With the outbreak of the coronavirus, should I let go of caregivers who also work in nursing homes?

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With the outbreak of the coronavirus, should I let go of caregivers who also work in nursing homes?

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My 88-year-old mother has a difficult personality, and we have been through many, many caregivers during the three years she has received care at home. She is now finally tolerant of her present staff of caregivers, but some of these caregivers also work in nursing homes. I realize that the caregivers who work in nursing homes are more susceptible to contracting the coronavirus, since the elderly population they care for is more at risk of contracting it. Is it wiser to let the nursing home caregivers go, or to allow them to stay on given my mother's tolerance of them? Without my even raising the subject, the caregivers who also work in nursing homes have assured me that they will take precautions to prevent contracting the virus (hand sanitizing, repeatedly monitoring temperature, etc.). I appreciate their pro-active stance, but I feel I must do what is correct to protect my Mom. Does anyone have a similar situation, or have an opinion on this matter? Many, many thanks!

Care Decisions Caregiving Coronavirus Home Care

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I understand your concern...... my Daughter is an LVN who works in a nursing home.... she also has lupus which makes her way more likely to have problems with any virus.... because her meds keep her immune system so low that it’s almost nonexistent.... but her answer is that there are germs and viruses that we come into contact with everyday. But we can’t be afraid of everything because if we are....... are we really alive anyway?

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This is a good time for facial masks for caregivers to wear when at your home. You need protection too.

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IMHO, I cannot answer that tough question.

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I would continue with the current situation having good infection control measures. At least you have the reassurance knowing that they will be vigilant. If you introduce new caregivers, you don't know if they will be a good fit for your mom and how vigilant they will be regarding infection control? The adjustment to new circumstances for your mother may be quite difficult.

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I'm writing from King County, Washington which is the epicenter of the coronavirus outbreak in the US. Please remember that all the deaths in the U.S., with the sole exception of one in Kansas (as of this writing) have occurred in King County and Snohomish County (right next door to King County) and that the total today, in the entire United States, is 48 deaths. With only a couple of exceptions, these occurred in one Life Care Center in Kirkland, WA, one rehab center in Stanwood, WA, and one Life Care Center in Kansas. Many people have been exposed, but only 48 have died. The fact that this has affected very elderly people first is, indeed, very scary, and it is important that we all practice social distancing, avoid large crowds, practice good hygiene, and insist those who care for our elderly do the same. I hate to see you fire the caregivers, when you, yourself, may have already been exposed to the virus. You won't know that unless you are tested or showing obvious symptoms (fever, cough, difficulty breathing) and it is hard to get a test if you aren't showing symptoms. This is a very tough spot for all of us with elderly people in our lives. If you are truly concerned about the caregivers, I'd ask what is being done to isolate the elderly folks in the nursing home(s) where they work, and you stay informed about anyone who may be infected there--if any at all. Again, at this writing, only the homes in Washington state and the one in Kansas show any reports of people being affected and no new cases from those homes have been reported.

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Two more just died last night here in Clark Co. , Wa. It was community spread.
We are self quarantined because my husband has health issues besides dementia. It’s been difficult to go for walks and keep a distance from people because he is friendly and wants to talk to everyone and pet their dogs. Then he gets angry with me for trying to stop him. Just another complication in our already complicated lives.

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I think it's important to keep things as normal as they can be during this trying time. I think as long as the caregiver is taking the precautions that we all should be taking it's fine that they continue to care for your loved one. If you have to do it on your own it will burn you out and remember stress makes us sick. Best wishes and remember to take care of yourself as well!

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That was my moms doctors concern it was more for me as the caregiver not getting exhausted and being more susceptible due to that. The lady we have is working at an Assisted Living that is locked down to visitors. The staff and residents are having twice a day temperatures taken. Which is a good precaution for those homebound that do have to step out here and there.

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I understand your problem. My husband is being cared for at home with Parkinson’s dementia AFIB and so on. I’ve worried about people coming into care for him for weeks now. However, it is a necessity for me to have help. He can’t stand or walk a few feet without help walker plus helper. The size difference alone (about a foot in height) requires more help than I physically can give. So I hope for the best everyday. Sanitizers , soap and water are available for frequent use and prayers for common sense. Wishing you all healthy days ahead.
rachel

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I would not let them go. But I would ask them to change clothes, if they have come from another client. As a family member, make sure supplies are available & convenient to use such as hand wipes in every room.

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LET THEM GO!!!

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Easier said then done in some cases.

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I chose to suspend caregiver. It is going to be very hard on my mother because of her extreme anxiety and sundowning. I pray for all of you and your vulnerable loved ones.

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This is a difficult and nuanced decision that you have to make. The problem with nursing homes is that the residents there have conditions that require them to go to hospital, sometimes often. During my mother's last year of life, she required five hospitalizations (fractured hip, medication complications, aspiration pneumonia). Each time one requires hospitalization, one risks exposure to whatever is in the hospital. Sometimes it is an antibiotic resistant bacteria which my dad picked up after a surgery and required three hospitalizations over 2 years. My point is that a nursing home has a revolving door to the hospital so to speak. Your mom is at a very vulnerable age for the coronavirus. I believe that you would be able to travel to your mother's, especially if you contact your local senior council and obtain some sort of documentation that proves that you are needed for the care of your mom. You should do this no matter what you decide. If you can't take care of her on your own because her needs are too great, or if you are working in a job that you believe puts you at a greater risk of exposing the virus to her (er nurse, for example), then keep her caregivers. That being said, my mother had caregivers in the home. There was a rotten virus going around. I repeatedly instructed her caregivers not to come if they were sick....that I could step in for a few days. One person didn't heed my instructions. They were there all morning, sick. My mother caught it, and I believe that this illness is what caused her to fall and break her hip. Up until then, my mother had good balance and was very deliberate in her movement.

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I think you should keep the caregivers that your mother finally likes. Because they work in precarious situations, they are probably taking more precautions than the average population.

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We had wrestled with this as well and after speaking to my agency we decided to keep the caregivers.
My main reasoning was in the event that we are all quarantined the only ones that will have access to the highways and be able to get to my mom are the caregivers.
So for example if we are all quarantined none of my family would be able to get to my mom only the caregivers would be able to be on the roads giving care.
The agency confirmed that they would be able to supply her with groceries medicine and anything else she may need.
The only restriction they have at this time is that they are not taking them out of their home.
Our agency has confirmed that they are taking every precaution every measure possible with her please.
They are all badged and able to perform care even if we are all quarantined.

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Nursing homes have installed extensive measures to check health of staff before and after shifts. These are probably the safest folks you can employ.

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Some times in Life We have no choice therefore We are compelled to take a risk. As your Mom likes these Caregivers I would keep them on, after all you can not manage your Mom's Care with out Them.

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I think you are doing what you can do to protect your mother but there is only so much that can be done realistically. If you let the staff go, how are you going to care for her? If you change staff, no guarantee those that don't work in NH also won't be exposed elsewhere. No aides at all? Then what, you are providing care yourself? And never going to shop for supplies? I don't have our LO's at home; my mother is in one facility and my FIL in another. I have no control over how their care is provided; I can only trust that both places are doing the best they can and if someone happens to get it, really not that much we can do. Someone here mentioned that the virus ran quickly thru the nursing home in Kirkland despite scrutiny. That shows a lack of understanding of the situation. They possibly had the virus in Washington state earlier than other states but it was no known and people were infected before anyone knew. And there was no testing available so many people were infected before anyone was aware. So Kirkland is hopefully an anomaly.
My FIL has his 95th birthday on Saturday. He cannot have visitors. I was planning to get a cake from a local bakery and drop it off for everyone to share. The facility was agreeable to that but now I think we will not do that either as I would be concerned possibly about contamination on the surface of the box. That is something I can control so I think we won't send anything over there. I think you have to do what you can do and make peace with what might happen if something happens. This is uncharted territory.

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What about dropping off some sealed "Little Debbie" cakes/cupcakes?

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"...since the elderly population they care for is more at risk of contracting it..." That is incorrect. The elderly population is more at risk of *dying* from it if they get it. The general population is more at risk of *contracting* the virus because we have more contact with the outside world e.g. grocery stores, shopping malls, schools, office buildings, etc.

They are coming to work in clean uniforms, right?
Does their work involve touching your mother's face?

In my opinion, you are better off making sure everyone washes their hands when they come to your mother's house. Washing your hands and not touching your face are the best ways to prevent getting sick.

Your mother is a "difficult personality" and I would not risk upsetting her when she finally is content with her caregivers.

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Perfect answer!

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Contrary to many posts, Assisted living and nursing facilities are safer than most places from the virus. Seniors are "at risk" of the serious results like death, but are at less risk of contracting the virus. More concern should be directed at caregivers who go to the grocery store.

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I know I would feel more comfortable but Now probably wouldn't be a good time as you might not find someone new or might cause stress on your mom.

Just make sure they all wash their hands with soap and water for 29 seconds the second the walk thru the door.

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The workers are often underpaid and overworked, over stressed. They are often made to come to work even when feeling sick. Nursing homes should be shut down completely.

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That really makes a lot of sense. Where are you going to put those who can no longer take care of themselves, who have no family in the area where they live, and are on their way out? You need to think before you speak.

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My dad is in AL and we also hire outside caregivers. The company that employs them haselected not to send caregivers since all they would do is be cooped up in dad's room because they are on lockdown. My dad is suffering badly. He likes to be in the lobby. Insists I let him move home (he still owns a house). Not gonna happen. Just getting through this one day at a time.

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figures, just when he was adjusting somewhat, now he's cooped up and miserable. sigh, we can't win! hopefully it'll get better soon... hopefully...

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Thank you for posting this question. I have been wrestling with the same question, except that none of my mother’s caregivers work in a nursing home. Two of my caregivers ONLY work with my mom. The other works for an agency and I received a letter saying that they were training their people on Coronavirus hygiene. I also work some days and nights. I don’t think that I could physically or mentally take care of her by myself. If it comes down to it, I will have to, but for now...after reading these posts, I will keep the caregivers I have hired. Thank you!

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Mom lives with me and I’m working from home for the foreseeable future. I have given the two aides the time off w pay for the same amount of time. One also works in an AL and takes 2 buses & a subway to get to us; the other works in retail in Rite Aid/Walgreens type of store, in the hand sanitizer aisle! I don’t want to risk their exposure any more than it is, or ours.

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As with Arwen31, kudos for giving the time off with pay! It is likely a win-win situation for both sides - they get their usual pay (and a little break, possibly less exposure and it would make them more willing to come back when the time is right!

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We have suspended all cargivers.
Althout our caregivers wash hands upon entry, change their clothes and shoes, bio-contamination is risky
As many as 20,000+ Coronavirus can rest on the head of a pin. As shown in the redult of a recent NIH/Princeton/UCal study released only last week the virus remains virulent for hours and sometimes days on various surfaces. On paper and cardboard for about 24 hours, and in plastic, stainless steel etc. for days.

Those who work at nursing homes and medical clinics are the greatest risk. The aides can bring the virus in your home on their face, hair, and back of hands.

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i suspended my mom's caregivers as well. So true about the virus remaining on surfaces, my local library shut down and have to wait at least three days to process returned books because the virus might be on them.

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My caregivers and I are being careful and I am wearing gloves, because I work outside home.none of them work in nursing home all home health aides for people who don"t get out. No garrantees. I am there with her 16 hrs after work am I safe for mom, who knows I drive the handi cap and elderly so we sanitize our vehicles all the time. If they are standing by her and staying I wouldn't. We should have probably done it 2 weeks ago I am in NY and there are 3 aides I am hopeful we were careful enough. I am afraid any of us could bring it in and mom is 92. No one has answers use your gut feeling. Opening a door, pumping gas, using cash to pay all a risk, hang in there we are all trying to figure this out. My aides do not want to not work so all being as careful as possible. I want to get mom checked as soon as they allow to make me feel better

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You want to get her checked for what? Coronovirus? Does she have symptoms? Could you bring it in? Yes. Have you? Who knows? You are correct, anyone could bring it in. There is only so much you can do about it. Taking her temperature at the same time daily, or even twice a day is as good indication as any of her infectious status; people are not getting testing without symptoms at this point. Don't drive yourself crazy with this. We can only do the best we can and be careful.

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Once again, thank you all so very, very much for your extremely helpful responses!! Being able to read your objective input has enabled me to see things from a logical perspective. In the end, of course, there are strong pros and cons to either decision, and we can only do the best we can in trying to arrive at the most prudent one. Many, many thanks again to each and every one of you who have taken time from your very busy schedules to respond to my dilemma!! XOXOXOXOX

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I feel your pain, I am struggling with the same decision. I do all my mom's cares, so aides are only coming in for respite twice a week. I canceled one, will probably end up canceling the other, it's just hard to think of zero visitors for months on end.

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Social isolation means social isolation. People coming into the house is just as bad as you leaving the house. We have someone that comes by for bathing. I've put that on hold for the duration.

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If you think I'm going to sit in my home all day long and look at the four walls, you're crazy

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I hear you, I've had to take the very same decision 2 weeks ago, and I have literally agonized over it. And my mom's (93yo) helpers weren't even working in a nursing home, they were just taking public transports.

I'm in Europe, in Italy.
2 weeks ago we weren't in a lockdown yet. I didn't sleep for a couple of nights about this decision. I really didn't know what to do, the helpers are payed per hour and I felt terrible leaving them without a job in a difficult moment for everybody. I also didn't feel the strenght to do everything by myself, from cooking, to therapies, to cleaning, foodshopping etc. I talked with a friend and she told me to write down a list with all the pros and cons.

My pros of them keeping coming were essentially about less stress for me, and a help for them in a difficult economical moment.
My cons were the risk of me or my mom dying.

The list made me decide instantly. I put all of them in payed holiday leave for 2 weeks and cancelled all appointments. Today, with our present situation, I can tell you that I feel very, very happy about my decision. We are in a lockdown now, so they wouldn't be able to come anyway, but I did my part, and I know my mom hasn't been in contact with anyone for 2 weeks already and this makes me sleep at night.

This is just my experience of course, perhaps your list will be different, but it was a very good tool for me.

Everything will be alright. :)
Warm wishes

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Arwen, your answer I'm sure has helped the OP. It has helped me - I also have relatives relying on daily carers.

I have been watching the news & the only positive thing has been watching the Italians singing from the balconies. The community spirit was so touching & reminded many people what is important.

Wishing you & your Mother safety though this time.

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If you let them go, can you manage your mom on your own? ANYONE who has any contact with the outside world has a chance of contracting this virus. Even if you order groceries online & have them delivered, the items could have been contaminated at the store. Pumping gas. You would have to find a person with NO one living in their house & never having contact with anyone/anything to remove all risk. That's just impossible. I'd trust the nursing home workers as much as anyone else.

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Thank you so very much for setting my somewhat scattered thoughts straight! I cannot manage my Mom on my own. I'm an hour away and I work. The caregivers I've hired are intelligent, pro-active and sincere. I'm going to let things be for the time being and keep a close eye on the situation... Many, many thanks!!

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With the outbreak of the coronavirus, should I let go of caregivers who also work in nursing homes?

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