Your Carers Toolkit

Whether you're finding yourself in a caring role for the first time, or you're just looking for some additional information or advice, at West Yorkshire and Harrogate Health and Care Partnership we are working hard to ensure you feel supported.

The programme has created a Carers Toolkit offering guidance and support, along with useful resources to encourage you to think about your Plan B.

You can download your Carers Toolkit here.

Caring for your loved one with Covid -19

The coronavirus (Covid-19) outbreak is particularly worrying for unpaid carers. Many people will have been thrown into the caring role, rapidly and be unprepared. Those who are already existing carers (e.g. for those with long-term conditions) may see their role change as new caring tasks are required. This guide is designed to provide you with practical advice and tips that hopefully will help you look after your loved one and manage new symptoms such as of breathlessness, cough, fever and pain during this difficult time.

credit: Carers Leeds

PPE

New PPE must be used for each ‘episode’ of care.

Used PPE must be stored securely within disposable rubbish bags, placed inside another bag, securely tied and kept separate from other waste in the room. These should be set aside for at least 72 hours before being disposed of as normal.

Waste

Personal waste (such as used tissues, continence pads and other items soiled with bodily fluids) and disposable cleaning cloths can be stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal.

Laundry

Do not shake dirty laundry before washing. This minimises the possibility of dispersing virus through the air. Wash items as appropriate in accordance with the manufacturer’s instructions. Dirty laundry that has been in contact with an ill person can be washed with other people’s items. Items heavily soiled with body fluids, such as vomit or diarrhoea, or items that cannot be washed, should be disposed of, with the owner’s consent.

Management of fever

Fever is when a human's body temperature goes above the normal range of 36–37° Centigrade (98–100° Fahrenheit). It is a common medical sign of the virus. Other terms for a fever include pyrexia and controlled hyperthermia. As the body temperature goes up, the person may feel cold until it levels off and stops rising.

Is it fever?

Fever is defined as a body temperature of: 37.5oC or greater. Their chest and back feels hotter than usual.They may also be:

shivering
shaking
chills
aching muscles and joints
other body aches

Drugs that may help:

2 x Paracetamol tablets every 4-6 hours , no more than 8 in a 24 hour period

Unless their doctor has told you too do not give ibuprofen to relieve fever

Management of cough

Cough is a protective reflex response to airway irritation and is triggered by stimulation of airway cough receptors by either irrtants or by conditions that cause airway distortion. It can be very distressing and make sleep or rest difficult.

Cough Hygiene

To minimise the risk of passing on the infection:

Cover the nose and mouth with a tissue when sneezing, coughing, wiping & blowing the nose
Throw it away straight away into a closed bin
Wash hands with soap and water, alcohol hand rub or hand wipes after coughing, sneezing, using tissues

Things that may help:

Drink or sip water
- fluids
- Honey & lemon in warm water
Suck cough drops / hard sweets
Raise the head when sleeping , using pillows or books under the feet of the bed
Avoid smoking
Humid air may help if it is possible to provide this

Drugs that may help

Simple linctus 5-10mg by mouth, 6 hourly

If they have an underlying cause to their cough, bacterial infection or uncontrolled COPD, HF or asthma, continue t take your medicines prescribed by the doctor

If severe speak to their GP about other solutions such as stronger medicines such as codeine linctus, morphine sulphate, sodium cromoglicate

Management of pain

Your loved one may experience pain due to existing illnesses but may also develop pain as a result of excessive coughing or immobility from the virus. Pain can be very distressing and difficult to watch but there are lots of things you can try for your loved one. Often the key is taking regular pain medications, rather than waiting for the pain to start and then taken the medicines.

Mild pain

Step 1: start regular paracetamol , 2 tablets every 4-6 hourly, no more than 8 tablets in 24 hours

Step 2: persistent or worsening pain: stop paracetamol if not helping pain and start codeine 30-60mg four times a day regularly

Step 3: if paracetamol, or codeine is not helping speak to your GP about stronger alternative

Do not take ibuprofen

If they feel sick

Strong painkillers can make your loved one feel sick or even vomit. If this happens speak to their GP about anti sickness drugs.

Sometimes you need to try more than one to see which one works best, if your loved one still feels sick, ask their GP to prescribe a different type

Tablets can be crushed in ice cream or similar if this helps

If they cant take drugs by mouth

There are lots of alternatives available that do not need to be taken by mouth or in tablet form. Ask their GP about pain patches, injections, liquid drugs, tablets that dissolve under your tongue.

Management of breathlessness

Breathlessness is a discomfort with breathing and is a common cause of major suffering in people COVID-19. Breathlessness is not greatly helped by oxygen but there are lots of things you can try that may help.

Reversible causes

COVID -19 often causes breathlessness however if your loved one has other reversible causes causing breathlessness you should continue to give the medicines as prescribed

Things that may help

Trying different positions may help; sit upright, legs uncrossed, let shoulders droop, keep head up; lean forward
Try sitting propped up
Relaxation techniques
Reduce room temperature
Cooling the face by using a cool flannel or cloth
Mindful breathing techniques, distraction and psychological support can all reduce the sensation of breathlessness.
Simple menthol lozenges may help soothe an irritant cough.

Dementia Carers

We appreciate that this is a worrying time for everyone, especially for families looking after someone with dementia. Dementia UK have answered some frequently asked questions on their website which can be viewed here.

Meri Yaadain is a Community interest Company (CiC) supporting "meaningful impact in supporting people from Black Asian Minority Ethnic (BAME) communities who face barriers in accessing information, services and advocacy". The website offers support and guidance for those living with dementia, but also those caring for loved ones living with dementia.

Parent Carers

The government have released information and guidance around mental health for parent carers which can be viewed here.

As a parent carer it can be difficult having those important conversations about COVID-19, the Mental Health Foundation have created a guide offering advice on "talking to your children about scary world news".

Young Minds have also wrote an article looking at "helping your child with anxiety", as well as offering some advise on "looking after your mental health while self-isolating".

There is also a PDF workbook from Mindheart to download and print out, which your child can use to colour or write down their thoughts about how they're feeling. This resource could be useful in managing your childs anxieties or getting a gage of how they're really managing and what they understand. The resource is available in several different languages inluding Polish, Hebew, and Welsh.

Young Carers

There's a lot of information available to support young carers, recognising that many young people will find themselves in a caring role for the first time. Below you will find a summary of information to help you understand the current situation surrounding COVID-19.

The CBBC Newsround have a bunch of resources available going into detail about COVID-19 and anxieties that you may be feeling, all the information provided is easy to digest and can be found here.

The charity Young Minds have written a blog "what do you if you're anxious about coronavirus" about what young people can do if they are feel anxious about Coronavirus.

Looking after your mental health is essential during these difficult times. There's a lot of support surrounding young people’s mental health on the Charlie Waller Memorial Trust website. They have free resources which you can download to support your wellbeing and help you to manage your mental health; the website also have a free "daily planner" which can be used to help implement structure into your day, or your loved ones.

Caring for someone outside of your household

Caring for someone outside of your household can be a challenge at the best of times. It's important to ensure you know the contact number of your loved one's GP and named worker and ensure they have your contact details as next of kin. Consider setting up a rota/schedule for regular phone calls to keep in touch or using technology such as WhatsApp or Facetime to keep your family and friends connected over long distances. This will help support your loved ones mental health, and your own. Make sure to consider a Plan B if you're unable to offer care, either on a temporary or permanent basis.

Following government guidance, you are able to leave the house to continue to provide essential care unless you start showing symptoms of COVID-19. If you are caring for someone who is deemed to be extremely vulnerable, take extra precautionary measures by only providing essential care and ensure you follow the NHS hygiene advice for people at higher risk.

Looking after your mental health

These links have some useful tips and advice on looking after your wellbeing: