An old woman sits in front of a personal support worker as they both face the camera

Covid-19 Policy And Safety Plan

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Limestone City Home Healthcare continues to safely offer a range of essential in-home support services in compliance with all public health guidelines and Covid-19 safety measures. The health and comfort of our clients remains our number one priority, and we understand what a difference home care can make in the lives of isolated elders when they are required to stay home.

Purpose: To ensure safety for caregivers and clients

Home care organizations provide comprehensive services to clients in their homes and communities and therefore play a key role in preventing unnecessary hospital and long-term care admissions. Home care is used to describe formal non-medical or personal care delivered in the home.

Infection prevention and control strategies to prevent or limit transmission of COVID-19 in the home care setting:

Prompt identification of all persons with signs and symptoms of COVID-19

Infection prevention and control preparedness

Limestone City Home Health Care is maintaining awareness of data on the local and regional spread of COVID-19.

All caregivers are pre-screened prior to visits using our scheduling portal

All caregiver are requested to not leave the area – to not travel to any deemed hot spots unless for emergency purposes. Any travel must be approved by Limestone City Home Health Care Inc.

Caregivers are provided with proper PPE

  • All staff should ensure that:
    – They adhere to organizational IPC policies and procedures and jurisdictional public health guidance
    – Once daily, they self-monitor and immediately report any new signs or symptoms to the home care organization management
    – Prior to working every shift, they report to the home care organization management if they have had potential unprotected exposure to a case of COVID-19
  • Staff ill, or with an exposure to someone with confirmed COVID-19, as defined by occupational health or their local public health department, or those otherwise determined to require self-isolation according to public health directives, must follow the policies of jurisdictional public health authorities to determine restrictions and when they can return to work.

When masks and face shields are applied for the full duration of visits, home care staff must:

  • Perform hand hygiene before they put on their mask and face shield when they enter the home, before and after removal, and prior to putting on a new mask or face shield
  • Wear a mask securely over their mouth and nose and adjust the nose piece to fit snugly
  • Not touch the front of mask or face shield while wearing it or removing it (and immediately perform hand hygiene if this occurs)
  • NOT dangle the mask under their chin, around their neck, off the ear, under the nose or place on top of head
  • Remove masks just prior to leaving the home, while in an area where client or other household members are not present and discard in a waste receptacle followed by hand hygiene
  • Remove full face shields just prior to leaving the home, while in an area where client or other household members are not present and dispose of or reprocess as per the home care organization’s infection prevention and control guidance
    – If masks with attached visors are used these should be removed and discarded in a waste receptacle
  • Perform hand hygiene during and after PPE removal and between client encounters

Staff are instructed where to get tested if they become symptomatic or if requested by local public health authorities or the home care organization. Staff are required to get tested on a weekly basis and proof of negative results to continue to work.

If staff become ill:

  • Staff are instructed to contact the office immediately if they are feeling ill
  • Staff will be required to get re-tested for COVID-19 19 and will be unable to work until a negative result has been received.
  • Clients will be informed when a caregiver is ill and will be kept updated on the status of the caregiver’s results.

Home safety risk assessment

A trained staff member will conduct a home safety risk assessment to verify that the environment is suitable for providing the necessary level of care in the home. Assessment verifies:

  • Whether the client and household members are capable of adhering to the recommended precautions such as hand hygiene, respiratory hygiene, environmental cleaning and limitations on movement within the home
  • Household members maintain a physical distance of 2 metres from staff during the visit unless personal care is provided. Household member are to wear face masks when the 2 metre distance is not possible.


Caregivers must ask each client or any other member in the home if they are experiencing any signs or symptoms of COVID-19 or if they have been in close contact of anyone with confirmed symptoms of COVID-19.

  • Clients or household members with signs or symptoms of COVID-19 should be advised to self-isolate and contact their primary care provider or refer to local public health for further guidance.
  • Those experiencing more severe symptoms should be referred to emergent care
  • Client’s who require complex care will continue receiving care and the caregiver is required to wear full PPE

Droplet and Contact Precautions

Droplet and Contact Precautions should be implemented for all clients diagnosed with or presenting with new signs or symptoms of possible COVID-19

  • Signs or symptoms may include:
    – Fever (temperature of 38.0°C or greater), OR
    – Any new or worsening respiratory symptoms (cough, shortness of breath, runny nose or sneezing, nasal congestion, hoarse voice, sore throat or difficulty swallowing), OR
    – Any new onset atypical symptoms including but not limited to chills, muscle aches, diarrhea, malaise, or headache.
  • Gloves, long-sleeved cuffed gown (covering front of body from neck to mid-thigh), mask and face or eye protection should be worn upon entering the client’s home or when within 2 metres of the client on Droplet and Contact Precautions. Examples of face or eye protection (in addition to mask) include full face shield, mask with attached visor, non-vented safety glasses or goggles (regular eyeglasses are not sufficient)
  • PPE should be removed in the correct order and discarded into a waste receptacle when exiting the client’s home.
    – Full face shields should be removed (disposed of or reprocessed as per the home care organization’s IPC guidance) *If masks with attached visors are used these should be removed and discarded.
  • Hand hygiene should occur according to best practices for putting on or removing PPE

Environmental cleaning and disinfection

The client, other individuals living in the home, and the home care support worker should be informed on environmental cleaning practices. Surfaces that are frequently touched (e.g., bedside tables, bedframes, and door handles) should be cleaned and disinfected daily.

For high-touch surfaces such as door handles, toys, and phones, it is recommended to use either:

  • Regular household cleaners, or
  • In the event that regular household cleaners are not available, use a diluted bleach solution to disinfect the environment.
    – Clean surfaces initially and disinfect with diluted bleach prepared according to the instructions on the label or in a ratio of 1 teaspoon (5 mL) per cup (250 mL) or 4 teaspoons (20 mL) per litre (1000 mL) assuming bleach is 5 % sodium hypochlorite, to give a 0.1 % sodium hypochlorite solution. (Health Canada’s Hard-surface disinfectants and hand sanitizers for COVID-19).

Particular attention should be paid to cleaning and disinfecting the bathroom and toilet surfaces and the client care area. Any surfaces that become contaminated with respiratory secretions or other body fluids should be cleaned and disinfected as soon as possible. The virus that causes COVID-19 may be shed in stool; therefore, it is important to ensure that bathrooms are thoroughly disinfected.

Client and household member education

Clients and household members should be directed to appropriate national, provincial, territorial, or local COVID-19 resources pertaining to:

  • The importance of hand hygiene and how to wash hands and how to use ABH
  • Instructions on respiratory hygiene (i.e., covering their cough with a tissue or coughing into their elbow followed by performing hand hygiene)
  • How to safely and effectively care for a client with suspected or confirmed COVID-19 to prevent the infection from spreading to household contacts
  • Instructions on how and where to dispose of used supplies
  • The importance of not sharing personal hygiene items such as soap, cream or lotion, toothpaste, toothbrush, razor (or electric shaver), towel, skin, nail and other oral care items, including with family members.

Physical Isolation

Physical isolation is the mainstay of defence against Covid-19, but comes with its own terrible list of side effects. Older adults who are socially-isolated are more likely to become inactive, grow frail, become depressed, experience advancing dementia or eat poorly. These health outcomes are interrelated, with each worsening the other, and can be irreversible or even fatal.

Loneliness and isolation can lead to serious health challenges if left unresolved. According to the Centers for Disease Control and Prevention, they can cause increased rates of anxiety, suicide and depression as well as these other health consequences:

  • Four times the risk of premature death
  • 32% increase in stroke
  • 29% increase in heart disease
  • 50% increase in dementia

The implementation of physical distancing is an essential step in reducing transmission of the virus. Unfortunately, in an effort to flatten the curve, physical distancing may be causing social isolation and loneliness. Although loneliness and social isolation can affect anyone regardless of age, the elderly are particularly vulnerable, especially under the current conditions of the pandemic.

“The frail elderly are particularly at risk because of limited (or impaired) physical mobility, less autonomy, increased vulnerability to infections and immunological depletion, cognitive decline, chronic health conditions, lower injury thresholds and higher recovery times,”

Stephanie Cacioppo, director of the Brain Dynamics Laboratory at the University of Chicago’s Pritzker School of Medicine.

Social isolation and loneliness do not always go together. Loneliness, unlike social isolation, is a subjective feeling. According to Lisbeth Nielsen, director of the division of behavioral and social research at the National Institute of Aging, loneliness is the “sense of suffering from being disconnected from other people, which is different than social isolation which is simply not being around other people or not having close connections.”

Social isolation can also lead to feelings of loneliness. Observational and correlational studies have linked persistent feelings of social isolation and loneliness with a higher risk of developing certain mental and physical health conditions like heart disease, high blood pressure, anxiety, depression and even premature death.

“Loneliness also triggers a stress response that there is an imbalance in our social homeostasis,” Cacioppo said. This biological phenomena has been associated with increased inflammation and a hyper-activation of the immune system, which, according to experts, contributes to some of the chronic diseases that older adults are already more vulnerable to developing.

The health consequences of loneliness may also manifest as changes in routine and self-care. Is your loved one still keeping a routine, getting up at the same time every morning, going to bed at the same time? Do they have food in the house, are they preparing meals and keeping up with bathing? These are some simple examples of everyday routines which may become neglected over time in those suffering from isolation and loneliness.

Many older people who are following stay-at-home or isolation guidelines are finding that they are cut-off from the types of activity that bring meaning or purpose to their life, communal activities, recreational or exercise or just face-to-face social interactions that they are used to having. An individual in-home care plan with a reputable and accredited provider can not only serve to manage their care, but can also relieve some of the effects of isolation during a pandemic.

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