Infection Control for Home Caregivers

Hand hygiene: the single most important habit

Most infections spread on hands.

Wash your hands with soap and clean running water (for at least 20 seconds, covering palms, backs, between fingers, thumbs, fingertips and wrists), and dry with a clean towel or disposable paper towel, at these times:

• before and after caring for your parent, including touching their body, food, medicines or equipment;
• before preparing and serving food, and before eating;
• after using the toilet, changing a pad, helping your parent with toileting or handling soiled laundry;
• after coughing, sneezing or blowing your nose;
• after handling rubbish, pets, cleaning or outdoor contact;
• after removing gloves;
• whenever hands look dirty.

Alcohol-based hand rub is a good alternative when hands are not visibly dirty, rubbed in until dry; it does not work well on dirty hands and does not replace washing after toilet care.

Keep nails short and clean, avoid wearing rings or bracelets while giving personal care and cover cuts with waterproof dressings. Help your parent wash their hands before meals and after the toilet; offer wipes if they cannot reach the basin. Keep soap and clean towels accessible; do not share towels.

Gloves, aprons and masks

• Disposable gloves are used for contact with body fluids, soiled items, open skin or wounds, and when cleaning toilets and commodes. They are not a substitute for hand washing: wash hands before putting them on and after taking them off. Change gloves between tasks and between areas of the body; never reuse single-use gloves.
• A plastic apron protects clothes when handling soiled laundry or personal care.
• A mask may be useful when you are unwell with a cough or cold and must still care for your parent, or if your parent has a respiratory infection, as advised by the doctor. Use properly, change when damp, and do not touch the front.
• Eye protection is seldom needed, but may be, for splashes in certain situations.

Ask a nurse to demonstrate the order of putting on and removing protective items if your parent has an infection that could spread.

Personal hygiene and skin care for your parent

• Bathing and washing: keep the skin clean and dry, especially in folds, the groin, under the breasts and between the toes, where moisture and bacteria thrive; see bed bath step by step.
• Dry thoroughly, moisturise dry skin and check daily for redness, cracks, sores or fungal infections; see fungal skin infection in elderly.
• Mouth care twice daily, with denture cleaning; poor oral hygiene is linked to chest infections; see oral care for frail older adults.
• Nail and foot care, particularly for diabetes; see diabetic foot care at home.
• Incontinence: change pads promptly, clean the skin gently from front to back and use a barrier cream if advised; see incontinence associated dermatitis.
• Wounds and pressure areas: keep dressings clean, dry and intact, and follow the nurse's instructions; see wound care at home for older adults and pressure ulcers: stages and care.
• Catheters and tubes: handle only with clean hands, keep the drainage bag below bladder level, never disconnect unless taught and report any fever, cloudy or smelly urine; see catheter care basics for families.
• Hydration and mobility: drinking enough and moving as able reduce urine and chest infections; see hydration for older adults.

Cleaning the home

Routine cleaning with soap or detergent and water is effective for most surfaces. Disinfectants are needed mainly where there is body fluid contamination or a known infection.

• High-touch surfaces: door handles, switches, bed rails, remote controls, phones, walking aids, table tops and taps should be wiped regularly.
• Bathroom and toilet: clean daily, with particular care for commode chairs, urinals and bed pans, which should be emptied, washed with detergent and hot water and dried after each use, using gloves; see commode chair cleaning and hygiene.
• Spills of body fluids: put on gloves, wipe up with disposable towels, clean with detergent and water, then disinfect with an appropriate household disinfectant, following the product label, and dispose of the cloths in a sealed bag. Wash hands.
• Never mix cleaning products, particularly bleach with other chemicals, which can release harmful fumes. Ventilate well and keep chemicals out of reach of confused persons.
• Damp and mould: fix leaks and ventilate; see pest, damp and mould at home.
• Pests and mosquitoes: use nets and screens, keep food covered and reduce standing water; check with the doctor before using sprays and coils near people with breathing problems.
• Air and ventilation: open windows, avoid smoke, and use an air purifier only if advised; see indoor air quality for older lungs.

Laundry, waste and equipment

• Soiled clothes and bedding: wear gloves, handle without shaking, remove solid waste into the toilet, wash separately on the hottest suitable setting with detergent, and dry thoroughly in sun or a dryer. Wash hands afterwards.
• Towels and cloths: use separate ones for the person, and change daily; do not share personal items such as razors or toothbrushes.
• Waste: place used pads, gloves and dressings in a sealed bag in the household waste. Sharps (needles, lancets) go in a rigid sharps container; see insulin and injections at home. Ask the clinic or local authority about disposal of any infectious or medical waste, since rules vary.
• Equipment: clean thermometers, nebuliser parts, oxygen humidifiers, masks, tubing and inhaler spacers as the manufacturer or nurse advises; see how to use a nebuliser and oxygen concentrator safe use at home. Clean wheelchairs, walkers and shower chairs regularly.

Food and kitchen hygiene

• Wash hands, work surfaces and utensils before and after handling raw food.
• Keep raw meat, fish and eggs away from cooked and ready-to-eat foods.
• Cook food thoroughly, especially meat, fish and eggs; reheat leftovers until steaming hot and only once.
• Refrigerate cooked food promptly; in hot weather, do not leave food out for more than an hour or two, and use clean water.
• Wash fruit and vegetables well, and peel where suitable.
• Drink safe water; boil or use a reliable filter, and keep storage containers clean.
• Check expiry dates; avoid street food and uncooked salads if your parent has weak immunity, or follow the doctor's advice.
• In power cuts, keep the fridge shut and discard food that has been warm for long.

Visitors and illness in the household

• Ask visitors who are unwell, with coughs, colds, fever, diarrhoea or rashes, to postpone. Encourage hand washing on entry.
• If you or a family member is sick, avoid close contact with your parent as much as possible, wash hands often, cover coughs and sneezes with a tissue or your elbow, wear a mask when giving care and ask someone else to help if you can.
• Keep children's vaccinations up to date, and be aware of infections going around schools.
• If your parent has an infection such as influenza, COVID, tuberculosis, scabies, diarrhoeal illness or a skin infection, ask the doctor how to protect others: separate room if possible, own towels and utensils, extra cleaning and masks as advised.
• Carers should check their own health: if you have symptoms, seek advice and avoid contact where possible; see caregiver burnout signs and prevention.

Vaccines

Vaccines are one of the best protections for older people and carers. Ask the doctor about influenza, pneumococcal, COVID-19, tetanus, shingles and other vaccines suited to your parent's age and conditions, and your own vaccines as a carer. Schedules and availability change; see vaccines for older adults in india and vaccines for lung health after 60.

Spotting infection early

In older adults, signs may be subtle. Watch for:

• fever, chills or a low temperature; use a thermometer; see digital thermometer guide;
• new confusion, drowsiness, agitation or a fall;
• cough, breathlessness or fast breathing; see pneumonia prevention and recovery in seniors;
• burning urine, frequent urination, cloudy or smelly urine, or new incontinence; see home remedies for urine infection in seniors for general background and see a doctor before relying on home remedies;
• redness, heat, swelling, pus or pain in the skin or a wound;
• diarrhoea, vomiting or abdominal pain;
• loss of appetite or not drinking.

Call the doctor the same day for any suspected infection; do not give leftover antibiotics or start medicines on your own. Call 112 for fever with confusion and fast breathing, severe breathlessness, shivering and collapse, spreading redness with severe pain, or if the person cannot be woken.

Protecting yourself

Wash hands, use gloves and aprons as needed, cover cuts, keep your own vaccinations up to date, avoid touching your face, do not eat in the sickroom and take care with needles and sharps. If you are pregnant, immunocompromised or have a chronic illness, ask your doctor about your risks as a carer. Seek advice if you are exposed to an infectious disease.

When to ask a professional

A nurse or doctor can teach you specific infection control for catheters, wounds, tubes or infectious illnesses. A pharmacist can advise on cleaning products and supplies. A public health authority can advise on notifiable diseases. For senior citizens' information and support, Elderline 14567 is a helpline; check current availability. In an emergency, call 112.