Home Care Sector Faces Distancing, Supply Challenges

Mar 26, 2020 By Katie Lannan

Agencies Take Steps to Ensure Elder Care

Older adults are among those most at risk from the coronavirus, and the agencies and workers that deliver them meals and care for them in their homes are confronting new challenges during the public health crisis.

While facing additional demand with more people confined to their homes, service providers who work with elders are also dealing with the same difficulties accessing cleaning supplies and personal protective equipment that have been widely reported.

Mass Home Care, the trade association that represents aging services access points (ASAPs) and area aging agencies throughout Massachusetts, said its members have continued offering their essential services — including case management, personal care, homemaker services, meal delivery and elder protective services — “without interruption” during the COVID-19 crisis.

The association has activated a series of emergency protocols, and said ASAP and agency staff are now screening consumers and workers for COVID-19 as they continue their daily meal delivery and home care services.

A Mass Home Care survey last week found that 84 percent of members needed hand sanitizer, 63 percent did not have enough face masks, and almost half did not have enough gloves for their meal delivery personnel and elder protective services workers. Of the 121 home care agencies who responded to the survey, 85 percent did not have an adequate hand sanitizer supply, 71 percent did not have enough face masks, and over 40 percent did not have enough gloves.

“These supplies are critical for our frontline workers to continue to provide care throughout our communities,” Mass Home Care said in a statement. “Both our consumers and their workers are very concerned about the spread of COVID19 throughout the community. Without these necessary supplies and protections, our workforce will be unable to fulfill their roles in our community settings.”

Earlier this month, the state issued guidance to home care agencies, encouraging them to develop or review business continuity plans to keep critical services running if staffing levels drop, be prepared to change their practices, cross-train personnel, and ensure adequate cleaning and hygiene supplies are on hand.

Of the 1,838 COVID-19 cases in Massachusetts as of Wednesday, 255 were in people 70 years old or older, and 249 were recorded in people in their 60s.

Valerie Frias, CEO of the Boston nonprofit Ethos, said her organization began “looking at contingency plans upon contingency plan” when cases of the coronavirus first started appearing in the United States.

Ethos runs the meals on wheels program in Boston and typically delivers 8,000 meals a day. Frias said about 100 new requests are coming in daily, and she anticipates the organization will end up doing 10,000 meals a day.

To meet the increased demand, Frias said Ethos has been hiring backup drivers and making sure the kitchens they contract with can take on extra capacity.

Wellness Checks

Delivery drivers are equipped with gloves and hand sanitizer, and Frias said will also be wearing masks “to the extent that we can get them, and to the extent that we can’t, we have a sewing project going on to at least have some protection for the drivers and also for the elders.”

Drivers who have built relationships with the elders they serve and traditionally done well-being checks when delivering food are no longer handing meals directly to their clients but hanging the meal on a doorknob, knocking, stepping back several feet and awaiting a verbal greeting from inside the home.

“It’s still a check, and they ask if everything is OK, if they need anything,” Frias told the News Service. “That piece, that wellness check, sometimes that’s the one human interaction that elder may have in a day, so we want to make sure we’re continuing that.”

With a statewide emergency order banning most gatherings of more than 10 people and a stay-at-home advisory from the Department of Public Health, Ethos has begun holding some of the classes it traditionally runs in-person, like tai chi, online, Frias said.

“We’re trying a different model because we want to make sure we are interacting with people as much as possible,” she said. “In a world where social distancing is so important for public health, we also know that self-isolation is tremendously difficult for everyone, but especially on elders and especially on subsets of the elder population.”

Other groups that work with elders are also adjusting their operations.

Elder Services of Worcester Area has adopted a similar distancing protocol for its meals on wheels programs, and has discontinued non-critical home visits. When ESWA staff does make a home visit, the organization said, they will use personal protective equipment and practice social distancing.

ESWA is also contacting its consumers by phone to check in on topics including access to food, medication, and additional supports. In an update to local councils on aging, EWSA said that information would help identify their most vulnerable consumers and “will prove to be vital should our workforce be impacted as a result of the COVID-19 outbreak.”

Mystic Valley Elder Services, based in Malden, has instituted a no-visitors policy at its office and is using phone calls in place of home visits, while continuing meal delivery service — with extra shelf-stable and frozen meals. BayPath Elder Services in Marlborough has its staff working remotely, and Elder Services of Berkshire County is requiring employees or volunteers to stay home if they feel sick, and requiring staff who have traveled to self-quarantine before returning to work.

Springwell, a Waltham nonprofit serving seniors and people with disabilities, posted a notice on its website describing maintaining its meal delivery program as “both a priority and a challenge in the face of staffing shortages, and potential supply issues.”

“At the moment, after volunteer drivers for our home-delivered meals program, our most critical need is funding from individuals and businesses, which will enable us to manage the increasing costs of providing services and respond to the growing needs of the elderly and disabled, without delay or restriction,” the notice said.