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Nursing Homes, Assisted Living and COVID-19

More than 43,000 long-term care residents and staff have died from COVID-19, representing over a third of the nation’s known coronavirus deaths.

Over 50% of family members are now more likely to choose in-home care for their loved ones than they were prior to the COVID-19 pandemic, according to a recent survey by Transcend Strategy Group.

Why Are Nursing Homes So Vulnerable To COVID-19?

• People age 65 and older are at higher risk from COVID-19.

• People with chronic medical conditions such as heart disease, diabetes, kidney disease and respiratory illness are also at higher risk from COVID-19.

The nation’s 1.3 million nursing home and assisted living residents generally fit both risk groups.

Certain conditions at nursing homes also aid the spread of the virus:

• Frequent close physical contact between residents and staff.

• Understaffing.

• Employees that work in multiple long-term care facilities, increasing chances of spread from one facility to the next.

• Shared resident rooms cause close physical contact.

• The transfers of new residents from hospitals and other settings.

These factors made nursing homes breeding grounds for viral and bacterial diseases prior to the COVID 19 pandemic:

The Centers for Disease Control (CDC), states that over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly 1 million persons reside in assisted living facilities. Data on infections in long-term care facilities (LTCFs) is limited, but it is estimated that 1 to 3 million serious infections occur every year in these facilities.

These infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others.

Infections are a major cause of hospitalization and death with as many as 380,000 people die of these infections in LTCFs every year.

Nursing Home Staff should:

• Wear personal protective equipment, such as face masks and gloves.

• Wash their hands or use hand sanitizer before and after contact with each resident, after using medical equipment, and after taking off masks, gowns, and/or gloves.

• Place alcohol-based hand sanitizer in all resident-care areas, including inside and outside resident’s rooms.

• Practice cough etiquette/hygiene.

• Stay home when sick.

• Clean residents’ hands after toileting or eating.

• Clean and disinfect medical equipment between each use.

How nursing home residents and their families can reduce the spread of COVID-19:

Wash their hands or use hand sanitizer and remind other residents to do the same.

• Practice social distancing from other residents whenever possible.

• Inform the administration if they observe staff who appear to be sick or are not taking the steps listed above to prevent the spread of COVID-19.

• Request that the administration provides regular updates to residents about what the facility is doing to prevent the spread of COVID-19 and care for any residents who are ill.

• That the administration shares the results of the facility’s self-assessment of their infection control practices.

• Ask facility staff to schedule a regular time for residents to communicate with their family and to assist them if they need help.

If you have concerns about the facility’s infection control practices or other issues:

• You can still use the facility’s grievance process if they have any complaints or concerns.

• Talk to the director of nursing or administrator about your concerns and ask what they will do to address them.

• Contact the Long-Term Care Ombudsman program for assistance. The Ombudsman program advocates for residents and can help resolve concerns.

• File a complaint with your state survey agency.

About Unique HomeCare Services

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the Greater Boston communities in Suffolk, Middlesex, Norfolk, Bristol, and Plymouth counties.

We provide private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing Assistance, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence Assistance, Feeding Assistance, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.

 

When And How to Use Hand Sanitizer Correctly

Most people do not use hand sanitizer correctly, which increasing the chance of spread COVID-19 and other germs.

The CDC recommends washing hands with soap and water whenever possible because hand washing reduces the amounts of all types of germs and chemicals on hands.

Using Hand Sanitizer CorrectlyIf soap and water are not available, using a hand sanitizer with at least 60% alcohol can help you avoid getting sick and spreading germs to others.

Hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

Background

Even if your hands appear to be clean, they carry germs. Hands pick up micro-organisms (germs) in a number of ways:

• When people who are sick sneeze or cough, the germs that are making them sick are expelled into the air in tiny droplets. If these droplets get onto your hands and then you touch your mouth, eyes or nose without washing away these germs, you can get sick.

• You can also get sick if you don’t wash your hands or sanitize them before and after preparing food and after using the toilet.

• Washing your hands or sanitizing not only prevents you from getting sick, but it also reduces the risk of infecting others.

• Other people can also get sick from the germs unwashed hands leave on objects and surfaces such as doorknobs, keyboards, and other equipment in the home or workplace.

Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

• Soap and water are more effective than hand sanitizers at removing certain kinds of germs.

• Although alcohol-based hand sanitizers can inactivate many types of microbes very effectively when used correctly, people may not use a large enough volume of the sanitizers or may wipe it off before it has dried.

Hand sanitizers may not be as effective when hands are visibly dirty or greasy.

• Studies show that hand sanitizers work well in clinical settings like hospitals, where hands come into contact with germs but generally are not heavily soiled or greasy. However, when hands are heavily soiled or greasy, hand sanitizers may not work well. Handwashing with soap and water is recommended in such circumstances.

Hand sanitizers might not remove harmful chemicals from hands.

• Hand sanitizers cannot remove or inactivate harmful chemicals. If hands have touched harmful chemicals, wash carefully with soap and water.

If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

• Sanitizers with an alcohol concentration between 60–95% are more effective at killing germs than those with a lower alcohol concentration or non-alcohol-based hand sanitizers.

• Hand sanitizers without 60-95% alcohol may merely reduce the growth of germs rather than kill them outright.

When using hand sanitizer, apply the product to the palm of one hand and rub the product all over the surfaces of your hands until your hands are dry.

• Make sure your hands are dry before using hand sanitizer as wet hands will dilute the product.

• Use enough product to cover all the surfaces of your hands and fingers.

• Rub the hand sanitizer over the front and back of hands, between your fingers, and under your nails.

• Rub your hands together until the product has evaporated. Do not wipe off the hand sanitizer as it needs to dry on the hands to be effective.

About Unique HomeCare Services

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the surrounding Greater Boston communities.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.

 

How To Wash Your Hands Correctly

The simple act of washing your hands is not something most of us thought about until the COVID-19 crisis.

Most of us do not wash our hands correctly to effectively remove germs.

Washing Hands Correctly

Washing your hands correctly or using an alcohol-based hand sanitizer, is the most effective action you can do to protect yourself against a number of infectious diseases, such as the “flu”, the common cold, and COVID-19. Not only will it help keep you healthy, but it will also help prevent the spread of infectious diseases to others.

Background

Even if your hands appear to be clean, they carry germs. Hands pick up micro-organisms (germs) in a number of ways:

• When people who are sick sneeze or cough, the germs that are making them sick are expelled into the air in tiny droplets. If these droplets get onto your hands and then you touch your mouth, eyes or nose without washing away these germs, you can get sick.

• You can also get sick if you don’t wash your hands before and after preparing food and after using the toilet.

• Washing your hands not only prevents you from getting sick, but it also reduces the risk of infecting others.

• Other people can also get sick from the germs unwashed hands leave on objects and surfaces such as doorknobs, keyboards, and other equipment in the home or workplace.

• The CDC’s guidance for washing hands is not new. Until the COVID-19 crisis, most people have not paid attention to this guidance.

Wet your hands with clean, running water (warm or cold), remove jewelry, and apply soap.

• Hands could become recontaminated if a basin of standing water is used that has been contaminated through previous use.

• The temperature of the water does not appear to affect microbe removal. However, warmer water may cause more skin irritation for some people.

• Remove any hand or arm jewelry you are wearing under running water as they may harbor germs.

• Using soap to wash hands is more effective than using water alone because the surfactants in soap lift soil and microbes from the skin.

Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, in between your fingers, and also under your nails.

• Lathering and scrubbing hands creates friction, which helps lift dirt, grease and microbes from skin.

• Microbes are present on all surfaces of the hands and are in particularly high concentrations under the nails. Therefore the entire hand needs to be scrubbed.

Scrub your hands for at least 20 seconds. Use a timer or sing the “Happy Birthday” song twice from beginning to end.

• Evidence suggests that washing hands for 15 to 30 seconds removes more germs from the hands than washing for shorter periods of time.

• You are scrubbing the dirt and germs off your hands. The soap does not kill these germs.

• 20 seconds of scrubbing your hands at a sink is much longer than you think. In fact, 20 seconds is about 3 to 4 times longer than most people think it is. Some people sing the entire “Happy Birthday” song twice to time how long they are washing their hands.

• After thoroughly washing your hands wash any jewelry you removed.

Rinse your hands well under clean running water to wash away the germs and then wash your jewelry.

• The purpose of scrubbing with soap is to lift dirt, grease, and microbes, including the disease-causing germs, from your skin so they can then be rinsed off of hands with the running water.

• Rinse off any hand jewelry you have removed.

• Replace the jewelry and dry your hands with a clean towel.

About Unique HomeCare Services

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the surrounding communities.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.

 

COVID-19 Basic Information And Facts

There is much misinformation on COVID-19 spread by social media and the rumor mill. Not only can this misinformation create panic, but it is also dangerous as proper prevention based on science and fact may not be used.

Know the facts about coronavirus disease 2019 (COVID-19) and help stop the spread of rumors.

What Is A Novel Coronavirus?

A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019, called COVID-19, is not the same as the coronaviruses that commonly circulate among humans and cause mild illness like the common cold.

A diagnosis of coronavirus 229E, NL63, OC43, or HKU1 is not the same as a COVID-19 diagnosis. Patients with COVID-19 will be evaluated and cared for differently than patients with common coronavirus diagnosis.

Putting COVID-19 Into Perspective

As COVID-19 is newly discovered much about the virus is unknown or unconfirmed and more is learned daily.

The current mortality rate figures for COVID-19 maybe deceptively high as health officials say the number of those with the virus may be under-reported which could lower the mortality rate significantly.

There is currently a 3.4% mortality rate globally for COVID-19 versus a mortality rate for previous outbreaks of 9.6% for SARS, 34% for MERS, and 0.02% for Swine Flu. The mortality rate of the common flu this season is 0.1% in the US., which sounds low, but has caused 46,000 deaths this flu season. Thus, the common flu this season is 5 times deadlier than Swine Flu.

The concern with COVID-19 is it seems more contiguous than the common flu and more deadly.

How Does COVID-19 Spread?

The virus is thought to spread mainly from person-to-person. The transmission is between people who are in close contact with one another, meaning within about 6 feet.

The transmission is through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby and possibly be inhaled into their lungs.

Can Someone Spread The Virus Without Being Sick?

People with the virus are thought to be most contagious when they are most symptomatic, meaning the sickest.

Some transmission might be possible before people show symptoms. There have been reports of this occurring with COVID-19. However, this is not thought to be the main way the virus spreads.

Can The Virus Spread From Contact With Contaminated Surfaces Or Objects?

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. But this is not thought to be the main way the virus spreads.

For safety until more is known, it should be assumed that the virus can be transmitted from contaminated surfaces or objects.

How Easily Does COVID-19 Spread?

How easily a virus spreads from person-to-person varies. Some viruses are highly contagious and spread easily like the measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

COVID-19 seems to be spreading easily and sustainably in the community in some geographic areas. This is called “community spread”. Community spread means people have been infected with the virus including some who are not sure how or where they became infected.

Who Is At Higher Risk?

According to the World Health Organization, “older persons and persons with pre-existing medical conditions, such as high blood pressure, heart disease, lung disease, cancer or diabetes, appear to develop serious illness more often than others.”

Although most people infected will COVID-19 have mild symptoms, about one in five require hospitalization.

So far there have been no fatalities of children under age 9 and the highest number of deaths have occurred to those 80 or older.

What Are The Symptoms of COVID-19?

The following symptoms may appear in 2-14 days after exposure.

· Fever

· Cough

· Shortness of breath

Just because a person exhibits these symptoms does not mean they have COVID-19. All the normal illnesses are still out there, the common flu, colds, and pollen season is starting.

Reduce Your Risk Of Getting Sick

· Clean your hands often and properly during the day. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place. 20 seconds is much longer than you think. Washing your hands does not kill germs. You are scrubbing the germs off and washing them away. Use a timer if needed.

· If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.

· As much as possible, avoid touching high use surfaces in public places such as elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.

· Avoid touching your face, nose, eyes, etc.

· Clean and disinfect your home to remove germs. Practice routine cleaning of frequently touched surfaces. For example: table tops, counters doorknobs, light switches, handles, desks, toilets, faucets, and sinks

· Clean your cell phone several times a day. Realize that your hands touch surfaces with germs all day. Your hands then touch your cell home, using apps, texting, etc., and you then place the cell phone next to your face when making calls.

· Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

· Avoid all non-essential travel.

· You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.

For a PDF version please click here.

About Unique HomeCare Services

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the surrounding communities.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.

 

Unique HomeCare Services and Coronavirus (COVID-19)

Reducing the spread of Coronavirus (COVID-19) especially in the high-risk population we service is of vital importance.

Our procedures have always emphasized infection control and prevention to minimize transmission between our clients and staff, including proper hand washing before giving care, using disposal gloves during care, and properly hand washing after giving care.

Per the Massachusetts Department of Public Health and the federal Centers for Disease Control and Prevention (CDC) guidance for Agency Based In-Home Caregivers & Workers, please see the guidance below, we have reviewed our procedures.

During this heightened period of concern we have:

· Employees review of all Unique HomeCare Services procedures.

· Employees review COVID-19 information and updates from the Massachusetts Department of Public Health and the federal Centers for Disease Control and Prevention (CDC) as they are released.

· Plans to address possible workforce shortages.

Please contact Unique HomeCare Services with any questions or concerns.

 

Agency Based In-Home Caregivers & Workers
(e.g. Home Health Agencies, Personal Care Management Agencies, Home Care Agencies, Adult Foster Care, etc.)
2019 Novel Coronavirus (COVID-19) Guidance

March 2020

This guidance is based on what is currently known about the transmission and severity of 2019 novel Coronavirus Disease (COVID-19). The Massachusetts Department of Public Health is working closely with the federal Centers for Disease Control and Prevention (CDC) to provide updated information about the COVID-19 outbreak. This guidance will be updated as needed and as additional information is available. Please regularly check mass.gov/2019coronavirus for updated interim guidance. Additionally, if you are a CMS-certified agency, please review and stay updated on CMS guidance. Each organization faces specific challenges associated with implementation based on its population, physical space, staffing, etc., and will need to tailor these guidelines accordingly. This guidance is intended to supplement, not supplant, provisions from regulatory agencies that oversee health care organizations. Organizations may develop their own policies, but these policies should be based on current science and facts and they should never compromise a client’s or employee’s health.

Background

What is Coronavirus Disease 2019 (COVID-19) and how does it spread?

· COVID-19 is a respiratory virus. Current symptoms have included mild to severe respiratory illness with fever cough, and difficulty breathing.

· According to CDC, the virus is spread mainly from person-to-person, between people who are in close contact with each other (within about 6 feet).

· Spread is from respiratory droplets produced when an infected person coughs or sneezes.

Who should be most cautious?

· Those considered “high risk” include people over the age of 60, anyone with underlying health conditions or a weakened immune system, and pregnant women.

What should agencies be doing to mitigate the risk of spreading COVID-19?

Screen yourself, staff, vendors, and clients for any of the conditions below:

· Sick with fever (higher than 100.3 o F) or newly developed respiratory illness such as cough, shortness of breath, or sore throat.

· Recent international travel (i.e., within the past 14 days) from COVID-19-affected geographic areas.

· Close contact with a person diagnosed with COVID-19 in the past 14 days

Preparing and Educating Staff:

· During times of COVID-19 circulation in the community, ensure employees are able to stay home if they have symptoms of acute respiratory illness or if they need to care for a sick family member.

· Make sure your employees are aware of these policies. Do not require a healthcare providers’ note to
validate illness or return to work, as healthcare provider offices and medical facilities may be extremely
busy and not able to provide this documentation.

· If employees become ill with respiratory symptoms while at work, they should be sent home as soon as possible.

· Make sure your employees are aware of these policies. Sick persons should cover their noses and mouths with a tissue when coughing or sneezing (or cough into their elbow or shoulder if tissues are not available) and perform hand hygiene immediately after.

· Those with symptoms of acute respiratory illness should stay home and not return to work until they are free of fever (oral thermometer temperature of less than 100.3 degrees) and any other symptoms for at least 24 hours, without use of fever-reducing or other symptom altering medicines (e.g. cough suppressants).

· If an employee is diagnosed with COVID-19 they cannot return to work until they have been authorized to leave their home by their local board of health.

Identify ways to limit direct person-to-person contact by leveraging technology, where appropriate.

Provide access to personal protective equipment (PPE), such as facemasks and gloves, as available.

· CDC recommends universal use of Standard Precautions when caring for any client.

· Reinforce the importance of strict adherence to Standard Precautions during all client encounters.

· Standard Precautions are based on the principles that all blood, body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes may contain transmissible infectious agents.

· For example, a facemask and eye protection should be worn during the care of any client if splashes, sprays or coughs could occur during the client encounter.

· Similarly, gloves should be worn if contact with body fluids, mucous membranes, or nonintact skin is anticipated.

Avoid unnecessary out of state or international travel and avoid large gatherings or crowds.

· Agency staff, and especially caregivers, provide essential services that help others to function throughout their daily lives. Agency staff health and the health of those you serve is of utmost importance.

· Agencies should set up ways to appropriately limit staff travel and possible exposure.

· Cancel large and do not attend large gatherings of more than 250 people.

Reinforce the practice of good daily hygiene with all staff.

· Wash your hands often with soap and water for at least 20 seconds, especially:

· After going to the bathroom;

· Before eating;

· After blowing your nose, coughing, or sneezing; and

· Upon entering and exiting the client’s home.
· If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.

· Cover a cough or sneeze with a tissue and dispose of tissue.

· Don’t touch your eyes, nose or mouth without first carefully washing your hands.

· Properly clean all frequently touched surfaces on a regular basis using everyday cleaning products.

· Avoid sharing dishes, drinking glasses, eating utensils, or towels.

· Wash dirty dishes in a dishwasher or, if by hand, with warm water and soap.

· Laundry can be washed in a standard washing machine with warm water. It is not necessary to separate laundry used by a client from other household laundry.

· In order to avoid germs, do not shake dirty laundry or “hug” dirty laundry to your chest to carry it.  Monitor staff emotional health.

· Emotional reactions to stressful situations such as new viruses are expected. Remind staff that feeling sad, anxious, overwhelmed, or having trouble sleeping or other symptoms of distress is normal.

· If symptoms become worse, last longer than a month, or if they struggle to participate in their usual daily activities, have them reach out for support and help.

Monitor staff emotional health.

· Emotional reactions to stressful situations such as new viruses are expected. Remind staff that feeling sad, anxious, overwhelmed, or having trouble sleeping or other symptoms of distress is normal.

· If symptoms become worse, last longer than a month, or if they struggle to participate in their usual daily activities, have them reach out for support and help.

· If one is available, encourage employees to call their Employee Assistance Program. The National Disaster Distress Helpline is available with 24/7 emotional support and crisis counseling for anyone experiencing distress or other mental health concerns. Calls (1-800-985-5990) and texts (text TalkWithUs to 66746) are answered by trained counselors who will listen to your concerns, explore coping and other available supports, and offer referrals to community resources for follow-up care and support.

Complete the Coronavirus COVID-19 In-Home Care Agency Checklist Tool on pages 4-8.

Organizational Preparedness. These preparedness steps may help protect your agency while minimizing disruption to your important services.

· Develop or review business continuity plans for how to keep critical services going if staffing levels drop due to illness or taking care of ill family members or children that may be temporarily out of child care or school settings.

· Be prepared to change your practices as needed to maintain critical operations (e.g., prioritize clients or temporarily suspend some services, if needed).

· You may also wish to refer to CDC: Interim Guidance for Businesses and Employers to Plan and
Respond to Coronavirus Disease 2019 (COVID-19)

· Cross-train personnel to perform essential functions so the site can operate even if key staff are absent.

· Assure you have adequate supplies of soap, paper towels, tissues, hand sanitizers, cleaning supplies, and garbage bags. If possible, a supply of disposable gloves and paper facemasks will be useful if persons become ill while at your program site.

Steps to follow if staff, or someone they know or care for is sick:

If staff are sick:

· They should stay home and not come to work. Do not schedule them to work if they are sick.

· Follow the steps outlined on page 9.

Follow the flow chart on page 9 to determine the best care path for an individual for whom your agency provides care and who is diagnosed with COVID-19 or is experiencing symptoms.

If you have staff that live with a sick individual some general guidance to share with them includes:

· Keeping the sick person in a separate, well-ventilated room and apart from other people and pets as much as possible.

· If a separate space is not available, keeping a distance of at least six feet from people who are well.

· A sick person who is coughing or sneezing should wear a mask when around other people. If the sick
person cannot wear a mask, the caregiver should wear a mask. The bathroom should be cleaned every day using a household disinfectant according to the directions on the label. Wear gloves while cleaning.

· Providing the sick person with a separate bathroom if available and a trash bag within reach.

· Limiting activities outside the home until the sick person is feeling well for at least one day.

· Limiting outside visitors.

Coronavirus COVID-19 In-Home Care Agency Checklist Tool (Page 1 of 4)

1. Review your Emergency Plan/Continuity of Operations Plan.
2. Update your Plan to reflect changes based on your review and current situation.
3. Update all workforce contact information.
4. Coordinate with local emergency operations/ local health department/health care coalition
5. Review personnel policies with regard to use of personal time, sick time, overtime. Develop
contingency policies.
6. Check with your vendors about supply chain especially those that provide you with medications for your clients.
7. Plan to address workforce shortages. Contract with other agencies for additional workforce.
8. Develop a plan to cross train workforce wherever possible.
9. Develop a questionnaire to identify which workforce members are available to work extra and flexible hours. Also identify workforce members that may be employed by another health care provider as they may have a commitment to that organization in an emergent situation.
10. Communicate your plan with partner agencies.
11. Help your workforce develop a plan for their families.

CLIENT CARE

1. Assess your Client Classification Levels for possible triage and keep hard copy easily accessible. Do this on a regular basis while we are in this current situation.
2. Identify client family members who may be able to take on more care responsibility if necessary.
3. Develop a Back Up Care Plan.
a. List names and responsibilities.
b. Get governing authority approval.
4. Begin to develop plans for possible surge capacity based on staffing and client classification levels. This means forecasting with a possible significantly reduced workforce.
5. Develop alternate staffing patterns such as longer days.
6. Ask screening questions before each visit and identify responsible person for conducting screening (scheduler, supervisor, worker, etc.).

SITUATIONAL AWARENESS

1. Communicate with local emergency preparedness organizations.
2. Assign one person to monitor daily updates from CDC, DPH, and World Health Organization.
3. Be aware of state updates, resources and communications.

INFECTION CONTROL AND PREVENTION

1. Educate/re-educate workforce in the following:
a. Standard Precaution
b. Transmission- based precautions such as
1) contact
2) droplet
2. Review Nursing Bag Technique with all field personnel.
3. Download multi-lingual client seasonal influenza information and distribute to clients and
their family members.
4. Re-educate workforce on handwashing protocols using running water and waterless hand
sanitizers.
5. Offer seasonal influenza vaccination to workforce and clients.
6. Check PPE supplies and dates. Move outdated to back and label as outdated but do not discard at this time.
7. Educate workforce again in donning and doffing of PPE and in sequential order.
8. Review your infection control policies for surveillance, recognition, identification and reporting requirements for workforce and clients.
9. Have a process to monitor and report any workforce or client illnesses in your organization.
10. Develop an occupational health plan and policies for any workforce members with an exposure to COVID-19.

About Unique HomeCare Services

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the surrounding communities.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.