We have put together the following advice to answer some key questions about coronavirus and CP.
As always the safety of our clients is our top priority. Taking into account the feedback from our clients, we have been working hard to make sure that we can continue to provide the support and services that our clients require.
Please be aware that following the government's announcement of lockdown 3.0 we will only be treating urgent cases in person. We understand that each individual will have preference to the support that they receive, so our therapist team will be in touch with you if you have an appointment booked to talk through your options. We will be restricting in person therapy sessions to protect our staff and clients but will also be running virtual sessions.
Please note that you will not be allowed in to the centre if you have been asked to self isolate because you have been in contact with someone with Coronavirus. This also includes if you have been contacted by the Track and Trace App. We ask our clients to accept full responsibility for this and to make us aware as soon as possible.
Additionally, we will still be running our virtual BoBaby and virtual adult meet ups that so many of you continue to enjoy.
Unfortunately we will be rescheduling our training sessions that are due to be held in November and December. Please keep an eye out for the new dates and we will be in touch with anyone who has already booked on.
We are here for you. It is a difficult time for everyone and we encourage you to reach out to us. If you need support dealing with CP during this lockdown, please don’t hesitate to contact us.
How we are keeping you safe
- Our therapists will look different and will wear PPE, but are still their friendly selves
- There will be fewer staff members in the centre, many are working from home
- All our team received training in COVID-19 Secure procedures
- We have strengthened our cleaning regime across the centre
- Hand sanitising procedures are in place as you enter and leave our centre
- We are limiting the numbers of people attending so we can keep 2m apart
- You will see screens and floor stickers throughout the centre
- For safety, we will be taking the temperature of all staff and visitors each day
- We are staggering our appointments to minimise the numbers of patients arriving at any one time
- We are allowing longer gaps between appointment times to allow for full cleaning in between patients
- We ask that you enter our centre no earlier than 5 minutes before your scheduled appointment
- Please help us by making your bookings and payments by email / online
- One of our team members will call you in advance of your appointment to check you feel well
- In line with the latest government guidelines, all staff will be wearing a face covering when in the centre
- We recommend downloading the NHS COVID-19 app for contact tracing
What is coronavirus?
Coronavirus (COVID-19) is a new illness that can affect lungs and airways. The most common symptoms of coronavirus (COVID-19) are recent onset of:
- new continuous cough and/or
- high temperature, over 37.8 degrees celsius
- a loss or change to your sense of smell or taste
For most people, coronavirus (COVID-19) will be a mild illness. Some people with the virus can show flu-like symptoms, including a fever and a cough. Sadly, for a small percentage of people this can progress to severe pneumonia which can then cause breathing difficulties. The dedicated NHS 111 phone line is available for those who display symptoms, and an online tool will guide you on what action to take.
General advice includes:
- Wash your hands with soap and water often – do this for at least 20 seconds
- Use hand sanitizer gel if soap and water are not available
- Wash your hands as soon as you get back home
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands afterwards
- Do not touch your eyes, nose or mouth if your hands are not clean
The Government and World Health Organisation has set movement limitations for everyone not considered in an essential job role, to only leave their home for a limited set of purposes. If you are a family member caring for someone with CP, this will help you avoid bringing the virus into the home. Consider travel only if necessary:
Practice robust hand washing every time you re-enter the home from travelling outside, before you touch anyone or any surfaces in the home. The virus can live on some surfaces after contact from 3 to 72 hours depending on porous surface level, so protect others by washing your hands immediately when you return home. Avoid disseminating your saliva to someone (e.g. via sneezing) by covering your mouth and nose when necessary (e.g. with a tissue) and avoiding hand contact (e.g. hand shaking) and avoiding touching your face or the face of the person you care for.
If you are caring for someone who can not wash their own hands, advice includes:
- Preparation: Ensure your own hands are thoroughly washed and dried first. Where appropriate wear gloves e.g. if this is part of your regular routine/protocol. Check if there are already any individualised recommendations regarding positioning and handling of the person’s hand/arm.
- Washing: Do not force hands open or force fingers/thumb to move. Use slow, gentle-but-firm handling. If possible immerse the hand in a basin of warm soapy water. Gently use your thumb to work into the palm – it can help to start at one end (e.g. at pinkie finger) and use small rotating movements to ease into the fist.
- Handling a person: Working for arms away from body to help loosen tightness.
- Other: Involve the person with CP in the process: check they are ready to start, check if they have a preference over which hand to do first. Drawing attention to the hands can often result in the muscle tone increasing. Distraction can help – chat about other things!
Extra considerations for caring with someone with CP:
- Unilateral Cerebral Palsy (UCP) - People with UCP/Hemiplegia are likely to be able to manage washing their own hands. Where the hand is particularly tight it is very important to ensure that every ‘nook, cranny and crease’ is reached and dried.
- Bilateral Cerebral Palsy (BCP) - Many people with a moderate to severe form of BCP (e.g. Severe Spastic Quadriplegia) are dependent on others to wash their hands. Any carers should first ensure they have washed their own hands (and where appropriate wear gloves) before assisting someone else.
Much has been written regarding the use or non-use of face masks. Unless using a highly specialised mask it is unlikely masks will protect you from the virus. However, using a facemask may be useful to prevent spread of the virus if you have it and you find it difficult to cover your mouth or respond quick enough to catch a cough or sneeze.
- Before putting on a mask, clean hands with alcohol-based hand rub or soap and water.
- Cover mouth and nose with mask and make sure there are no gaps between your face and the mask.
- Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.
- Replace the mask with a new one as soon as it is damp and do not re-use single-use masks.
- To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.
Links regarding the use of masks can be found at:
- World Health Organisation – When and how to use masks
- A video showing how homemade masks can be made if you know someone who is handy with a sewing machine. These are an alternative to disposables and can be washed at hot temperatures.
- Equipment: If you/your child typically use supportive equipment, you should check to make required arrangements for standers/walkers etc to be transported home.
- Wheelchair/accessories hygiene: Make sure you are frequently cleaning wheelchair handles, armrests, breaks of the wheelchair and clips of the harness/hip belt/feet straps. These components are regularly touched and serve as risk areas for contamination.
- AAC users: If you are responsible for helping someone manage their communication system there are some specific things you should consider:
- Ensure whatever (high & low tech) communication systems are being used, are kept current to reflect the vocabulary that someone may want/need to access. Any new additions/changes should be made known to everyone involved and the vocabulary itself should be easily accessible i.e. not embedded deep so lots of navigation is required.
- Ensure you wash your hands before you handle the communication aids and their bags (e.g. before you mount/programme/switch it on/off).
- Ensure communication aids and access devices such as touch-screens, switches, styli, joysticks etc. are regularly washed and dried thoroughly. Check manufacturers recommendations for how to clean.
- Don’t forget to regularly wash mounting brackets and edges of devices – many people with cerebral palsy stabilize themselves on these and so it is important that they are kept clean.
Recommendations to keep well during this time include:
- Sleep: Sleeping has been shown to restore our immune system and allows us to mentally prepare.
- Nutrition: Maintaining a healthy diet is key to good health. Vitamin C and Zinc play an important role in this. Our body can’t store vitamin C so it is good to ensure our diets include it.
- Water: Keeping well hydrated helps keep secretions moist and therefore easier to clear (cough). This is especially important if you are already prone to respiratory problems.
- Keeping active: Whether in a wheelchair or mobile – keeping physically active is a good way of looking after our mental and physical health. Aerobic exercise in particular is beneficial to provoke deep breathing.
- Managing posture: Aim to change position regularly. This could mean getting out of your chair e.g. standing frame, side lying, sitting up, rolling, moving position within your chair. Continue with any recommended physiotherapy programme you have been provided with. This is very important if you have a chest-physio programme as it can aid in keeping your chest clear.
- Breathing: Practicing deep breathing exercises allows your chest to stretch, in turn expanding lung capacity and allowing you to get well sooner.
More tips for those with restricted movements:
- Lie comfortably on your back - if your lower back arches a lot, place one or two pillows under your knees.
- Your parent or carer can lift your arms above your head as far as you feel comfortable and possibly prop your arms with additional pillows for support. Once positioned comfortably, focus on taking slow deep breaths and even slower releasing your breath.
- Practice for few minutes and then turn on your side and bring on arm up to your ear and breath in the same slow manner into your side for few minutes. Repeat on the other side.
What if I get infected with coronavirus?
It is important that everyone keeps up-to-date with UK national guidance on coronavirus in order to protect themselves but also those they come into contact with.
The most common symptoms of coronavirus (COVID-19) are recent onset of a new continuous cough and/or high temperature. If you have these symptoms, however mild, stay at home and:
- Do not leave your house for 7 days from when your symptoms started (if you live alone) and your symptoms do not get worse (if they do, contact NHS 111). If you live with people, isolate yourself from them to avoid spreading the virus.
- Do not leave your house for 14 days if you live with someone who has symptoms, in case you become affected. NHS advice is that you do not need to call NHS 111 to go into self-isolation if your symptoms are mild and you start to feel better.
Your body’s immune system will be working to remove the virus. To help yourself stay well while you're at home:
- Rest and sleep.
- Drink plenty of water to avoid dehydration – drink enough so your pee is light yellow and clear.
- Take paracetamol to lower your temperature.
- When resting: Try propping yourselves with extra pillows to keep you comfortable. V-Cushions can be very useful. Re-position yourselves regularly – change sides.
- Hydration and nutrition: Drink plenty of fluids and try to maintain a healthy diet – nutrition is important for your body to manage illness.
The majority of people experience mild symptom and get better/symptoms improve within the 7 days. If your symptoms worsen during home isolation (for example if you develop shortness of breath) use the NHS 111 coronavirus service. If you’re not in immediate danger but you feel you cannot cope with your symptoms at home, your condition gets worse, or your symptoms do not get better after 7 days, use the NHS 111 coronavirus service. If you do not have internet access, you should call NHS 111.
For a medical emergency dial 999. If it is an emergency and you think you may need an ambulance, call 999 and make sure to mention that you have symptoms of COVID-19.
You should also remember to avoid spreading the virus.
Nursing Times – Improving hand hygiene after neurological injury
UK Government Guidance for Households: https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance
UK Government general information: https://www.gov.uk/government/collections/coronavirus-covid-19-list-of-guidance
World Health Organisation advice: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public