COVID-19: Advice for families

You can find the latest guidance from the Government on COVID-19 here. The advice for the elderly is broadly the same as the rest of the population.

However, what has become clear throughout the pandemic to date, is that elderly people are more likely to show symptoms for COVID-19, more likely to be admitted to hospital and ultimately much more likely to die than younger age groups.

This of course means the disease should be taken seriously. We’re advising those we help care for to stay at home except for leaving the house for socially distanced exercise.

Self-isolating

People should self-isolate if they’re displaying any of the following symptoms until they’ve been tested:

• you have a high temperature
• you have a new, continuous cough
• you’ve lost your sense of smell or taste or it’s changed

If you or your loved one takes a test and is found to test positive, self-isolation for the next 14 days is legally required under the current law.

Social distancing

For those who have no option but to leave the house, they should practice ‘social distancing.’ This means remaining at least two metres away from anyone else. This prevents potential contact with droplets that could contain the virus from causing infection.

Shielding

In the most extreme cases, the Government has called for ‘shielding’. This is a severe form of self-isolation applying to those who are categorised as ‘extremely vulnerable’. Previously, these people were ‘strongly advised to stay at home at all times and avoid any face-to-face contact.’

However, the advice has changed in the most recent guidance set out in October 2020. Now, shielding advice varies depending on the tier a particular region is in. The key principle of the advice is that those in ‘extremely vulnerable’ groups should limit social interaction as much as possible, especially in high-risk areas. However, they should leave their house daily for exercise.

Should the advice change, the Government has indicated that it will contact ‘extremely vulnerable’ people directly to inform them of the new changes. We’ll also endeavour to update you on this.

Personal hygiene

When it comes to personal hygiene, the advice is that washing your hands tops the agenda. This is the same when it comes to the elderly:

• Wash hands using soap and water thoroughly for at least 20 seconds.
• Capture coughs and sneezes in a disposable tissue, throwing it away immediately.
• Avoid touching any part of the face, specifically your eyes, nose and mouth.
• Domestic hygiene (please see the guidance below)

Along with personal hygiene comes domestic hygiene. Here are three things you, your loved one or their carer should keep on top of:

1. Keeping the house generally tidy. If your loved one does become infected, there may not be the opportunity to do a deep clean.
2. Cleaning surfaces often, ideally using a bleach-based spray (depending on the surface), as this is highly effective at killing viruses. As a rule, the more a surface is touched, the more often it should be cleaned.
3. Doing the laundry frequently, as dirty garments can hold the virus. Any dirty washing should not be shaken or disturbed, as this can release the virus into the air.

Generally, the older you are, the more serious the condition can be. Elderly people – especially those over the age of 85 – are in a higher risk category. This means COVID-19 is very serious and all advised precautions should be taken to minimise risk of infection.

Additionally, those with any pre-existing symptoms that weaken the respiratory or immune system, such as hypertension, heart disease, asthma, and diabetes face an increased risk. As do those recovering from cancer or a recent transplant.

For 85% of people who contract the virus – and the vast majority of those in higher-risk groups – the symptoms will be mild. Many may simply confuse it for a common cold or mild flu.

In total, around 15% of those infected with coronavirus go on to develop severe symptoms. These include problems with breathing, low levels of oxygen in the blood and fibrosis of the lungs. It’s very common for those experiencing complications to develop pneumonia, which is an inflammation of the lungs that can inhibit breathing.

In 5% of cases, these issues can become critical. In these circumstances, sepsis, acute respiratory distress syndrome and organ failure may be likely. These are all treated in an intensive care unit (ICU), which is why the Government is currently planning a large expansion of ICU beds.

According to the World Health Organisation (WHO), current figures show over 96% of the total population and 80-90% of the over 80s will make a full recovery. However, these are based on the number of confirmed cases and the number of associated deaths.

Realistically, many more people with cold-like symptoms, such as coughs and sneezes, will have had the condition without being tested for it. This means realistically, it’s likely to be closer to 99% of people who survive.

One of the most difficult things about COVID-19 is identifying it when it shares so many symptoms with seasonal flu. Typically, those infected have experienced a particularly dry and continuous cough, as well as fever – identified as a temperature above 38 degrees celsius.

Those with coronavirus don’t often experience other symptoms of flu, such as headaches, vomiting and diarrhoea. Whatever symptoms your loved one is showing, it’s important they follow the Government advice of self-isolation.

If you’re displaying any symptoms of COVID-19, the first thing to do is get a test. You can get this delivered to your home. You should self-isolate until you receive the results. If you test positive, you should self-isolate for 14 days.

If symptoms are minor, as they are for the vast majority of people, the NHS recommends those familiar, common-sense measures we often take when we’re feeling under the weather. These include getting plenty of rest, drinking plenty of water and using over-the-counter painkillers if required.

Bear in mind, if your loved one’s condition deteriorates – such as them having breathing difficulties – or symptoms don’t go away within seven days, you should call the NHS on 111. They’ll advise on how to proceed.

Beyond treatment, it’s also really important to ensure your loved one does their bit to prevent the spread of infection – by removing themself from any unnecessary social contact and staying indoors. Of course, that also means maintaining good personal hygiene.

You get a test by visiting the NHS website and ordering a home testing kit. This should arrive within 48 hours. You should only get a free NHS test if at least one of the following applies:

• you have a high temperature
• you have a new, continuous cough
• you’ve lost your sense of smell or taste or it’s changed
• you’ve been asked to by a local council
• you’re taking part in a government pilot project

The COVID-19 test is a swab kit. The results are ready within 72 hours. This can be taken in hospital, in a specialist drive-through testing clinic or coronavirus testing pod. However, if you feel your loved one needs to be tested, they should – under no circumstances – just turn up. All testing is done by appointment, following a call to 111.

Despite criticism, the UK is already testing many more potential coronavirus patients than many other European nations and has recently committed to testing up to 10,000 every day.

Efforts are ongoing to create tests that can deliver results at the ‘bed-side’ and, separately, tests to reveal whether someone has built up immunity to the virus.

Ultimately, the Government guidance depends on the tier of the area you’re in and the level of risk. However, regardless of the tier you’re in, our advice is the same. Your loved one should take COVID-19 seriously. We would advise:

• Avoiding trips to public spaces such as cafes, shops and pharmacies. Instead, they should have someone else go and drop supplies off in a secure place for them to collect or order online.
• Avoiding face-to-face contact with people unless absolutely necessary – replacing it with technology where possible.
• Washing hands often with soap and water for at least 20 seconds, or hand sanitizer if that’s not possible.
• Throwing away any used tissues securely.

Ultimately, the risk of harm from social isolation is also significant and shouldn’t be underestimated – and this is a key lesson from the first peak. It’s important that elderly people are in regular contact with a reliable support network, both to stave off any feelings of loneliness/depression and to ensure their wellbeing is monitored.

We strongly advise you don’t visit your loved one. Don’t meet them in-person however tempting it is. The evidence from the first wave could not be clearer – staying away saves lives.

However, self-isolation shouldn’t mean social isolation. In fact, you should be more proactive than ever in terms of keeping in touch with your loved one.

Of course, in certain circumstances, it’s unavoidable. However, when doing so you should undertake all precautions in terms of personal hygiene:

1. Remove outer garments, such as your coat and shoes, immediately upon arrival.
2. Maintain a distance of at least two metres (where possible) from your relative.
3. Wash your hands thoroughly with soap and water for at least 20 seconds before, during and after your visit.

Prof William Keevil, Professor of Environmental Healthcare, University of Southampton says that ultimately ‘the longer the stay the greater the potential risk to your host.’ So, try and keep the time you’re visiting to a minimum and largely to ensure they’re ok.

Set up regular routines in which you communicate via telephone or video call. If you’re able to, it could be a good idea to buy your loved one a tablet or mobile device to encourage more frequent communication. This will help reduce feelings of social isolation and loneliness.

Yes, your loved one should still visit their GP surgery if there’s a clear need to do so. The Government is actively encouraging people to visit their doctor as normal. This may change if the number of COVID-19 cases continues to increase.

As with anything, minimising health risks associated with coronavirus – and any lockdowns – is all about planning ahead. This means you need to make sure there’s someone close at hand to help your loved one in the event of them contracting the virus. Here are some important areas for which it’s best to think ahead:

Essential errands: Whether it’s you, a professional carer – or even a neighbour – someone needs to be able to run errands, such as grocery shopping and the collection of prescriptions. They’re allowed under the lockdown measure as it’s an important way of reducing the chances of the elderly contracting the virus. Face-to-face contact should still be avoided, these can be left in a secure place for their collection.

Plan a routine: As frustrating as a lockdown is, it shouldn’t mean completely letting go of physical activity. You should chat with your loved one about adding physical elements in their daily life – even if it’s just a walk around the garden.

Communication: As it’s wise to limit face-to-face contact, you should put a plan in place to communicate with your loved one on a frequent basis via telephone or video call. A good way of doing this is establishing a regular routine. You should also encourage the rest of the family to do the same. This will reduce feelings of isolation and mean your family picks up on any symptoms faster. As mentioned above, enabling regular, remote communication more easily with a tablet could be a good idea.

The positions of the UK nations are increasingly different from one another. To find out more the latest guidance for your area, you should check with the NHS and health executive for your nation of the UK. These will offer you the most relevant information:

• England: Check the NHS website for guidance on symptoms, and Public Health England for latest Government measures.
• Scotland: Check the NHS Scotland website for guidance on symptoms, and Public Health Scotland for latest Government measures.
• Wales: Check the Public Health and NHS Wales website for guidance on symptoms and the latest Government measures.
• Northern Ireland: Check the HSC website for guidance on symptoms and the latest Government measures.

To track the progress of the global pandemic, and get useful summaries of the latest research, visit the World Health Organisation website. This is the United Nations agency responsible for global public health.