In US, home care is the new front in looking after COVID-19 victims
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Ruth Caballero paused outside an unfamiliar apartment door, preparing to meet her new patient.
She covered the knob with a plastic bag. Put on a surgical gown, then a heavy-duty N95 mask, a lighter surgical mask on top. Cap, face shield, shoe covers. Hand sanitizer between each step of the process. Finally, the nurse donned two sets of gloves and knocked on the door with her elbow, ready to care for her first coronavirus patient.
After about three weeks in a hospital, the man was home in his New York apartment but still so weak that sitting up in bed took some effort.
鈥淵ou made it out of the hospital, so you are a miracle,鈥 Caballero, of the Visiting Nurse Service in New York State, told him. 鈥淣ow let鈥檚 keep you out of the hospital.鈥
Home health care is becoming a new front in the national fight against COVID-19 as some patients come back from hospitals and others strive to stay out of them.
Home care nurses, aides and attendants 鈥 who normally help an estimated 12 million Americans with everything from bathing to IV medications 鈥 are now taking on the difficult and dangerous task of caring for COVID-19 patients.
While Americans are being told to keep to themselves, home health providers and their clients still largely have to engage in person, often intimately. Many agencies are ramping up phone or video visits but can鈥檛 always get paid for them, and even the smartest phone can鈥檛 listen to someone鈥檚 lungs or get them to the bathroom.
鈥淟ike their colleagues in hospitals and nursing homes, home care workers have faced a scarcity of protective equipment, but with a lower public profile. Some agencies have scoured for masks at nail salons, auto body shops and tattoo parlors,鈥 said William Dombi, president of the National Association for Home Care and Hospice.
The crisis is testing the industry, but it鈥檚 also a moment of pride for workers who have often felt under-recognized.
鈥淚t is a challenge to keep the business operational, but it鈥檚 an opportunity,鈥 Dombi said. 鈥淲e鈥檙e getting a chance to establish what can be done.鈥
Coronavirus care at home has expanded rapidly in the last few weeks. At least some agencies in most states are now taking COVID-19 patients referred after hospitalization or nursing home care or as an alternative to them.
Still, some patients have struggled to get care. After being diagnosed with coronavirus-related pneumonia late last month, Penny Wittbrodt contacted multiple agencies around her home in Winchester, Kentucky. None was then accepting COVID-19 patients, although her doctor was able to arrange home oxygen. Wittbrodt, who has asthma and a history of respiratory hospitalizations, is still not well.
A retired home health nurse, Wittbrodt feels such care is especially valuable in the pandemic. 鈥淗ome health would expose far less people to COVID-19 than hospitalization,鈥 she said.
New York-based Americare Inc has taken about 100 COVID-19 patients released from hospitals, and over 200 of the agency鈥檚 other patients also have tested positive or shown symptoms.
When her agency first told Caballero and other nurses in March that COVID-19 patients were coming, 鈥淚 won鈥檛 say that I wasn鈥檛 nervous,鈥 she says.
But her first visit, to the man in the apartment, went well. When she called that night, he was not only sitting up but had gotten into a chair.
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