our faces after touching public surfaces – including elevator buttons or handrails. Germs do linger on those surfaces and could later get transferred to your body, clothing, or belongings.

For those who are interested, Wired has a detailed explanation of what "airborne" means when it comes to this virus.

https://www.specialtouchhomecare.com/home-health-aide/coronavirus-senior-care-questions-and-answers/