Advice for over 70 and medically vulnerable individuals
Last reviewed: Jan 2022
The Government and health authorities have issued advice for people who are over 70 and those who are extremely medically vulnerable to continue to exercise personal judgement. The risk of severe illness from Covid-19 increases with age. See the HSE guidelines for older people and Covid-19.
It is recommended that they stay at home as much as possible, limit engagement to a very small network for short periods of time, while remaining physically distanced.
When taking exercise outdoors, it is important to maintain 2 meters of distance from others. Wash your hands properly and often with soap and water or alcohol hand rub.
It is recommended to shop during designated hours only, while wearing a face covering. Always wear a face covering while using public transport.
Medically vulnerable individuals include people with severe respiratory conditions and transplant recipients, with a full list available at this link.
This list includes the following groups specific to cancer:
- People with cancer who are currently being treated with chemotherapy or or similar drugs (other than hormone therapy). You may also be advised to cocoon for two weeks before starting your treatment or before coming in for surgery or a particular test.
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment. If you are unsure if your type of blood or lymph gland cancer weakens your immune system, check with your cancer team.
- People who have lung or head and neck cancer and are having radiacl surgery or radiotherapy.
- People having immunotherapy or other continuing antibody treatments for cancer.
- You have lung cancer and are being treated with radiotherapy.
- People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
- People who have had bone marrow or stem cell transplants in the last 12 months, or who are still taking immunosuppression drugs.
- People with advanced cancer or cancer that has spread to another part of the body.
If you are unsure if you should be following advice on cocooning you should discuss this with your GP or your medical team.
If you are in this group you should take the following steps:
- Get vaccinated and attend for your booster when given an appointment as long as there is no clinical reason why you should not have it.
- Strictly avoid contact with someone who is displaying symptoms of coronavirus. These symptoms include high temperature and/or new and continuous cough.
- It is safer to limit social interactions to small groups. If possible, meet fewer people, less often and for less time. Meet outdoors if possible.
- Check that visitors who come to your home that they do not have any symptoms of COVID-19.
- When people visit you, ask them to clean their hands when they arrive. After they leave clean surfaces which they may have touched.
- Ventilate your home well by opening window and doors where possible.
- Wear a face covering when shopping, and try to confine your shopping to designated times for vulnerable people.
- Avoid crowded places, both indoors and outdoors.
- Wear face coverings when in confined public spaces such as shops where social distancing may not be possible, and when in crowded outdoor spaces.
- Keep in regular contact with others using remote technology such as phone, internet, and social media.
If you develop symptoms of coronavirus
The most common symptoms of coronavirus are recent onset of:
- Fever (high temperature) and
- Shortness of breath or difficulty breathing
- Fatigue (tiredness)
If you develop coronavirus symptoms, even if they are mild, self isolate (stay in your room). Get medical advice by phoning your GP and organise a Covid-19 PCR test. . In an emergency, call 112 or 999 if you are seriously ill. Do this as soon as you get symptoms. Do not visit the GP, pharmacy, urgent care centre or a hospital unless you are told to do so.
If you need to go to hospital as a result of catching coronavirus you should prepare a single hospital bag. This will include your next of kin or emergency contact, a list of the medications you take (including dose and frequency), any information on your planned care appointments and things you would need for an overnight stay (snacks, pyjamas, toothbrush, medication etc.).
Further guidance on cocooning
Cocooning means staying at home as much as possible and reducing your face-to-face contacts. Cocooning can protect people at risk of serious illness from the coronavirus. Some people will be asked to cocoon prior to treatment or surgery. You may also be asked to do a test for the coronavirus prior to treatment or surgery.
Limiting infection risk in the home
While people sharing the same space as you are not required to adopt these protective cocooning measures for themselves, they should do what they can to support you in cocooning and to strictly follow guidance on physical distancing.
Evidence shows that many cases of coronavirus infection display no symptoms yet the virus can still be passed on from those who are showing no signs of infection, especially through very close and prolonged contact.
The following steps will help keep people who are cocooning safe from infection, and should be followed as closely as possible by anyone coming into the same home:
- Everyone should always clean their hands regularly, especially after being outside the home, and cough/sneeze into your elbow.
- Be alert to anyone showing any of the symptoms of coronavirus infection – eg temperature, headache, loss of taste/smell. Coronavirus symptoms can appear similar to other colds and common illnesses like hay fever so medical advice should be sought if anyone in the household begins to show any signs of illness.
- You should stay away from other people in your home as best you can, and where common areas are shared try to ensure that the room has a good flow of air.
- If you have to go into the same room with other people at home you should try to keep at least 1 metre (3 ft) and where possible 2 metres away from them.
- If you can, you should use a toilet and bathroom that no one else in the house uses.
- If you cannot have your own toilet and bathroom, the toilet and bathroom you use needs to be kept clean (see advice below).
- Another tip is to consider drawing up a rota for bathing, with you using the facilities first.
- Make sure you use separate towels from the other people in your house, both for drying after bathing or showering and for hand-hygiene purposes. Using towels with different colours or patterns can help.
- If you share a kitchen with others, avoid using it while they are present. If you can, you should take your meals back to your room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing-up liquid and warm water and dry them thoroughly. Do not share cutlery and utensils.
- When using your own cutlery and utensils, remember to use a separate tea towel for drying these.
- Clean all regularly touched surfaces such as counters, table-tops, doorknobs, bathroom fixtures, toilets and toilet handles, phones, keyboards, tablets, and bedside tables every day. Standard household cleaning products work just fine, and even common soap and water is very effective.
It will of course be difficult for some people to separate themselves from others at home. You should do your very best to follow this guidance and everyone you share a space with should regularly wash their hands, avoid touching their face, and clean frequently touched surfaces such as door handles and table tops.
Supports for people cocooning
ALONE is providing a telephone support line, seven days a week from 8am-8pm, for all older people and their families to contact if they would like any advice, reassurance or additional support: 0818 222 024. This support line is also open to extremely medically vulnerable people.
The Irish Cancer Society is providing remote counselling sessions for people who are affected by cancer and who cannot access face to face services as result of the coronavirus pandemic. To access this service, please call our Freephone Support Line on 1800 200 700.
While it might be more difficult to see them, stay in touch with friends and family who are a vital support at this time. Take people you know and trust up on offers of help with anything you may need from outside, always reminding anyone you are in contact with of the precautions they should take to avoid passing on infections.
Finally, try to keep physically active. You can take short trips outside to get exercise and fresh air so long as strict social distancing is practised at all times.
Advice for carers
For family members and other people caring for anyone who is over 70 or extremely medically vulnerable, the following steps can help to keep everyone safe from infection:
- Wash your hands on arrival and often, especially before and after being in contact with the person you are caring for. Use soap and water for at least 20 seconds or use hand sanitiser.
- Avoid touching your face and 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 visit or provide care if you are unwell and make alternative care arrangements.
- Provide information to the person being cared for on who they should call if they feel unwell, write out the phone number of their GP and GP out-of-hours service and leave these prominently displayed.
- If it is an emergency, call the emergency services at 112 or 999 and remember to tell them that the person may have or has been diagnosed with coronavirus.
- Find out about different sources of support that are available.
- Look after your own well-being and physical health during this time.
The Irish Cancer Society continues to be available to provide support and information on this matter or any other queries related to cancer through its Freephone Irish Cancer Society Support Line on 1800 200 700.
For more information
1800 200 700