Nursing home caregivers are no strangers to the hazards of bathing the elderly, from frail to obese, particularly during transfers. But doing so in this age of COVID-19 is different.

With all of the splashing and thrashing, one errant droplet in an unshielded eye could end up being lethal.

Compounding challenges are profound shortages of personal protective equipment, such as masks, face shields, gowns and gloves.

In some nursing homes, aides have been enlisted to help in bathing, but with quarantines, the task typically falls on already stretched facility staff. Positive COVID-19 tests were on the rise as of press time. And so much besides PPE also is on pause, including many training and certification efforts.

In the cloud of these kinds of public health emergencies, where “normal” tasks are being restricted, some needs like bathing are being overlooked, Beth Kallmyer, vice president of care and support for the Alzheimer’s Association, told STAT News.

Not yet known was precisely how long SARS-CoV-2, the virus that causes COVID-19 infection, can live on bathroom surfaces such as  sinks, tubs and light switches.

“The key is to keep the [bathing] area cleaned and disinfected between patients,” said Connie Steed, RN, MSN, head of the Association for Professionals in Infection Control and Epidemiology. “The bathing area should be cleaned and disinfected in between resident use with a hospital-approved disinfectant.”

Patricia Howell, RN, BSN, clinical support manager for McKesson Medical-Surgical Extended Care, said one insidious challenge is residents or caregivers transmitting the virus to facial areas reaching from the forehead to the chin (the “T-zone”). Cleaning plastic wash basins inside a confined resident’s room also is fraught with danger. She advises using bath wipes or no-rinse cleansers instead.

“Being safe again in the future will take a leap of faith from all of us, whether it’s leaving our homes and gathering with friends or continuing to care for those in our LTC communities,” said Mary Madison, RN, clinical consultant-LTC/Senior Living, Briggs Healthcare. “We must never forget or let our guard down.”