By MARIA BOURNOVILLE

Aging and Disability Resource Center of Florence County

FLORENCE, Wis. — We are addressing this to all the family members and friends who provide care for persons living with Alzheimer’s disease and similar illnesses. The care you provide is always vital to the quality of life and well-being of that person. The novel coronavirus COVID-19 pandemic places extra burdens on you in providing that care.

We want to provide you with information you can use to strengthen the effectiveness of your caregiving and assist with your own peace of mind during this time.

Some basic facts

The information below represents what we currently know about COVID-19. We present these facts starkly because this is a serious situation. Having good information should help you to protect yourself and your person with dementia.

Something new

COVID-19 is a new strain of a virus that attacks not just the respiratory system but other organs as well. Because it is a new strain, very few people can resist it, no matter how hardy they may be. Our bodies haven’t seen this strain before, so our immune systems haven’t developed ways to fight it off. Also, there is, as yet, no vaccine, so no medical measures can yet be taken to protect us against it.

Serious

It is difficult at this time to have a very accurate picture, but COVID-19 appears to be a serious disease threat. The Centers for Disease Control and Prevention include, in their range of possible futures for the illness, a prediction that more than half of the U.S. population could be infected. The illness appears to have more serious outcomes than the flu, and death rate predictions are higher.

Risk factors

COVID-19 requires the body’s immune system to mount a response to fight it off. According to the World Health Organization, anyone who has a weak immune system is at risk not only for acquiring the illness but is vulnerable to becoming severely ill.

Two factors are associated with weakened immune response: age and underlying chronic conditions. Those older than 60, and especially those older than 80 — even those who seem fit — are at higher risk for acquiring the illness.

Also, smokers and individuals with chronic conditions such as cancer, lung disease, diabetes, high blood pressure, and heart disease are at increased risk for COVID-19.

Points of entry

The illness enters the body through the nose, eyes or mouth and then proceeds to the lungs. This is why we are advised to avoid touching our face. It may also enter through particles in the air. This is why social distancing and avoiding crowded situations are recommended.

Alzheimer’s and COVID-19

The person for whom you provide care is in a high-risk situation. Most persons living with Alzheimer’s disease are older than 65 — one risk factor — and most people older than 65 have at least one, and typically more than one, chronic illness, the other risk factor.

The CDC website — www.cdc.gov/coronavirus/2019-ncov/index.html — is an excellent source of reliable information.

Local health department numbers can be found at www.cdc.gov/coronavirus/2019-ncov/downloads/Phone-Numbers_State-and-Local-Health-Departments.pdf.

Guidance for caregiving

We recognize that we are relatively early in this outbreak and that information and guidance is coming out in an ongoing way, so the guidance we are providing is guidance for now. It will certainly change and we will provide updates as we learn of them. Follow these general rules to protect you, the person you care for, and your family.

General rules

Please follow these rules even if you or your person has not been diagnosed with COVID-19 or neither of you is showing signs of it —

— Self-care: The best protection for you and those you care for is for you not to acquire the virus. Do your best to stay healthy. Take your medications as prescribed and follow your exercise and rest programs.

— Handwashing and sanitizing: If you leave the home, always wash your hands when you return and frequently during the course of the day. Cleanse hands for at least 20 seconds (sing “Happy Birthday” twice). Use hand sanitizer often. Use hand lotion to prevent drying and cracking of skin.

— Do not shake hands: Avoid direct skin-to-skin physical contact. Wave, nod, bow, give the peace sign but don’t touch. Do an elbow bump, if you’re both in sleeves. And fist bumps? That’s skin-to-skin, too. So don’t.

— In your home: Clean surfaces in your home using the CDC’s recommended solution of 4 teaspoons bleach per quart (4 cups) of water. Clean door knobs, sink handles, refrigerator and oven doors, steering wheels, and other high-use surfaces daily. Change hand and kitchen towels daily. Open windows (if possible) to increase ventilation. Do not share dishes and utensils.

— Manage underlying chronic conditions: Chronic conditions, such as diabetes, heart disease and COPD, tax the immune system. Adhere to management regimens to prevent the condition from worsening. Ask providers to call in refill orders and see if the pharmacy can deliver — or has a drive-through pickup window. Do this for the medications that both you and your care-recipient take.

— Monitoring: Watch yourself and your person for symptoms such as fever, cough, sore throat. Take your temperature occasionally.

— Social distancing: Remove yourself and your person from close contact with groups of people. This is admittedly very difficult, so here are some thoughts. If you are working outside the home, see if it is possible to work at a distance through telecommuting means such as phone and videocall contact, etc.

— Examine patterns of social interactions: If you regularly attended worship services, see if your place of worship offers streamed services, or consider using the regular time of attendance as a time of home worship.

If you take your person shopping, reconsider. If you must, perhaps use smaller shops at off-hours, and avoid very crowded places. Call friends, family, or neighbors to see if they are going to the store and can pick up items you might need.

Think about outings that present minimal risks: taking walks, going for car rides.

— Family visits. This is a really hard one. Keep them small, one or two people at a time. Ask everyone who feels unwell, has come into contact with people with the virus or has any symptoms to stay away. Ask all others to follow the same safety rules you are. And while this is especially tough, no visits by grandkids

More home engagement opportunities

If you have relied on outings like those listed above as a way to keep your person pleasantly occupied during the day, then removing them from the schedule means you have to fill in those times with other engaging tasks and activities. So, plan for that.

Consider the kinds of at-home activities that seem to please and engage your person. Are there ways to repeat such activities over the course of a day? Are there similar kinds of activities you might try? For example, if the person enjoys helping with cooking, might s/he enjoy helping with the laundry? Try new things out and add those to your toolbox that you see to be working well.

Pay attention to your own isolation

If following the “rules” means you are finding yourself more homebound, be sure to check to see how this is making you feel. Take some preventive steps before you begin to feel a sense of being isolated.

Make arrangements with family, neighbors and friends to have regular contact. Phone and FaceTime calls can be helpful.

If a friend or family member can come in to be with your person for brief periods of time, seek and accept that help — observing all the rules if you leave the home (and also the advice about having help come in).

Help from outside the home

If you have someone coming into the home to help care for your person, then the general rules should apply to them as well. The person should adhere to hand washing rules, be urged to follow good self-care procedures, and monitor him/herself for symptoms of COVID-19.

If a home health care worker comes to your home and also visits other homes, ask to review the procedures she or he has in place to prevent the spread of COVID-19 to their clients.

Medical care

You are very likely in a position where you have to manage your person’s routine and chronic health care as well as to respond to changes in condition or react in an emergency situation. It’s important to recognize that, with COVID-19, you need to have a plan for how to handle some medical situations that might arise.

Primary care providers — nurse practitioners, physicians, physician assistants — can bill for telehealth with Medicare and Medicaid patients. So, call the office and see if they have put procedures in place for handling — through a phone call or a video call — routine visits and visits related to any concerns you may have.

If they don’t, ask for advice about handling routine and chronic care situations that you’d usually manage by bringing the person to the office.

If dealing with possible COVID-19 symptoms, should you call the office first? Go directly to an emergency department?

If you feel you have an emergency but are not sure, and cannot get through to your primary care provider, call your local emergency department. Most have a nurse or physician on duty who can offer advice about the need to come in immediately or wait at home.

If you think you or your person might be showing signs of COVID-19 and think you should be tested, it’s important to call your primary care provider — or the emergency department or your health department — first. They may be able to provide advice about whether you need to be tested immediately or if it is appropriate to wait.

If you do need to be tested immediately, they may also be able to direct you to the appropriate testing location. In many areas of the country, the clinic office or emergency department may not be where you can get tested, and testing sites may need a provider’s referral before they will test you.

If you and/or your person are participating in a research study, call your research coordinator for current information. Some studies have been put on hold; others may have moved to enable contact at a distance, such as by telephone.

To learn about caregiver support groups or programs, contact the Aging and Disability Resource Center of Florence County at 715-528-4890.

You also can go to www.florencecountywi.com, or check out the ADRC of Florence page on Facebook.