Home health care workers are taking extra precautions during the coronavirus outbreak to avoid carrying the infection to vulnerable clients, some of whom have expressed fears about visitors during the pandemic, according to Arkansas home care providers.
These caregivers play a significant and often unseen role in the community because clients can get the help they need without going to a hospital or medical facility, said Dayna Casas, the quality care manager and director of communications for Right at Home of Little Rock, part of a home care franchise.
There are 165 licensed private home care agencies in Arkansas, according to 2019 data from the Arkansas Department of Health.
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For the elderly or people with chronic ailments, home health care presents an alternative to life in nursing homes or assisted living facilities, where coronavirus cases have raced through some locations nationwide. But home health care workers also run the risk of unknowingly spreading the coronavirus to clients and others as they travel from home to home.
Right at Home caregivers put on face masks before entering a home, according to Casas, who also visits clients in their homes. Gloves are worn and later discarded.
"We tell them, if you go through 20 of them a day or 30 of them a day, go through 30 of them a day," Casas said. "We'd rather you be safe than you or the client getting sick."
Inside the home, doorknobs and countertops are sanitized with disinfectant wipes. After work, caregivers are asked to wash their clothes immediately and take showers to avoid carrying the virus to their loved ones, according to Casas, who specializes in caring for patients with Alzheimer's disease and dementia.
Because of the covid-19 outbreak, the company has kept clients with their original caregivers, a practice that can assuage fears "as far as they're worried about somebody coming in and bringing something to them," Casas said.
"We are cutting down on moving caregivers around from home to home," she explained.
The company's caregivers have been instructed to avoid crowded areas and practice social distancing for the well-being of their clients, she said.
The novel coronavirus sweeping across the United States is more dangerous for the elderly, people who are immune-system compromised, and people with serious health conditions, experts have said.
Scores of elder care facilities nationwide have reported outbreaks, including Little Rock's Briarwood Nursing and Rehabilitation, where dozens of residents and staff members have tested positive for the coronavirus, according to the Arkansas Department of Health.
Earlier this month, the Department of Health directed long-term-care facilities to bar all visitors except for "medically necessary" personnel and first responders.
The new restrictions have limited caregivers who normally enter assisted living facilities to provide extra help on top of the care provided by the facility's staff, according to Mike Martin, director of Visiting Angels Little Rock, a local franchise of a national home care company.
"We've lost some hours to that but, you know, we're still picking up new cases," Martin said. "I just started a new case today. I've got another assessment for a new case tomorrow and another one on Monday."
Drew Fuller, owner and CEO of Right at Home Little Rock, said his company is using a screening process for all clients and caregivers to protect the elderly and employees alike. Caregivers are monitoring clients' symptoms and asking if they are feeling ill.
Right at Home Little Rock is accepting new clients, Fuller said, but it has reduced the number of caregivers who visit a client's home, limiting contact with other care managers who ordinarily check up on a client from time to time for nonessential reasons.
Fuller said three clients out of around 25 have postponed visits or put some services on hold, but for the most part personnel continue to check on them by phone.
None of the company's approximately 45 active caregivers in Little Rock have fallen ill with the coronavirus, nor are any in self-quarantine after being exposed to someone with the virus, Fuller said. However, some caregivers have had to take time off work to care for children.
He said his office "luckily" stocked up on masks and has about 500 available; more masks were scheduled to arrive by the end of the week. Nevertheless, the biggest precaution is hand-washing, he said.
"We're washing our hands every hour -- anytime we go to touch a client, move a client, do anything like that," Fuller said.
Another Arkansas home health care provider reported challenges, including a lack of widely available covid-19 testing for employees and a shortage of personal protective gear.
Steven Hammond, vice president and general manager of Care IV Home Health, said three or four staffers have been exposed or potentially exposed to the coronavirus and remain under temporary quarantine.
The employees are asymptomatic, but out of an abundance of caution, "they still cannot work for 14 days," Hammond said.
If those employees could get tested and know for sure that they do not have the coronavirus, Hammond said, "then I could get them back helping the elderly and these homebound patients that we care for."
Additionally, the company is running short of personal protective equipment. Depending on the number of cases it gets, Hammond said, the company has only enough equipment left to care for covid-19 patients for a few days because N95 respirator masks are scarce.
Hammond said he was unable to confirm or deny whether his company is actively caring for covid-19 patients.
Though he couldn't give an exact count of clients who have expressed concern about home health visits, a lot of Arkansans don't want aides to enter their homes right now, Hammond said, based on what he has heard from associates.
"It's been reported across the state that other home health agencies are experiencing that as well," he said. "That the patients would just as soon not have anybody come in their home under the risk that they could bring something in."
Martin said he hasn't received any push-back from caregivers or clients in light of the outbreak. Starting a few weeks ago, the company began stressing sanitary precautions for its more than 50 caregivers amid the pandemic, he said.
The company is working to keep clients and their families informed, and it has asked people to let caregivers know immediately if they start exhibiting symptoms.
"I'm fortunate in that, you know, we're not a restaurant -- people don't congregate. It's just one-on-one, in-home care," Martin said. "So it's a lot safer, you know. You're not in a facility with a lot of different people coming in and out."
Metro on 03/30/2020