How Home Healthcare Workers Are Navigating the COVID-19 Outbreak

July 15, 2020
  • The COVID-19 outbreak is forcing home healthcare workers to change how they treat older adults and ill people.
  • Agency officials say their workers are conducting more televisits to help avoid transmitting the virus to their clients.
  • They’re also wearing personal protective gear more often and carrying thermometers to check for fevers.

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Doctors, nurses, and other health professionals at hospitals and clinics have been struggling to care for people with COVID-19 due in part to a shortage of masks and other personal protective equipment.

But there’s another frontline group of workers who may grow even more crucial as hospitals fill to capacity and nursing homes go on lockdown.

They are the home healthcare workers who provide services to millionsTrusted Source of people each year in the United States.

“In the past 2 weeks, we have totally changed our way of taking care of patients from A to Z,” said Dr. Eric De Jonge, chief of geriatrics for Capital Caring Health and the immediate past president of the American Academy of Home Care Medicine.

“We’ve had to ask ourselves… Who do we see? What do we do before a visit? Do we make in-person visits? How do we protect our clients? How do we protect our staff?” De Jonge told Healthline.



De Jonge says one of the first decisions they made was to use televisits when possible.

“We’re setting up Zoom for Healthcare, a HIPAA-compliant app, with our patients and families when we can, using their laptop, smartphone, or tablet,” he said. “It’s better than a phone call. You can see how sick they look and you can make eye contact.”

And his isn’t the only agency looking to use televisits.

“We have been faced with the dilemma of what to do with RN visits that are needed to set up a customized care plan,” said Melanie Lamar Hancock, RN, BSN, director of home care staffing for the Southern Maryland branch of the Right at Home care agency. “We’ve discussed implementing televisits for those initial consultations.”

“We are asking ourselves each day how we can prevent or decrease the spread of COVID-19,” Lamar told Healthline.

Screening workers

All of the agency officials who spoke with Healthline said they’re doing triage before any in-person visits.

“We are conducting daily phone calls with both clients and caregivers and asking screening questions to determine if they are at risk for spreading the illness,” Lamar said.

Honor, a home care company, is setting up a new pre-check-in process for its caregivers and building it into its app.

“We are currently shipping thermometers to all of our Care Pros who don’t have them. Once that’s completed, we’ll roll out the requirement for them to record their temperatures and confirm they have no flu-like symptoms,” Jessica Gilmartin, chief marketing officer of Honor, told Healthline. “That mimics in an in-home setting how facilities do safety checks for their entering personnel.”

Gilmartin says among the new infection control procedures is a requirement to wear masks, gowns, and gloves when interacting with anybody with flu-like symptoms.


Shortage of PPE

Agency officials interviewed by Healthline say they can’t get enough of the gear they need to protect their workers.

“Just like all healthcare workers are already being asked to put themselves at risk and do an incredibly difficult job, we’re now having trouble supporting them with personal protective equipment, some of which is really necessary,” said Marla Lahat, MSW, LICSW, executive director of Home Care Partners.

Lahat’s certified nursing assistants and home health aides provide support services like bathing, meals, laundry, light housekeeping, or respite for family members.

“We even had an order for 228 bottles of hand sanitizer. It’s on back order, and when we get it, it’ll only be eight bottles. I’m trying my best to find another source, but it’s really difficult,” she told Healthline.

The hardest item to find?

N95 masks. Tough times sometimes call for tough choices.

“There was a study we read that said you can use ultraviolet light to sterilize N95 masks so you can use them with reasonable safety,” De Jonge said. “So we ordered a small little UV oven, the size of a toaster oven, from Amazon. That is prolonging the life of our N95 masks.”

Some companies say the lack of that gear may make the people they care for feel uneasy.

“Some are requesting that caregivers wear masks in their homes. While many are in critical need of daily visits, several clients have canceled saying they would like to self-quarantine,” Lamar said.

“Normally we can fill up every schedule in the blink of an eye because we have so many people waiting and there’s so few home health aides,” Lahat said.

“But now some of our aides have gaps in their schedule. Their clients have canceled, new clients don’t want to take the service right now, and some of the aides don’t want to go somewhere unfamiliar,” she said.


Long-term consequences?

“It’s already a difficult job. It’s now even more difficult,” Lahat explained.

She says her workers are hourly wage earners, many of whom rely on public transportation. But because of the COVID-19 shutdowns, that transportation is often spotty.

“I’ve had aides waiting at a bus stop for hours for a bus that never comes,” she said.

“We already had a very, very critical shortage of certified home care workers nationwide,” Lahat added. “This may make it worse. People are going to say, ‘I’m not staying in this business. It’s too difficult. I’ll go work at a grocery store.'”