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Seniors and infection control

by Isabel Fawcett

In healthcare institutions, it is common for infection control programs to be woefully understaffed. Staffing realities aside, the practice of proven infection control techniques is critical to successful delivery of healthcare, whether in-home, elder daycare programs, assisted living communities, or nursing homes. Caregivers would be wise to be in-step with effective infection control practices while caring for their elders.

If there is one thing I most appreciate from my days of working in healthcare, it is the memory of having met a tireless, creative, and highly energetic infection control nurse. All new hires met the infection control nurse on day one on the job. Our new employee orientation included an hour-long segment presented by an infection control nurse.

Though many years have passed since I attended that orientation. I still remember the visual of a slide showing bacteria prior to hand-washing after using the bathroom. I also remember the contrasting visual of bacteria on a slide depicting the same person's washed hand after he or she had used the bathroom. In the latter, bacterial growth no longer eclipsed the slide.

That's pretty much all I needed to know to continue what I had been taught in my childhood about frequent hand washing and not putting my bare hand on faucets or door handles in public restrooms. I was not surprised that the Infection Control Nurse recommended the same thing I had been taught by my parents, teachers and school nurse in my elementary school. Some things never change.

I still use a paper towel to turn faucets off after having washed my hands. Old habits die hard. All of the guidelines are just common sense, in my opinion.

Infection Control, in a Nutshell

To say that infection control practice in healthcare is a science is my layperson's understatement of the year.

A good infection control practice and program is part of the well-laid foundation of responsible healthcare administration. The science of infection control speaks to the issue of infections, how they come about and how they are transmitted from host to host, including in healthcare settings between and among patients and/or healthcare staff.

H1N1 pandemic in 2009 had to do with the transmission of a flu 'bug' from animals (swine) to humans. When it comes to the spread of infection, modes of transmission are important to researchers.

The effective and responsible administration of infection control programs in healthcare reaches out to every patient, nursing and non-nursing staff and visitors, all of whom have important roles to play in the transmission and control of infection.

I cannot imagine a nursing home or a medical center where custodian or housekeeping staff is not educated on proper cleaning, disinfection and sterilization of equipment, floors and patient or resident rooms. Neither can I imagine a medical center where surgical technicians fail to follow proper disposal and sterilization techniques.

Occasional public health scares notwithstanding, healthcare institutions go above and beyond in keeping infection control practices in effect, though nothing is foolproof, especially in the age of superbugs.

Superbugs are one of many good reasons for care providers to remain in-step with long-standing, proven infection control techniques and practices. Infections are serious business, sometimes a matter of life and death, especially for chronically ill elders.

Basics of Infection Control

It would be impossible to provide an all-inclusive overview of even the basics of infection control practices in eldercare. Instead, I'll just share a few things for my fellow caregivers' consideration.

  • Moisture is a breeding ground for bacteria. Take care of moisture cleanup promptly, including in the kitchen, at the dining table, spills on the floor, standing water, or stale coffee in a mug, moisture on and around faucets, counter-tops and tabletops. While you're at it, don't forget washcloths, damp or wet laundry and more. No need to panic or drive yourself crazy, just be mindful of standing moisture.
  • Standing moisture and discoloration should be red flags, including any pinkish hue. Think salmonella, as in food poisoning cross-contamination.
  • Check toothbrushes frequently. They can (and do) gather mold if the moisture and old food particles conditions are just right. Keep new toothbrushes on hand. Toss used toothbrushes regularly. I toss toothbrushes when the bristles start to bend.
  • Disposable baby wipes are better than washcloths. If properly disposed of, they will not cross-contaminate other dirty laundry or your laundry hamper with added moisture and bacteria.
  • If you care for and supervise an elder who is forgetful, medicated to distraction or simply distracted, listen for running water after the elder uses the bathroom. Running water may mean hands have been washed, though not always.
  • Supply sufficient hand soap and paper towels in the bathroom. Like baby wipes, paper towels are disposable, which is why I prefer paper towels in our home rather than cloth hand towels.

No need to become obsessive or compulsive about infection control. Just be alert and well-informed. I am not a nurse or other health professional. I merely apply common sense and remain well-informed.

Supervise elders' bath time to determine whether or how to enlighten a distracted or aching elder on more thorough or proper bath hygiene.

Some elders hail from a generation where common sense infection control practices prevailed. If carers are lucky, as I have been with my octogenarian mother, infection control practices remain a part of her generation's traditions and Mom's independent daily routines.

Occasionally, she may skip a beat, such as when she feels too achy to brush her teeth on rare occasions, but for the most part, Mom is on top of her game. If she misses occasionally and I happen to figure it out, I step in to provide guidance that keeps her on track.

If you are preparing a meal in an elder's home for the first time, or any time for that matter, sanitize all kitchen and dining surfaces before using and cooking. I use Clorox wipes nightly and during regular cleanup in my kitchen, including the kitchen sink. Undiluted vinegar is also a good cleaning agent. In kitchen cleanup detail, I am my mother's daughter and always will be.

Before providing wound care, or any direct hands-on care, wash hands before and after. Know when to use latex gloves when cleaning or treating a wound. Avoid inadvertently transmitting bacteria to an elder's wound, including through cross-contamination of surfaces.

It is best to throw a Band-Aid or gauze away if it falls on the floor, or touches another surface before it is applied to an elder's body.

When in doubt, throw it out is the most basic advice I can offer. That includes improperly refrigerated foods. These days, Mom increasingly stores items in the freezer. In some cases, when I find those re-frozen foods, I toss them. It's just one of the many hidden costs of eldercare.

Better safe than sorry. Don't make infection control practices hard on yourself or your elder. Just try to not make yourselves sick. Practice sound infection control habits. You'll both rest easier.

Here's to your elder's good health - and yours.

Additional Resources

Center for Disease Control's Overview of CDC Guidance on Infection Control in Healthcare Facilities (2009 H1N1 Influenza), Arjun Srinivasan, MD; David Weissman, MD, October 30, 2009