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.