NATIONAL NEWS - One of the services listed as essential during the lockdown has been home-based care.

It is the elderly who are the main clients in the care industry, and it is also they who are among the most vulnerable to Covid-19, so special precautions have had to be taken by care firms and their staff in providing this vital service.

Also, elderly people's fears about catching the illness have had to be allayed by carer companies.

The Mossel Bay Advertiser spoke to representatives of two home-based care companies about how they and their staff have gone about business during the lockdown.

Local company, Swans Home Nursing, with its office in Mossel Bay, operates on the Garden Route.

The company said it had a list of questions for its carers - a verbal test - on their health status, which they had to answer. If the carer had flu-like symptoms, she would not go to work, and then testing for Covid-19 would be done.

Home-based care involves close contact with clients, such as washing clients and turning clients who are bedridden.

Swans manager Gerhard Swanepoel said: "Masks and gloves are provided to carers and where possible direct contact has been avoided."

Lonely
Many elderly people are lonely and sometimes the touch and attention from their carers are the only regular contact they have, so limiting this touch has been hard for them emotionally during the lockdown.

Swanepoel said his company had received a notification from a major medical fund stipulating that as far as possible, patients should be cared for at home, not hospitalised, in order to ensure there was enough space in hospitals, should Covid-19 spread more than expected.

With regards to clients' fears of catching Covid-19, Swanepoel said they had needed reassurance that Swans was doing everything possible to prevent the spread of the virus. "Some had been panicking," he noted. 

Besides the elderly, though, he pointed out that the following were also dependent on home-based care: stroke sufferers, people who had undergone procedures such as hip replacements and shoulder operations and those with back injuries.

Dr Martin de Villiers, medical director of Medwell SA Home Nursing, which operates thoughout the Western Cape, including the Garden Route, also pointed out that patients with advanced cancer or other life-limiting illnesses and Alzheimer’s disease sufferers also still required home-based care during this time.

De Villiers said under normal circumstances these services were provided like a well-oiled machine, but the lockdown gave the home-based care industry new insights to overcome the challenges of how to continue to provide these essential services.

He said: "Our patients who are elderly and suffering from chronic diseases are justifiably afraid because worldwide statistics indicate they are more vulnerable than others, with a higher probability of dying of Covid-19 infection.

Anxiety
"The emphasis on social distancing and the fact that carers and other healthcare personnel frequently travel to the place of care daily, creates anxiety in our patients and their families. They contemplated whether they were suddenly more vulnerable because they are being cared for by health care workers who entered their homes daily."

To provide perspective, De Villiers noted on Monday, 20 April, when he was interviewed: "Of 11 4711 tests done in South Africa to date, only 3% returned a positive Covid-19 infection result.

"This means although symptoms in patients may be Covid-19-like, in 97% of the tested cases negative for Covid-19, the diagnosis will be a common cold, sinusitis or a lung infection with another cause.

"It is also important to know that about 82% of COVID-19 cases are mild: patients only experience a slight fever, fatigue and a cough. The vast majority of people can stay at home and get better without hospital treatment.

"But a note of caution: in the elderly and vulnerable population a serious lung infection that leaves patients short of breath as a consequence of seasonal influenza and not caused by a Covid-19 infection, can also have dire consequences and therefore patients still need to consult their doctor."

De Villiers says Medwell SA has full kits of necessary personal protective equipment available in every area it operates in, to be used by its personnel when they care for patients where Covid-19 infection is suspected.

Screening
"We do a temperature and symptoms screen of all our nurses and care givers daily before they go on duty." He says this screening is universally accepted as a first step in ensuring that health care workers are not sick when reporting for duty. The symptoms screen simply refers to asking the nurse or carer the following:

• Whether there is any possibility of having been in contact with anyone diagnosed with or having had possible exposure to someone diagnosed with Covid-19;
• Whether she/he has a fever, or has been feverish, developed a cough or has experienced difficulty in breathing.

De Villiers noted: "Although the use of facial masks is recommended by patients infected with Covid-19 to prevent droplet spreading, our care workers are using facial masks even though they are not sick when caring for patients.

"Testing for Covid-19, as per World Health Organisation and the Department of Health recommendations, is only required if we are dealing with someone who has symptoms and is of very little value as a screening tool.

"There is also a smaller risk that the virus could be transmitted by hand by touching an object or surface where the virus survived and then touching the eyes, nose or mouth. "Therefore, the recommended sanitary precautions are strictly adhered to including frequent washing of hands, cleaning of frequently touched objects and surfaces in the place of care.

"When the patient has symptoms of a cold or sneezing, we will also recommend that the patient uses a facial mask to protect the carer from getting a cold or influenza," De Villiers said.

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