Author: Johanne Gosling

Date: 16 06 2020

Regulated health and social care organisations, which include care homes, are exempt from Government restrictions on working due to COVID-19.

In our June blog post, CNHC Registrant and reflexologist Johanne Gosling shares her experience of returning to work at a care home and treating residents during the coronavirus crisis.

I started working at MHA, the largest charity care provider in the UK, in February this year. The charity is committed to providing person-centred care and their values include nurturing the mind, body and spirit of those they care for. The MHA care home I work in - Hall Grange in Croydon – offers residential and dementia care for up to 86 older people. They are a forward-thinking home and decided to employ me part-time to offer residents reflexology on their hands or feet. As a touch-based but not overly invasive therapy that can help with relaxation, ease anxiety and aid restful sleep, reflexology is a good choice of complementary therapy for older people, particularly those with dementia. I have chosen a number of scented and unscented creams which offer a starting point of conversation to relax residents and can also evoke memories. Memories are often recalled after seeing pictures or talking about topics, and smell is just the same. Often residents will have memories of working in their garden or playing with their children. Sometimes they associate a perfume or fragrance with their parents or other family members.

On an average session, I arrive at work and touch base with the team of carers to see if there are any updates or new residents. They also advise me if they feel anyone in particular would appreciate treatment that day. I check each client’s care plan to make sure they haven’t got any allergies or medical conditions that would make them unsuitable to receive therapy. After treatment, I update their care plans to include what therapy I have delivered, and creams used.

Before lockdown I would follow the standard infection control procedure of washing hands between clients, using fresh towels for each client, using skin cleansing wipes, and using antibacterial wipes on bottles.

Returning to work in April

Just before the Government’s lockdown restrictions were announced, it was agreed that I would not work until there was a clearer picture of the risks involved. I returned to work on the 28 April after full discussions with MHA and talking to the team at the Complementary and Natural Healthcare Council (CNHC) for guidance.

It is my employer’s responsibility to ensure that I am able to work in a safe environment. From the start MHA have offered amazing support and training and their continued support during the COVID-19 pandemic has been no different. I was given up-to- date guidance and procedures to follow. I can only wear my uniform within the care home and not during travel there, and it must be washed after every visit. I have to socially distance as much as possible and wear a face mask at all times. Personal Protective Equipment (PPE) has been supplied and I have been trained in its use, including the order of removal. My apron must be removed first, then gloves, then I wash my hands, googles/visors are cleaned, my hands are washed, and lastly, I remove my face mask by only touching the ear loops and wash my hands again.

How does it feel to practice reflexology in PPE? 

In one word – hot! It takes more time as I have to put on and take off PPE and wash hands more often following the correct handwashing technique – not just before and after treatment as before. Wearing latex gloves during treatments feels strange. I believe that because reflexology is a touch-based therapy it is important to have skin to skin contact, especially with residents who have dementia. However, this is not possible at the moment so I will offer a few tips. Older skin can be fragile, so it is important when wearing gloves to use sufficient cream to avoid tearing or damaging skin. I tend to use gloves that are slightly bigger as I feel ones that fit exactly are too tight, easily torn and do not allow enough movement to carry out the reflexology routine. 

How have clients responded?

Where possible reflexology is now done in each resident’s room to comply with social distancing and infection control procedures. This can prove difficult with patients with more advanced dementia as they cannot always understand who I am and why I am in their room. In such cases, treatments are carried out in communal areas with as much social distancing as possible between residents and staff without causing distress to the client. I have witnessed the benefits and improvements in their wellbeing – mentally, physically, and emotionally. Dementia affect individuals differently. I have been involved with clients who, on reaching out initially, are tearful or agitated. However, having started to talk with them, maybe going for a walk in the garden, holding their hands and gently doing hand reflexology, I have left them asleep in their chair at ease. It is the combination of all these elements that meets each individual’s needs.

On sunny days I am able to treat residents in the garden. The sunshine and fresh air combined with the reflexology and a chat produce an amazing response with residents.

Even with the extra time and energy spent on observing very strict infection control procedures, it is still definitely worth the effort. As a reflexologist, I really appreciate the opportunity of being able to continue to use my skills to make a positive impact my client’s lives.