The Prime Minister's address to the nation on 23rd March 2020 imposed severe restrictions on the UK population in an effort to bring the coronavirus pandemic under control. People are now prohibited from leaving their homes except to carry out essential activities, for example, to shop for food and medical supplies and to take exercise alone eg walking, cycling, running, once a day.
Importantly, for families affected by dementia, The directive does allow people to go out if the reason is 'to provide care or to help a vulnerable person' and this applies to family carers as well as paid carers.
We are getting used to a daily briefing about coronavirus: just the day before (22nd March 2020) Public Health England released specific advice about 'shielding' vulnerable groups, recommending that people with complex medical problems remain in their own homes in self-isolation for 12 weeks.
It is a worrying time for families affected by dementia. The guidance on social distancing has raised many questions, and for those who need to self-isolate, curtailing face-to-face contact with support networks and services is placing huge demands on family carers.
This blog aims to clarify what the Government’s guidance actually means and help resolve dilemmas that families are facing. I have included some questions that members of the Live Better With community have been raising with me and in our on-line support group, and highlighted links to useful websites.
1) My mother is 83 and has Alzheimer’s. She is otherwise well and lives alone but relies on me to visit every other day and to help her with keeping the house up-together and taking her out shopping. Can I continue to visit?The Government’s guidance clearly states that we should all avoid face-to-face contact with other people unless there is something ‘essential’ that we need to do. In the case above, ideally the daughter should not continue to visit if her mother can live safely on her own for the next few weeks. Suggested strategies have included delivering parcels of food and other supplies to a relative’s front door, maintaining contact by telephone and through online platforms such as Skype, communicating through a closed window or door.
If a person living with dementia requires personal care or help with taking medications, this would be regarded as ‘essential’ and carers, whether family or paid, would need to continue to visit the person in their own home.
The recommended precautions are now well rehearsed: thorough and frequent hand washing, keeping surfaces clean, not sharing cutlery, minimising physical contact, keeping 2 metres away (insofar as this is possible).
Also, if you cough or sneeze this should be into a tissue and the tissue should be put into a bin straight away. But for any carer who develops symptoms that might be caused by coronavirus – a persistent new cough, high temperature, shortness of breath – they should stay away from their relative and self-isolate for a minimum of 7 days.
It is important to put in place a back-up plan should this situation arise. Are there other family members who can help, or a local home-care organisation that can step into the breach?
Carers UK has developed some helpful guidance.
2) Is it alright for me to take my father out for a drive?
This question has been asked by a number of family carers keen to find ways to keep their relative stimulated. Taking a person for a drive in a car doesn't pose a significant risk, as long as there is no close contact with other people, and the hand-washing protocol is observed. However, the Prime Minister's announcement on 23rd March 2020 rules out any 'non-essential' journeys and urges people to stay at home.
3) My wife is in a care home and I usually visit every day. However, the home is now in ‘lock-down’ and no family visitors are being allowed in. What can I do?
This is a very distressing situation affecting a great many families. People are concerned that their relative will deteriorate more quickly and will feel abandoned, having no understanding of the coronavirus crisis and its implications.
If you are in this or a similar situation, first of all, it is important to maintain an open channel of communication with the management of the care home. This is a challenging situation for everyone, the care home manager and staff team will be under considerable stress, trying to keep the workforce healthy and maintaining a safe environment for all residents. Check in on your relative as often as you feel you need to, pinpoint a key member of staff to liaise with and ensure that any specific needs your relative has are known about and documented.
Some excellent ideas for keeping relationships alive have been suggested by our community and posted on social media. Using applications, such as Skype and FaceTime, means that you can see your relative at specified times, and they can see you. This helps to keep the relationship fresh in their experience and will reassure you of their wellbeing.
Music is a life raft for many people with dementia too. Ensure that the care home is supplied with personalised playlist for your relative that can help to settle them and provide stimulation and meaning.
Many people will be having to stay in their own rooms at this time. Sending videos, pictures and messages will help to create a sense of comfort and familiarity.
4) Does the new guidance on ‘shielding’ for people who are particularly vulnerable apply to people with dementia?
The Government’s advice on ‘shielding’ is designed to protect people who are exceptionally vulnerable on medical grounds. Alzheimer’s disease and other forms of dementia are not included in the high-risk list of conditions to which this applies, however many people with dementia have co-existing illnesses. The full guidance on ‘shielding’ – which recommends self-isolation for 12 weeks from now – can be found here.
Older people over 70 years of age are more susceptible to developing complications from COVID-19. Because of the risks, many people are choosing to stay at home and self-isolate and others are managing their lives with minimal contact with other people.
The bottom line is: the less contact any of us has with other people, the fewer opportunities the virus will have to cross-infect and spread. The majority of people who develop COVID-19 will have mild symptoms and recover quickly; but for older people and those with underlying health conditions, the illness could be very serious, even life-threatening.
The difficulty with controlling this outbreak is that people can have COVID-19 without symptoms and can pass the virus on unknowingly
Please do get in touch if you worries or concerns, or would like to highlight any particularly difficult circumstances that you are struggling to cope with: firstname.lastname@example.org