Social distancing is one way to curb the spread of the coronavirus, but for health care workers who provide care in people’s homes, especially for the elderly, that type of care brings heightened risks, experts say.
Home health workers assist clients with daily tasks like bathing, dressing, toileting, walking and transferring out of bed; all things that require them to be extremely close to those they serve. In many cases, they also shop for groceries and pick up prescriptions and other necessities.
It’s a challenging time, but home health workers are committed to delivering quality care, said Pedro Zayas, spokesman for the SEIU Healthcare 1199 NE, which represents more than 5,000 independent personal care attendants.
“Our providers are people who went into this field because they like caring for others,” he said, adding that caregivers are diligent about self-monitoring for fever and other symptoms.
Cases of the highly contagious coronavirus continue to spike in Connecticut and nationally, with elderly people being particularly susceptible. To prevent the spread of the virus, health care experts recommend that people practice social distancing, staying 6 feet apart.
Dr. Mary Tinetti, chief of geriatrics at the Yale School of Medicine, said seniors using home health care should consider whether they can temporarily go without some services.
“There’s no question prevention is all about social distancing and washing. Both those things are a little difficult when you have home health aides coming in. This might be a time to look into what direct care is needed. For instance, people may not need to bathe every day. That’s going to be very direct contact. Maybe they can go down to a couple of times a week.”
— Dr. Mary Tinetti
Lynette Dockery of Meriden, a home health aide who works six days a week, is diligent about washing her hands, wearing gloves and masks, and using hand sanitizer. She says, however, supplies are getting low.
“We don’t have supplies. I have a few masks. We’re asking the state for more supplies,” said Dockery, a home health aide for nearly 20 years. “I don’t know what else we can do. It’s a really hard situation right now. It’s getting worse and worse every day.”
She worries about getting her client sick or becoming sick herself, as social distancing is impossible in her work. One of her clients is on dialysis and has a stent in her chest.
“We can’t stay 6 feet away from our consumers,” she said. “I have to bathe her. I have to do all her personal care. I make her dinner, get her dressed.”
Nationwide, there were about 12,200 home health agencies, employing the equivalent of 145,000 full-time workers in 2016, the most recent year for which data is available. In addition to daily care, about 96% provided some therapeutic services, while 83% provided social work services, according to a 2019 study by the National Center for Health Statistics.
An increasing number of Connecticut residents receiving Medicaid rely on in-home care, according to a 2019 Department of Social Services study that projected 82% of long-term care enrollees will use home care by 2040, up from 68% in 2017.
Linda Grigerek, president of Companions & Homemakers, which has 11 Connecticut locations, said, “Our caregivers have really stepped up. Caregivers are self-reporting any potential exposure to the virus and other illnesses, and self-quarantining to protect clients,” she said. Some who provide live-in care have sacrificed previously planned time off to instead stay with clients.
Grigerek’s agency has directed all caregivers to adhere to Centers for Disease Control and Prevention (CDC) guidelines during the pandemic.
Nonessential Care Sidelined
Home health care workers have already started to see decreased demand for their services as worried seniors forego services.
“A lot of our clients who receive nonessential care, most of those people are just canceling,” Grigerek said, predicting business likely will dwindle to only serving clients who need essential services. “Those are the people that we’re worried about.”
As elderly clients scale back on services, home health workers, who make minimum wage or close to it, could have trouble making ends meet, Zayas said.
“These workers don’t have sick leave. If you don’t show up, you don’t get paid. And if you get sick, you don’t have sick pay.” As income dries up, more aides could struggle to pay for hand sanitizer, masks and other supplies. “Inventory is not even available. Those are huge concerns.”
— Pedro Zayas
About 80% of home health aides are women, Zayas said. Some are single parents who are trying to balance work with caring for their out-of-school children and now face the possibility of reduced or no income.
Dockery, who lives with her 20-year-old son, is the sole breadwinner in her home.
Tinetti said seniors who have aides in their homes should remind them to wash their hands before and after each encounter and to disinfect surfaces repeatedly.
“We all need reminders to do it,” she said. “Older adults should feel empowered to remind them.”
Seniors also can ask care workers for suggestions to creatively engage with them from a safe distance, Tinetti said. For example, taking a walk outside, singing or dancing. Also, those who receive care from multiple aides can ask if just one aide can serve them for now.
“If it’s scary for us [aides], I can only imagine what it’s like for them,” Dockery said of seniors receiving in-home care. “When you’re in a home setting, they depend on you to lift their spirits and take care of them.”
Dockery said her job is “God’s work.”
“If I don’t go [to work], how’s she going to get to dialysis?” she said. “That’s life-saving; that has to get done.”