Your COVID tool kit – Fall 2021

It looks like COVID is here to stay, or at least for a while longer. Hopefully more like the flu, however: A seasonal virus we need to be careful about, with extra precautions during a surge. From mask communication tips, to pulse oximeters, plus rapid home tests for safe visiting, here are some tools to help tide you over.

Communicating despite a mask

There is no doubt that masks have made it much harder to communicate. With half the face covered, and that half including the mouth where significant emotion is expressed, masks can leave a lot of people guessing—and feeling disconnected.

It’s worse with dementia. Especially if the person you care for has a condition such as Alzheimer’s, masks make a confusing world even more bewildering. People with dementia are unable to rely on words as much as they used to. As a result, they draw heavily on facial expressions and other nonverbal cues to understand meaning and emotion. And those cues have to be consistent with each other.

Particularly for those who already have trouble recognizing people they know, masks make it even harder. If they can’t identify a person, how do they know even the basics of who is friend or foe? These cues about safety are vitally important to the comfort and mental state of people with memory problems.

What can you do?
Try focusing on these other tools to offset the “communication penalty” of a mask:

  • Tone of voice. Studies show that we actually can communicate up to 24 different recognizable emotions through our tone of voice. Exaggerating your inflection can help people with dementia get a more accurate read of your mood and intent.
  • Hand gestures. There is a lot that even very young children learn by watching the hands. People with dementia retain that skill. Gestures of caring and of emphasis can portray many emotions in a way that is useful for someone having trouble with words.
  • Other body language. It’s not just your hands that express warmth or anger, safety or danger. Your posture says a lot. So does whether you are standing over someone who is sitting, or kneeling to be more at their level.
  • The eyes. They say the “eyes are the window to the soul.” Indeed, our eyes, eyebrows, and forehead can convey a tremendous amount of information. We simply need to be aware to express our emotional intent through those “windows” so our words, tone of voice, and gestures all match in a cohesive communication.
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What is a pulse oximeter?

Most advice following a positive COVID test is to go home and address symptoms such as fever and nausea. They want you to save going to the hospital until it’s “really bad.”

Well, what does “really bad” look like? Typically, it involves trouble breathing, blue lips, and other signs of respiratory distress. What has been difficult about COVID is that a person can have low oxygen in their blood but not appear to be distressed. Then suddenly, they go downhill very fast. In an afternoon for instance. By the time they get to the hospital, things are serious indeed.

Enter the pulse oximeter (ox-SIM-eter). This little device fits on the end of a finger or thumb. Turn the oximeter on and it will shoot several beams of light through the nail and the flesh. In a few seconds, it will deliver a readout of the percentage of oxygen in the blood flowing past. This “oxygen saturation level” is a key measurement of how well the lungs are able to do their job.

In a normally healthy individual, the oxygen saturation rate is 96%–100%. If it falls to 92%, it’s a good idea to call the doctor. If 88% or below, get to the hospital.

Pulse oximeters tend to report falsely high saturation rates for African Americans and people who wear dark nail polish. The darker hue seems to cause an inaccuracy in the measurement of the light. Rather than focus on a particular number, therefore, know what your loved one’s rate is when healthy. Then watch for a drop of 4% or more from their usual reading.

Pulse oximeters are truly effective at catching a serious infection before it gets “really bad.” In fact, one large study determined that using a pulse oximeter and going to the ER when there had been a significant drop reduced the chance of having to be put on a ventilator by 50%.

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Rapid home test for visiting

Rapid tests for COVID are 98% accurate and a great way to determine whether a person is contagious. It can ease your mind about grandchildren visiting your older relative, for instance. It’s not a substitute for getting vaccinated. But it does provide a level of assurance that gathering for Thanksgiving is not going to spread the virus from one family member to another.

Look for “rapid” in the name. There are other home tests, but they require sending off to a lab. A rapid test will yield a result at home within 15 minutes. They usually cost $7–$12 each and come in a package of two.

When should you rely on a rapid test?
This test accurately relates whether an exposure three days prior has resulted in an infection. Because of that lag, timing of the test is important.

  • A week before the gathering, limit contacts. Mask if indoors. Avoid large crowds. (Follow these precautions in your travel plans to the destination also.)
  • Three days before the gathering, take a test. If it’s negative, you probably were not carrying any virus from before your added precautions.
  • The morning of your get-together, take the second test. If that test is negative, then your precautions were likely also effective. Consider it a green light to hang out with grandma that day.

Testing typically involves twirling a cotton swab in both nostrils and rubbing it on a special surface. Like a pregnancy test, one line means no infection, two lines mean you are infected.

Kids should do the tests too, especially since they are probably not yet vaccinated so could easily be carriers, even if they don’t have symptoms. (Vaccinated people can also be carriers with no symptoms, so they also should be tested just to be careful.)

If you get a positive. Assume you have COVID even if you have no symptoms yet. Consider that a red light and cancel the visit.

Contact us at 301-593-5285

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