How would you proceed here or wouldn’t you?

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blossom

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I have a dear client of some 15 years in her mid 80s with terminal lung cancer, virtually housebound and with a daily carer.

Her nails are one of her few remaining pleasures and I’ve had several texts!

No intention of working before we are allowed obviously. But I’m very concerned with her health problems especially as it’s lung cancer and her age as both put her very definitely into the very vulnerable category.

She does not care incidentally and would have continued right through lockdown if I’d let her!

So as and when work is allowed for us nail techs, would you treat this lady? I’m not normally mobile but since she’s had trouble driving (about a year) I’ve made an exception and pack up and go to her. This in itself could now be a problem with cross contamination I’m thinking. We use her table and chairs.

I’m unsure what to say to her and don’t want to give her false promises.

What would you do?
 
That is a dilemma!

I think it must be even harder to have to spend lockdown in isolation when you know you’re dying anyway. Poor lady.

Here in the Republic of Ireland, we’re still working to 20th July as our date to re-start hair and beauty services. This is Phase 4 of the Irish Govts. published plan for re-opening services so if she was my client, I’d be contacting her to book her in around that date. That way, she has a definite date to look forward to. Obviously, you’d have to explain about both wearing a mask but if she has breathing difficulties it is on oxygen, she might not be able to wear a mask?

I’m not up to speed with UK govt. plans. Have they announced a plan for re-opening beauty salons yet?
 
AcidPerm UK is 4th July at the earliest.
blossom - it is soooo difficult! I think though I would be of the intention to see her. She possibly hasn’t got much longer left & I’m sure she would love the attention. I would say as long as you make sure everything is sanitised, you wear ppe & she wear a mask if she’s able to, plus do a thorough consultation...go for it! Also, might be worth checking with your insurers just to be on the safe side though.
Anyway, the government has said those that have been shielding can now go out, & who knows who you can meet when you go outside so seeing you i’m sure would be safer than that.
 
I have a dear client of some 15 years in her mid 80s with terminal lung cancer, virtually housebound and with a daily carer.

Her nails are one of her few remaining pleasures and I’ve had several texts!

No intention of working before we are allowed obviously. But I’m very concerned with her health problems especially as it’s lung cancer and her age as both put her very definitely into the very vulnerable category.

She does not care incidentally and would have continued right through lockdown if I’d let her!

So as and when work is allowed for us nail techs, would you treat this lady? I’m not normally mobile but since she’s had trouble driving (about a year) I’ve made an exception and pack up and go to her. This in itself could now be a problem with cross contamination I’m thinking. We use her table and chairs.

I’m unsure what to say to her and don’t want to give her false promises.

What would you do?

Well....would see a legit vulnerable person that has been fully isolating in their garden, with full ppe and provide mask and face shield. For higher risk, I would see first at a point where i’d not have been out or working for 5 days. My friend is working in a hospital and they work on rotation of 5 days so that if they get symptoms or a temp they stop working with patients. This is non-covid lowest risk wards, for routine appointments not surgeries etc.It is working well for them so I think I will do something similar like a week on and a week off which they have also done successfully.

However as she has clearly said she doesn’t care, it is highly likely she’s been out risking her own safety and that of others (if she’s been able to get out), Be that going food shopping herself or allowing visitors or getting too close to visitors. Not saying she has or anyone like her has been, but clearly saying they don’t care means they are more likely to be bending the rules. Which would inevitably lead to a risk to your safety rather than the other way round.

I’ve been reading some interesting medical papers about ebola and some nurses moved form another ward and caught it because they had shields instead of goggles so I think I will be wearing both myself. That’s more personal choice but I would also offer client to do the same.

Alternatively a table shield you can take in your car and pop on top of your travel table, get her to use her own chair and you use your own chair like the rules with visiting people in gardens atm.

Really, at this point, I think it’s about protecting you first and foremost and just giving all clients the same required ppe you will wear when possible eg she won’t be wearing gloves for nails haha.

Anyone begging me for an appointment will be at the bottom of my list because they seem to be the most uncaring about their safety...which means they definitely won’t care about mine.

Everything else as normal. Haha. Normal.
 
Gosh, in your situation I’d really want to give her a treatment but I’d be terrified of infecting her. I’d imagine that her contacts will have been scrupulous to stay away if they felt unwell, but you should still treat her as if she’s infected, because that’s how you stay safe yourself. Screen her beforehand to make sure she’s not had any contact with anyone who’s developed Covid 19 symptoms in the preceding 14 days and of course you shouldn’t see her if she actually has symptoms herself

If you decide to see her, make her your first appointment of the day. Park up, sanitise your hands, put on a mask, apron and your glasses, if you wear them. Knock on the door and keep 2m away as you greet her and set up.

If she can’t wear a mask, see if you can be in a well ventilated space. You just need to crack a window open and sit in the draught. A mini portable fan on your desk would help if there’s no ventilation.

Make sure you’ve sanitised all your bottles beforehand, and set up your workstation with your equipment resting on couchroll. Remove jewellery and don’t touch your phone after you arrive - or keep it in a clear plastic bag if you need it. Don’t use products in jars, excepting nail varnish/gel/acrylic and remember when you’re setting up that you’ll have to chuck away any unused spatulas, cotton pads or buds that you’ve unwrapped/unboxed but not used.

When you’re ready to start work, put a visor on before you get closer than 2m and give her a mask if she can wear one. Ask her to remove any jewellery and her watch. Carry hand sanitiser, and both of you use it just before you touch her.

During her service, don’t eat or drink, don’t touch your face or remove your mask for any reason. If you have to touch your face, sanitise your hands first, get 2m away before you remove your visor and sanitise again before you touch her.

After her treatment, sanitise your hands, sanitise your bottles as you pack away, get 2m away before you remove your visor and leave her house. Pack your car, remove your apron, sanitise your hands and remove your mask and glasses. Sanitise your hands again. Get in your car and drive away

Phew I’m glad I don’t work mobile!
 
Gosh, in your situation I’d really want to give her a treatment but I’d be terrified of infecting her. I’d imagine that her contacts will have been scrupulous to stay away if they felt unwell, but you should still treat her as if she’s infected, because that’s how you stay safe yourself. Screen her beforehand to make sure she’s not had any contact with anyone who’s developed Covid 19 symptoms in the preceding 14 days and of course you shouldn’t see her if she actually has symptoms herself

If you decide to see her, make her your first appointment of the day. Park up, sanitise your hands, put on a mask, apron and your glasses, if you wear them. Knock on the door and keep 2m away as you greet her and set up.

If she can’t wear a mask, see if you can be in a well ventilated space. You just need to crack a window open and sit in the draught. A mini portable fan on your desk would help if there’s no ventilation.

Make sure you’ve sanitised all your bottles beforehand, and set up your workstation with your equipment resting on couchroll. Remove jewellery and don’t touch your phone after you arrive - or keep it in a clear plastic bag if you need it. Don’t use products in jars, excepting nail varnish/gel/acrylic and remember when you’re setting up that you’ll have to chuck away any unused spatulas, cotton pads or buds that you’ve unwrapped/unboxed but not used.

When you’re ready to start work, put a visor on before you get closer than 2m and give her a mask if she can wear one. Ask her to remove any jewellery and her watch. Carry hand sanitiser, and both of you use it just before you touch her.

During her service, don’t eat or drink, don’t touch your face or remove your mask for any reason. If you have to touch your face, sanitise your hands first, get 2m away before you remove your visor and sanitise again before you touch her.

After her treatment, sanitise your hands, sanitise your bottles as you pack away, get 2m away before you remove your visor and leave her house. Pack your car, remove your apron, sanitise your hands and remove your mask and glasses. Sanitise your hands again. Get in your car and drive away

Phew I’m glad I don’t work mobile!
Not looking forward to going back to my mobile business because of all this faff but it needs to be done.
Also remember, despite her health problems she may be one of the many who don’t show symptoms so even if she says she hasn’t got symptoms, she still may have Covid.
 
Absolutely
[/you should still treat her as if she’s infected, because that’s how you stay safe yourself.

60% of people are thought to be either asymptomatic or have such mild symptoms they don’t feel ill. But someone with symptoms is much more of a danger because they may be coughing/sneezing, sighing, sweating and blowing their nose/mopping foreheads or dabbing eyes. All of these actions spread virus more than normal hygienic behaviour.

If you have excellent hygiene in place and good ventilation you’ve got a low chance of being infected by an asymptomatic person.

Remember that a 1% risk of contagion means that you can see 99 infected people without a problem. That’s a great statistic if you’re a client, but we need to get the risk down to 0.01. That’s 1 in 10,000 which should cover even the busiest therapist. When you’re choosing your PPE you might want to reflect on the importance of decimal points
 
As you say she is virtually house bound and in her mid 80's with terminal lung cancer I don't expect she could be an asymptomatic carrier! She is extremely vulnerable with her age and health complications, encountering the Covid19 virus would undoubtedly be catastrophic for her.

I agree you should take advice from your insurer, be ready to describe your Coronavirus risk assessment to them. Before doing that it would be helpful to contact her care giver for any other actions that are in place to safeguard her in this situation.There may be extra considerations to include for this individual.

When my dad was terminally ill in hospital I remember his podiatrist came to take care of his feet even though the likelihood was that dad wouldn't last a couple of weeks. It pleased my dad no end, finally his toenails weren't catching on his bed sheets. When your world is reduced by terminal illness, what once may have been small pleasures become something so much more important. I would purchase disposable ful body coverings and go the full nine yards for this lady if it gave her some joy in her final weeks. Take in only what you need, consider making up and leaving a mini kit at her place. Her carer should have PPE for her to use already there.
 

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