COVID-19: Guidance for Community Attendants and In- Home Caregivers

This guidance is intended for community attendants and other in-home caregivers who make home visits or provide services in a home or community setting.

Guidance is based on the best information currently available and will be updated when appropriate. For updates, visit dshs.texas.gov/coronavirus/healthprof or cdc.gov/coronavirus/2019-ncov.

 

Don’t report to work if you:

 

• Recently traveled to a COVID-19-affected geographic area outside of the United States in the past 14 days.

 

• Have a fever or new respiratory symptoms such as cough, shortness of breath or sore throat.

 

• Have been in close contact with someone diagnosed with COVID-19 in the past 14 days.

 

• Have been told by a health care provider you might have COVID-19.

 

If you don’t meet any of the above criteria, continue working and providing services to people who need support with their activities of daily living:

 

• Follow the screening flowchart before every visit.

• Follow the guidelines below.

 

Client Assessment Prior to Visit

 

• Talk with your employer or client ahead of a scheduled visit, either by telephone, text message or video conference, if you can.

• If possible, conduct the entire visit virtually, either by phone or video conference.

  • Ask the client to report their temperature by phone or show it to you via video conferencing, then report the result. A fever is a temperature greater than 100.3 degrees Fahrenheit and 37.9 degrees Celsius.

 

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P.O. Box 13247 • Austin, Texas 78711-3247 • 512-424-6500 • hhs.texas.gov

 

 

• If you plan to visit in person, ask them beforehand if they, or a member of the household, have a fever or other COVID-19 symptoms, including cough or shortness of breath.

 

Recommended Actions During Visits

 

• If you are unable to reach the client ahead of the visit, contact your employer. Ask the client to conduct the first contact with them at least 6 feet away and outdoors or outside the residence, such as in a hallway, if possible.

  • Limit extra physical contact, such as handshaking, hugging, etc.

  • Model proper hygiene practices for clients and caregivers, such as proper handwashing, covering coughs and sneezes, and the use of hand sanitizer.

  • Practice social distancing. Social distancing is deliberately increasing the physical space between people to avoid spreading illness and staying at least 6 feet away from other people. Current guidance states to stay at least 6 feet away from other people.

  • Continue your practice of using gloves when supporting clients.

  • Regularly disinfect all high-touch surfaces, such as counters, doorknobs, telephones, computer keyboards, and any other household electronic or communication devices.

• If the client or household members have no fever or concerning symptoms (such as a cough or shortness of breath), proceed with the scheduled service under standard operating procedures.

• If the client or household members have a fever or concerning symptoms, such as a cough or shortness of breath, adhere to the following:

  • Notify your employer, or the person you talk to about your shifts, and follow reporting procedures for your local area. If needed, assist the client when calling their health care provider.

  • For all NONCRITICAL services, reschedule until after the client has been fever-free (without fever medication) for at least 24 hours and symptoms have improved.

◗For all CRITICAL services that cannot be postponed, use all recommended personal protective equipment (PPE).

 

Recommended PPE for a Home Where You Suspect COVID-19

 

• A single pair of disposable patient examination gloves. Change gloves if they become torn or heavily contaminated.

• Disposable isolation gown.

 

 

• Respiratory protection (such as N95 or higher-level respirator if available, otherwise use a facemask).

• Eye protection (such as goggles or disposable face shield that fully covers the front and sides of the face).

 

Guidance for PPE Use in the Home

 

• Use alcohol-based hand sanitizer with at least 60 percent alcohol before putting on and after removing PPE.

• Put on PPE outside of the home before entering the home. Face protection includes a respirator if available; otherwise a facemask, plus eye protection.

• For introductory visits, conduct the meeting in the area with the best ventilation (such as outdoors, outside the residence such as in an apartment hallway if feasible, or in the largest room available).

• If you have surgical masks available (not N95 respirator masks), have the client wear one.

• Wash your hands with soap and water, or use an alcohol-based hand sanitizer with at least 60 percent alcohol after an interview or visit.

• Ask the client if an external trash can is present at the home, or if one can be left outside for the disposal of PPE.

• Remove PPE outside of the home and discard in an external trash can with a lid, before departing the location. Don’t transport worn PPE in your vehicle.

• If you are unable to remove all PPE outside of the home, keep on your face protection (such as respirator and eye protection) after exiting the home.

• If you need to remove your gown and gloves in the home, ask if you can use the restroom, or keep a 6-foot distance in the same room. Once the entry area is clear, remove your gown and gloves and exit the home.

• Once outside the home, use alcohol-based hand sanitizer with at least 60 percent alcohol, remove face protection and discard PPE by placing in an external trash can before departing the location. Clean your hands with sanitizer again and wash with soap and water as soon as you can.

 

Guidance for Positive COVID-19 Cases

 

If after entering the home there is someone who has a fever, cough or shortness of breath who reports they have tested positive for COVID-19, have traveled from a COVID-19-affected geographic area, or have been in contact with a person diagnosed with COVID-19 within the past 14 days, you should:

 

• Call 911 if you believe this to be an urgent situation for yourself or the people in the home.

 

 

• Immediately exit the home.

• Clean your hands with soap and water or an alcohol-based sanitizer.

• Notify your employer, supervisor, or the person you contact about your work hours.

 

Because the novel coronavirus (the virus that causes COVID-19) response is rapidly changing, this is interim guidance.

 

Reliable Information Sources

 

Find up-to-date novel coronavirus information at dshs.texas.gov/coronavirus/healthprof or cdc.gov/coronavirus/2019-ncov.

 

If you are in need of PPE, contact your Public Health Region or your Local Public Health Organization.