Caring for a loved one at home during Covid-19

Caring for a loved one at home during Covid-19

Palliative care physician Dr Kathryn Mannix on caring for someone with Covid-19

Bestselling author and old friend of The Art of Dying Well, Dr Kathryn Mannix describes what to expect should we find ourselves caring for a loved one with the coronavirus at home.

Dr Kathryn’s words are taken from our podcast: Episode 18: Dying, Recovering and Caring during the Covid-19 Pandemic, which was recorded in April 2020.

If you are caring for a loved one at home during Covid-19 what are the signs to look out for? What are the key factors to consider?

“If somebody’s decided that they want to stay at home and take their chances with this virus, then first of all, I think there’s a really important conversation to be had with them.

“For instance, there are some treatments that actually can help them to feel less unwell in hospital, are they really sure that they don’t want to give themselves the chance of having those treatments? So… to just test that decision out a little bit first.

“Some relatives of mine – who’ve been married for more than 60 years to each other – they’ve decided they don’t want to run the risk of one of them dying separated from the other one, so if they catch this, if either of them catches it, they will stay at home.”

What about protecting yourself, and shielding the rest of the family?

“So families then need to think about shielding, that perhaps one person is allowed to talk to the other from the doorway of the room, but can’t be as close as they might like to be, because we don’t want to turn the illness into another person’s illness as well.

“We’re now seeing that families are being provided with protective equipment, masks, gloves and aprons for going in and doing care. And actually what they’ll see at home is the same sort of care that people are getting in hospital, but families might be asked to do some of the giving of medications.”

What will I need to know?

“District nursing services have the same number of nurses they’ve always had, but with now many more sick people to try and travel between, so some families already, for example, learn to give injections – if they’ve got a family member who is diabetic and can’t give themselves their insulin injection –  we know that we can train the family to help them to give those injections.

“So it might be that there’ll be a crash course in giving injections so people aren’t waiting for medicines till the nurse has got time to get to the house, get all of the PPE on, and get into the room to help.”

Will I be able to help my loved one?

“Yes largely it’s managing the main symptom – which is going to be breathlessness – again, the same as in hospital, by using morphine; as tablets or as morphine liquid, and finding a dose quite early on where a long-acting morphine tablet – taken twice a day – is the right dose to keep somebody’s breathlessness damped down. And if it gets a bit too much at some points in the day then there’s quick acting morphine, liquid or tablets, which can be used to just top up in between time.

“So really at home, it’s just about being able to help people to get up and down to have their meals, to have their drinks, to get to the toilet. It might be that nursing services will need to provide some extra kit in the home.”

What other care might they need?

“It might be that sometimes people just can’t manage to get up and down to the toilet and you need to just help them to be able to wee or poo comfortably and sensibly in bed. Now, for men it’s relatively easy to be able to wee into a bottle or a jar, it’s much more difficult for women, but there are ways of making a kind of pad, that people can wee onto, by rolling up a towel and putting it underneath them, and then putting that straight into the wash afterwards.

“There’s a fantastic little booklet which has been made by Baroness Finlay, who I think is another friend of the Art of Dying Well, which is called Caring for your Dying Relative at Home with Covid-19, and it does what it says on the tin. And it’s so practical and it’s so useful, it’s just different ways of being able to help somebody; keep them comfortable, help them move in the bed, manage the laundry, very, very practical things. You can tell she’s not just a professor of palliative medicine, but she’s a wife and a mum, and she just understands how to deliver care at home in a really compassionate way – so that’s a fantastic resource for people.”  

Read the booklet Caring for your Dying Relative at Home with COVID-19 at Hospice UK website.

What else should people think about?

“I just hope that what we’ve been talking about today is going to be something that’s going to really help people to be less afraid, and to take courage and to say yes, I can do this… and it’s hard and it’s sad, and I can do it, and we will get through this. And this person I love may very well survive it, even though it’s frightening, or if they are going to die, well we’re going to make sure they’re comfortable and that they know they are loved, and how important they’ve been to us. And we won’t be left with a regret at the end of it.”

If you’d like to hear more from Dr Kathryn Mannix please listen to our podcast: Episode 18: Dying, Recovering and Caring during the COVID-19 Pandemic.  

The Art of Dying Well