By Clare Absher RN BSN Updated: 02/04/2021 Need help finding care?
Photo by NCI on Unsplash
My extremely robust and healthy 87-year-old mother was on lockdown for many months to avoid the risks of COVID-19 exposure. However, despite extreme caution a lone visit from an asymptomatic friend resulted in Mom getting COVID. As she succumbed to this dreadful virus, I was alarmed to witness how systematically it attacked her body. My 40-year nursing career did not prepare me for the unpredictable and harrowing nature of this illness.
My sister and I diligently cared for our mother for two weeks at home until pneumonia set in, giving rise to a short hospital stay. We were frustrated to find little support for help with her care at home when turning to Mom’s physicians and other resources for assistance. Perhaps in retrospect, the medical community also felt ill-equipped to aid in this unchartered territory we have come to know as COVID-19.
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Regardless of the lack of professional support, my sister and I were forced to manage our mother’s care one day at a time and treat her myriad of symptoms as they arose. As you probably have heard by now, COVID-19 seems to drastically impact everyone very differently. COVID-19 varies widely in severity, symptoms, and duration of the illness. My mother’s course of illness encompassed a full-on assault of multiple body systems, while other victims experience little or no symptoms.
Undoubtedly, my hope is that you and your family are fortunate enough to elude this virus entirely. Nevertheless, since COVID-19 will be prevalent for a long while it seems prudent to share any practical caregiver tips in the event you are faced with caring for a loved one with this illness.
First, the emphasis must be to protect yourself from catching this virus. Exposure to the virus is exceedingly likely when your loved one is symptomatic, especially with excessive coughing. Taking all safety precautions increases the chances that you will remain healthy and able to continue to care for your loved one.
Be kind to yourself, and resist allowing guilt to override smart safeguards. I wanted to hug Mom many times when she was in the throes of this monstrous illness; but I was forced to avoid close contact in an attempt to avert illness. Rigorous precautions allowed my sister and I to miraculously circumvent COVID while caring for Mom.
Try to get a hold of reliable PPE (personal protective equipment) such as N95 masks. N95 masks are extremely effective in protecting you from contracting this virus. It likely will not be easy to secure nursing grade PPE, but the chances of escaping exposure to this contagion goes up exponentially when wearing a properly fitted N95 mask. My sister and I were lucky to have an N95 mask for each of us that we reused by double masking with disposable protective masks, which are readily available everywhere. In addition, we also sprayed our N95 masks daily with alcohol to further decontaminate them. K95 masks, while not known to be as effective as N95, may offer better protection than some other disposables and they are more accessible.
Nonetheless, don’t overlook the need for persistent hand washing. Remember to do this when removing your masks and along with any contact with your loved one and their environment. Quarantine from those family members in your household that may be called upon for back-up caregiving, to avoid potential exposure to others and ensure that caregiving duties can proceed as scheduled should someone become ill.
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Dehydration and loss of appetite are caused by many viruses and influenzas, and it’s no different with COVID-19. As you are likely aware, it seems this virus causes many to lose taste and smell, further compromising nutrition. Keep a good supply of hydration and electrolyte supplement drinks on hand such as Pedialyte, Liquid IV, or similar products. Avoiding dehydration and electrolyte imbalance is critical to prevent hospitalization.
My 87-year-old mother never lost her taste or smell but had no appetite and was unable to hold down any food. Her risk for dehydration was further exacerbated by bouts of explosive diarrhea. Apparently, the scientific literature reports that 50% or more of those with COVID suffer with GI symptoms such as nausea, vomiting, and diarrhea. Meticulous oral hygiene is important to prevent thrush and mouth ulcers. Fortunately, Mom was able to hold down Pedialyte for adequate hydration. Explore different supplements to find those that work best for your loved one.
Intermittent fevers are a common symptom for many infected with COVID. Buy an oral or ear thermometer, or better yet an infrared no-touch thermometer. No-touch thermometers are more costly but allow a simple forehead swipe to eliminate the need to disturb your resting loved one. Treat high fevers as with any illness, with Tylenol and cool cloths as needed. Additional hydration is necessary due to loss of fluids from high temperatures.
Fatigue seems to be the most universal symptom of COVID-19. The fatigue associated with this virus seems to be exceptionally intense, based on accounts from many survivors. Therefore, creating a restful, quiet, and peaceful environment is a matter of high priority for your loved one. Limit disturbances by grouping caregiving measures together such as temperature and blood oxygen checks, giving meds and fluids, and a bathroom trip as needed. Repositioning in bed with pillows and clean dry bed linens will also add to your loved one’s comfort.
Cough and shortness of breath are potentially serious symptoms, and potentially life-threatening, due to Covid-19. A home pulse oximeter is an invaluable tool that you can purchase for about $20 at your local pharmacy. Monitor blood oxygen levels in your loved one to warn of pending danger. We frequently monitored Mom’s oxygen levels for a drop below 94%, that might lead to an emergency hospital visit.
Room humidifiers can help some with dry cough, especially at nighttime. We tried various cough medications and found that Tessalon Perles were the most effective. Mom’s oxygen levels rarely dipped below 93% and never were low long enough to cause distress. Eventually and unfortunately, Mom’s breathing worsened when pneumonia developed in both lungs due to the COVID-19 virus and hospitalization was imminent.
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A few other takeaways to mention from our family’s experience caring for Mom. Don’t let your guard down even if you get an initial negative COVID test result. Instead, focus on symptoms.
Mom had a negative result at 5 days after exposure, giving us a false sense of relief. By day 7 she had full blown symptoms and only then did she test positive.
I was surprised to discover a simple measure in the hospital that helped to relieve Mom’s shortness of breath. Positioning her on her side flat, and not elevated on her back, aided her breathing significantly. The ER nurse explained that they had learned this side position gave patients with COVID pneumonia considerable relief. Nasal oxygen, along with IV infusions comprised of a course of antibiotics and steroids, offered additional treatment.
The anxiety caused by the physical and emotional elements of this virus was immeasurable for my mother, long after the virus had departed. She became an insomniac due to intensely frightening nightmares. Mom described the dreaded fear she felt when she allowed herself to sleep because of feeling she was unable to breathe. A low dose anti-anxiety medication has been required for her to adequately rest even to this day, many months later.
The fatigue lasted months after Mom’s body was free from COVID. Her attention span was severely limited but steadily improved with time. Her hearing loss worsened but thankfully was helped by hearing aid adjustments. Mom’s hair fell out in big clumps for months after illness and reportedly is not uncommon to many survivors.
Additionally, many people have shunned COVID-19 “survivors.” There is a pervasive negative stereotype that those that contracted this virus must have done so due to risky behaviors. Even worse are those that believe COVID isn’t a serious illness but helpful in “thinning the herd” of those more susceptible to the virus, such as the sickly and elderly. Where these unfounded and ignorant ideas come from is beyond me, but nonetheless a hurtful burden for those with COVID and their caretakers.
My elderly mother miraculously survived this horrific illness. We are forever grateful but at the same time saddened by the grief of others who experienced such heartfelt losses. The severity, diversity, and unforeseen aftermath of COVID-19 should not be overlooked among survivors and their families. I strongly encourage others to share their caregiving experiences related to COVID-19 in the hopes it may help another, even if it is in a small or unexpected way.
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Clare Absher is a Registered Nurse with 45 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.
