Caring on the frontline of the COVID-19 crisis: a nurse's story

Since early April, older Australians have been urged to self-isolate in a bid to stay safe during the coronavirus pandemic. For thousands of vulnerable elderly people receiving in-home care, hunkering down has meant adapting to changes in how their care is delivered and for some, cancelling their home visits altogether.

Kathy, from the NSW Central Coast, says even though we, as a country, are isolating, it is vital not to ignore our elderly. "It is important to continue with home visits for my clients to ensure they are safe, well and not isolated. It is easy to be forgotten in a time of crisis."

Kathy's home care clients range in age from their early 70s to 100, and all live alone - often after the loss of a spouse. Some need a little help around the house, others are living with dementia or have medical conditions that require extra assistance.

A typical day for Kathy can involve helping clients around the house, simply having a chat and a cuppa, driving them to appointments, helping administer medication or aiding with basic daily activities such as showering, dressing or feeding.

She says throughout the lockdown, the safety of her clients has been at the forefront of her mind.

"I have felt the responsibility of ensuring I do not expose my elderly vulnerable clients to the risk of COVID-19 and definitely have concerns for the more frail ones with underlying medical conditions putting them at a higher risk if they were to be exposed to the virus," Kathy tells The Senior.

"As I continue about my personal life, I constantly have in the back of my mind the fact that the risks I take are also risks for my clients.

"Basically it comes down to an immense amount of trust they place in me to do the right and moral thing by them and live my life at work, and away from work, in a way that respects that their lives are just as valuable as my own."

She said it is vital that people realise the impact their decisions can have on older people during the pandemic.

"An extremely hard side of this has been seeing the community make risky decisions that put the elderly at risk. I believe that all lives are just as valuable no matter if you are young and at the beginning or older and towards the end.

"I want society to know that we all play a role in keeping each other safe in this COVID-19 crisis: that any decision we make, and any risk we take, has an indirect impact on others."

To this end, Kathy and her clients - who she describes as some of the most selfless and interesting people she's met - have had to adapt to many changes in how their home care is delivered, from wearing personal protective equipment (PPE) to social distancing.

"I have clients whose family has suspended their loved ones' aged care packages while the risk is high in order to limit the potential exposure. I have clients whose families have requested we wear PPE," said Kathy.

"Other clients are continuing on as normal and are in fact still going out into the community, while some are staying in the safety of their homes.

"Some clients struggle to understand the changes they need to make and others ask me the same questions every visit. Some clients want to be on the other side of the room and some still want to be in my personal space and struggle not to touch."

The absence of hugs and human contact is something Kathy struggles to come to terms with.

Another hurdle Kathy and her clients faced at the beginning of the outbreak was the difficulty getting hold of basic supermarket items.

"The lack of availabilty of toilet paper was a big issue. I overcame this with a stash in the boot of my car that I could dispense to clients as they needed it. The lack of long life milk, disinfectant cleaning products and canned foods was also an issue. Once again, I sourced them in my own time to ensure no one went without."

When it comes to embracing new technology, Kathy said many clients have surprised her. "I've had clients use text, Facetime and Zoom to keep in contact with loved ones. Surprisingly, I would say about half of my clients have embraced the need to use technology during this time, with some navigating it themselves."

And while Kathy's shifts can be long, emotionally and physically draining, and unpredictable, she said she wouldn't do any other job.

"I love working with the elderly and that is literally what gets me through each day. The bond I develop with each client is a give and take. I offer them care and companionship and in turn they offer me friendship. I admire their strength and reilience."

And like many care workers on the frontline, Kathy finds one of the best ways to unwind after a shift is to have a debrief with a friend or immediate family member "and if I need to, I have a cry".

"I try as hard as I can to keep work as work, however it doesn't always happen. I have an allocated time in my afternoon/evening for me to bushwalk, exercise and sweat, to forget about anything else while I focus on me.

"To be honest, sometimes I just sit with a cup of tea and feel privileged to be able to make a positive contribution, and think maybe I am the lucky one."

*Name changed to protect the privacy of her clients.

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