CDC Coronavirus Disease 2019 (COVID-19)

Hospice Visits

• If you want to decline visits from staff do to the precautions recommended by the CDC to protect yourself and others in your home from the virus please call Reliance Hospice  877-659-5998 and notify the team that you would like to decline the physical visit. Please let hospice know if you are willing to accept a visit over the phone instead. Make sure to notify hospice of any medications or supplies you need refills on.
  • If a patient, family members or facility staff present with any signs or symptoms of illness, hospice visits will be made over the phone to protect the health of hospice staff and limit exposure to any contagions that could be passed to others.
• In the event that a hospice staff shortage occurs due to precautions in place to limit the spread of the virus (ie school and work closures) hospice may provide telephone triage visits or attempt to contract with other hospice or health care agencies to provide needed services to Reliance Hospice patients.
• Nursing visit frequencies are subject to reduce to once every 14 days with phone calls in between to reduce exposure or potential spread of virus or contagions. Other discipline frequencies are subject to change as well.

Who is at Higher Risk?

• Older adults
• People who have serious chronic medical conditions like:
  • Heart disease
  • Diabetes
  • Lung disease
• Read more about High Risk Complications (www.cdc.gov)

STEPS TO PREVENT ILLNESS

• There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus.

The virus is thought to spread mainly from person-to-person.

• Between people who are in close contact with one another (within about 6 feet).
• Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Droplets can also be present on surfaces and spread through contact with contaminated surface and then contact with mouth/nose/eyes.

Take steps to protect yourself

Clean your hands often

• Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Wash your hands after touching surfaces in public places.

Avoid close contact

• Avoid close contact with people who are sick
• Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
• Avoid all non-essential travel including plane trips.

Take steps to protect others

Stay home if you’re sick

Cover coughs and sneezes

• Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. (Try to avoid as droplets on elbow can transfer to another person if touched or brushed up against) Throw used tissues in the trash.
• Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.

Wear a facemask if you are sick

• If you are sick:  You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. 

• If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.

Clean and disinfect

• Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
• If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

To disinfect:

Most common EPA-registered household disinfectants will work. Use disinfectants appropriate for the surface.

Options include:

• Diluting your household bleach (10:1 water to bleach)
  Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
• Alcohol solutions. Ensure solution has at least 70% alcohol.

Watch for symptoms

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

The following symptoms may appear 2-14 days after exposure.^*

• Fever
• Cough
• Shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

What To Do If You Are Sick

Stay home except to get medical care

• Stay home: People who are mildly ill with COVID-19 are able to isolate at home during their illness. You should restrict activities outside your home, except for getting medical care. Isolate to one room and use a separate bathroom from the rest of the people in the home if possible.
• Avoid public areas: Do not go to work, school, or public areas.
• Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.
• Limit contact with pets & animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus.

Treatment Protocol

Treatment of cough, congestion, and fever possibly related to the Coronavirus

• The Coronavirus is not responsive to antibiotics. There is no curative treatment available at this time. Treatment is directed towards ensuring comfort and relief of symptoms.
• Fever – normal temp 98.6. (97.6 rectal, 99.6 mid axillary) Treat if over 101 (temp less than 101 is body’s natural method to treat infection). If normal temp is lower, e.g. 97, then lower threshold for treatment accordingly.
  • Acetaminophen 500 mg q4h, or 325 mg, two qid, not to exceed 3000 mg/day.
  • NSAIDs such as Aleve, Motrin
• Wheezing, airway spasm, air flow blockage
  • DuoNeb nebulizer QID and Q4h prn
• Cough –
  • if need expectorant to thin secretions, use Robitussin plain, DM, or with Codeine. 1-2 tsp QID to Q4h
  • Normal Saline Nebulizer to thin deep secretions QID and Q4h prn
  • If no expectorant needed, use Phenergan plain, DM, or with Codeine. 1-2 tsp QID to Q4h
• Congestion –
  • Atropine drops or Levsin to reduce and dry up secrections. QID to Q4h
  • Robitussin thins secretions, Atropine and Levsin thicken secretions and try to prevent more from forming. The two groups of drugs work opposite to each other and should not be used together.
• Hydration – drink 8+ cups of liquid/d including water, tea, juice, health drinks.

WELCOME TO RELIANCE HOSPICE & PALLIATIVE CARE

Orange County’s First Hospice House