Case presentation
An elderly woman in her 80s with dementia was referred to our home
nursing station in 2021.Originally, she used to run a restaurant with
her husband but they closed it five years ago due to health concerns.
Her husband also passed away three years ago and she has been living
alone since then. Normally, she used a daycare service six days a week
from Monday to Saturday, where she received exercise, leisure
activities, and cleanliness care including bathing assistance.
Additionally, she used to receive cleaning service and personal care
from a home care service once a week, and her son also visited her
almost every day. Meals were usually delivered to her home in a lunch
box, and she was able to eat at the dining table. However, sometimes,
due to short-term memory loss, she used to miss her meal. To ensure she
ate it, her daughter-in-law could call her and her son could visit her
every morning. In most cases, she was able to defecate on her own, but a
few times she failed to do so, so the caregiver had to check her diapers
and encourage her to change them.
In late June 2021, her son was found to be infected with SARS-CoV-2 and
was admitted to a hospital. As she had been in close contact with him,
the visiting physician immediately conducted a PCR test on her. Despite
the test result being negative her usual home care and daycare services
were completely suspended as she was in contact with an infected person.
Furthermore, her daughter-in-law also did not feel comfortable visiting
her. So, our institute was recommended by the public health center to a
care manager who was seeking a home nursing station equipped to care for
patients who had been in close contact with COVID-19 patients. Our role
was to manage for home care until a short-term accommodation could be
found.
We made our first home nursing visit around noon, the day after her
son’s admission. We were informed in advance that she had dementia and
she could refuse care services. However, we did not experience any
rejection for care and appropriate precautions were taken to prevent
COVID-19 infection. When she learned her son had been admitted to the
hospital, she broke down in tears. Upon calming her down, nursing staff
checked her vital signs, helped her take meals, medication and looked
after her hygiene needs. After a few days, the care manager was able to
find a private facility where she could stay for a short period. Besides
helping her prepare for the stay, our staff took her to a cab where she
was accompanied by her daughter-in-law.