Isolation
Are you taking care of someone who is infectious? Whether it is COVID-19, the flu or a cold, these virus-caused illnesses can spread like crazy – the good news is, you can limit the spread using a few practices nurses use.
Mindset
The mindset is that the air around the sick person is “contaminated”. Anything the air touches is “contaminated”. Contaminated means potentially has the virus and could infect someone else.
The virus travels and lives in the moist air of breath. Even though authorities don’t agree about how long the COVID-19 virus lives, we know that viruses can live in moisture outside of a body for some amount of time. Infecting another person is a matter of getting that moisture droplet with virus into their respiratory tract.
Therefore, the two ways to keep the well from getting sick are first, to decrease the infected droplets, hence the use of masks on the ill person. Secondly, to prevent the droplets from touching the mucous membranes of the well. This is where handwashing, PPE, goggles, not touching your face, and limiting time in an infected area come in.
Room
When you are dealing with a virus that is spread by droplets, like COVID-19, it is ideal to give the infected person a room of their own to recover in. This really helps contain the bug, keeping it out of the rest of the household.
However, not every house has this luxury. The goal then is to define a limited area. Maybe a corner of the living room could be rearranged to hold a bed and a chair. To limit air flow, set up curtains or hang sheets or place a paneled room divider (like a dressing screen). Not only does the barrier decrease the droplet spread it reminds the household of the isolation while providing some privacy for the ill person.
Anytime someone will be in the ill person’s space, the one sick with the virus should wear a mask. The person going in will also need to use some protection and follow basic sanitation rules. Specifically:
- Wear gloves (Disposable type if possible. If disposable are not available, then reusable, washable gloves will work. Wash them while wearing them, then sanitize them. [I use with 1:1 vinegar/water solution] and let them air dry.)
- Wear a mask (Disposable paper or washable cloth. Allow it to dry thoroughly between uses. Get a fresh one at least once a day.)
- Wear glasses or goggles (Eyes are an often overlooked portal for virus infection)
- Consider wearing a gown over your clothing (Especially if changing the bed or giving a bath)
- Consider wearing a washable scarf over your hair. (This depends on how much coughing and sneezing the patient does when you are in their space. Be sure to wash your hands after you remove the scarf.)
The patient’s room or space will also need to be sanitized. That means surface areas wiped once a day or so. Use whatever sanitizing agent you are comfortable with, just remember that strong odors are irritating to the patient’s already inflamed respiratory tract. So, choose a type that has less odor, and do the wipe down when the patient is in the bathroom.
Sleep and Rest
Spend as little time as possible in the same air space as the infected person. They will need some care, but try to group cares into 20 minute chunks. Masks are effective for at least that long and the ill person will not get too worn out.
A big part of a person fighting a virus and becoming well again is sleep. So, as you are taking care of them allow for more sleep.
Eating
During the time the sick person is infectious (until they are completely well) they should eat alone. If they need assistance to eat or drink, this will be part of the personal care being given, that means no more than 20 minutes at a time.
All dishes and utensils taken into the sick room or space are “dirty” when they come out, whether they have been used or not. They must be handled specially. Consider what works best for your situation – using disposables like paper plates, etc. or using household dishes and utensils. Whichever you use I find it easiest to place them on a washable tray eith the food and carry everything into the room at once.
Throw away all disposables (paper plates, cups, napkins, etc.) in a trash can in the room or area. Put all washable dishes directly into the dishwasher. If you will be handwashing them, put them directly into hot soapy water. Wash them and rinse in very hot water and allow to air dry. Some people like to use a 1:10 dilute bleach/water solution for a final rinse. I like to do the final rinse with a 1:1 water/white vinegar solution.
If it works better and there is room, set aside a bin in the patient’s space and collect the washable dishes throughout the day. Then once a day you can deal with the dirty dishes. Be sure to sanitize the bin and any area you set it on.
Any tray that goes into the sick person’s area must be washed and rinsed (just like the other dishes) whenever it is brought out.
Trash
The sick person’s area must have a trash can with a disposable liner. A plastic liner is best because it will contain moisture. All things the patient uses that are to be thrown away should go in that trash can. Especially any tissues or napkins the sick one has coughed or sneezed into.
They will also need a small trash bag near them. In hospitals, we tape a paper or plastic bag on the nightstand or overbed table. Put it in a place that the sick one can easily reach and secure it so it will stay. A paper lunch bag or a plastic grocery bag taped to a side table works well. That bag must be removed (and replaced) every day – pull the tape off the table, fold over the top of the bag, and place it in the trash can. Do not empty the bag – simply throw it and its contents away.
Always wear gloves when handling trash.
Laundry
When someone is sick, they need their bed linens changed more often than usual. They are in bed more. Their body is sweating out “toxins”. They probably aren’t changing clothes as often. For all those reasons, plus the fact that it simply feels better, bed linens, especially the bottom sheets, need to be changed frequently. Exactly how often you can decide.
Hospitals often change linen a minimum of once a day. In home care it is often done weekly, more often if the patient is incontinent. Consider the amount of sweating and coughing. Do they use a bedpan or urinal? Sometimes the under-pads are changed frequently and top sheets are less often.
Clothing, pajamas, bed linen, towels and wash cloths used by someone who is infected should be put directly into a cleanable linen hamper or basket. Use a disinfectant cloth over the outside of the hamper or basket just before you take it out of the room. Run the load of clothes separately from other household laundry, in the manner you usually would. If at all possible dry them in a clothes dryer on high heat. An alternative would be to hang them to dry in the sun. It is the heat and the sun’s rays that kill the germs. Your washer is OK to use for other household laundry. Disinfect the laundry basket inside and out, and anywhere it touched outside the sick room.
Bathroom Needs
The ideal is for the sick one to have a bathroom that only they are using during this time. Then, the bathroom will be treated just like the rest of sick room as noted above.
We don’t all have this luxury. Still there are ways your household can remain safe even sharing a bathroom with someone who is infected. Remember, the bug we are talking about here is spread mostly in the air on droplets. Another consideration is how weak the sick person is. Sometimes the best thing is for them to have a bedside commode, or use a bedpan or a urinal. Those devices call for more caregiving time and effort, however, if there are many people using one bathroom, the bedside devices are worth thinking about.
If the sick person is using a shared bathroom, they should wear a mask. They should bring their own hand towel, paper towel or hand wipes rather than using any that are in the bathroom. When they have left the room wait a few minutes, allowing the air to settle, then enter to sanitize counter surfaces, toilet flusher, and doorknobs.
Bathing
To help the body get rid of the effects of sickness, it sweats. And getting clean usually feels really good to someone who is stuck in bed. The choices are a shower, a bath or a sponge bath.
A shower is good if the person feels up to it (it takes more energy than a well person generally realizes). The precautions are just as in the section on BATHROOM NEEDS with the addition of using the bathroom fan and sanitizing the shower and faucets when the person is finished. So, this includes using their own towel and wash cloth.
A bath tub bath is also fine, just be sure they don’t get too warm. Also, they might need a stand-by assist to steady them getting in and out of the tub. Use the same sanitizing guidelines, just include the tub and faucets. And of course using their own towel and wash cloth which will be put into their own dirty linen hamper.
A sponge bath or bed bath is necessary when the patient is weak or if no tub or shower is available. One top priority here is to be sure the person does not get chilled. Wash in sections, keeping the rest of their body covered with a towel or bath sheet. A second priority is to rinse their skin well, so that the soap will not dry their skin. Using a foaming type of soap automatically decreases the amount of soap used. Plan to empty the basin of water at least twice, this keeps the water warm and fresh. I will write more detailed instructions in a later post.
General
Getting into the mindset takes some time. And it must be balanced with the knowledge that your immune system is on your side to keep you well while you help someone who is ill. After I have been in any place I think might be infected, especially if I have had to wear a mask there, I wash my hands. Then I rinse my face. Then I wash my hands again.
These practices will limit your and your household’s risk of being infected by the ill person in your home.