COVID-19 and the Safety of Home Health Care

by Amy Potter - Saturday, May 16, 2020
The Coronavirus is scary and it is especially scary for people over 65 years of age. As we talk with seniors, they tell us that they understand what they need to do to stay safe. They know that staying at home, frequent hand washing for at least 20 seconds each time and social distancing are very important.

As a result of COVID-19 many seniors and their families are concerned about others coming into the home and many are postponing needed health care. 

How safe is it to have health care in the home during this time? We recommend the following considerations in making this decision:

Is the healthcare team being screened for symptoms?
The home care team should be screened for symptoms daily. The Home Therapy team is required to report any symptoms before their first patient each day or before 9:30am. We follow all the guidance of the Centers for Disease Control (CDC) including the symptoms we monitor in ourselves and our patients. Our team must also immediately report any symptoms during the day and go home if they do not feel well.

Are clinicians trained in infection prevention and do they follow CDC guidance?
Infection control training and practice are Medicare requirements for each clinician. In addition to years of training in medical schools. Home Therapy provides regular infection control training and oversight. However, basic infection prevention measures must be amplified during COVID-19. These are just a few of the many steps taken to prevent infection spread.

  1. There are specific times that hands are washed and sanitized during the care visit.
  2. There are specific protocols for the use of gloves and gowns. Masks are always used.
  3. We dispose of used equipment in secure bags before we leave the home.
  4. Only approved disinfectant can be used and all surfaces that are touched must be cleaned.
  5. We provide our patients and caregivers with masks.
  6. We take a limited number of supplies & equipment into the home.
  7. We no longer have the patient/caregiver sign a statement that we made the visit to eliminate the touching of a pen or electronic device.
  8. Our clinicians wash their scrubs nightly.

Are there precautions not to mix COVID-19 patients with patients that do not have the virus?
We screen each patient and everyone in the home before we enter. We call this “doorstep screening”. If symptoms are present, we do not proceed until we can identify the reason for the symptoms. We report the symptoms to the patient’s physician immediately and follow his or her instructions. We also have a special clinical team that serves only patients that are confirmed to have the virus or are waiting on a test. We do not mix clinicians.

Could you be creating a different health problem if you do not move forward with home health?
This is a big consideration. Statistics are telling us that seniors are not getting medical care after having a stroke and a heart attack. We are aware that seniors are falling and suffering injuries and not seeking medical attention. Chronic conditions such as CHF, Diabetes, COPD, and high blood pressure must be managed, and help is often needed to do that. The Coronavirus preys on patients with these conditions and these chronic conditions make it more difficult to overcome the virus. Assistance with the management of the chronic disease may be essential to avoid a trip to the Emergency Room or a hospital stay. It is reported that some seniors have been rationing medications so they do not have to get out or send someone to get more. The mismanagement of medications is a huge risk factor for adverse events. It is anticipated that in the near future hospitals are going to be full of seniors that require care because they have failed to get the care they need during the virus. The likelihood that some seniors will end up in the hospital – the exact place they want to avoid because of COVID-19 – increases if needed home health care is not received.

Are a limited number of clinicians assigned to you?
You do not want a revolving door of different nurses or therapists. You want a consistent care team. Home Therapy does not use staffing companies. All the clinicians are our employees and we have a personal relationship with them all. They have all been screened and trained by us. 

Can the clinicians help you stay safe while focused on getting better?
Each clinician will spend some of the time with you educating and training you on infection prevention and how to avoid the virus. We also have several information tools about COVID prevention in your home notebook. We will even help you set up a telehealth visit with your physician if you need that assistance so you do not have to leave your home or be frustrated with the technology.

Are there aspects of home health care that be postponed or phased in? Do all the visits have to be in person or could telehealth be used?
It may be helpful to talk to your physician and home health team to determine if your care could be prioritized.  It may be that not all the care is needed at the beginning and some of it could added in phases.  By determining if it is possible to begin with the most essential services we could limit the number of clinicians coming into your home until the virus is on the decline in your area. You can also talk to the home health team about whether some of your clinical care can be offered via telehealth.

If we can help you think through the advantages and risks of having home health or answer any questions you may have, please call us at 512-637-1550 and ask for the Administrator.