Frank De-Levi Discusses How COVID-19 Is Impacting Home Healthcare Services Across the United States

As the pandemic develops, it is becoming clear that providing medical care in the home setting is a useful strategy for diminishing and controlling the spread of COVID-19. Home healthcare is an essential service that delivers crucial support to seniors, individuals with chronic disabling conditions, patients recuperating from injuries, and people at the end of life. “The elderly and individuals with enduring diseases are at a higher risk of obtaining COVID-19, and hospitals and long-term care facilities may be unsafe for these individuals to receive care,” says Frank De-Levi of HomeAssist Home Health Services. The CDC reports that older adults have a greater risk of requiring hospitalization or dying if diagnosed with Coronavirus, as well as certain medical conditions can also increase the threat of severe illness. Facilities like HomeAssist, which is run by both Frank and his wife Kristina, has employed several precautions to provide safe and effective care to their housebound patients. Today, Frank De-Levi discusses how home healthcare services have been affected by COVID-19 and ways to improve home care during and after the pandemic.

Lower Demand for Home Healthcare Providers

Despite a professional consensus that home healthcare is a markedly safer place to receive treatment amid COVID-19, demand for in-home care has been declining since the onset of the pandemic. According to a June survey from Home Health Care News, 90% of home health agencies have experienced a drop in revenue, with roughly two-thirds facing at least a 20% decline. As time passes and medical professionals learn more about COVID-19, new information on the virus’s spread gets released to the public. The Centers for Disease Control and Prevention (CDC) notes transmission occurs between individuals in close proximity (less than six feet apart), via droplets or tiny particles produced when an infected person coughs, sneezes, talks, or breathes. “Beneficiaries of home services may not be aware of the safety measures put in place by home medical health agencies to protect them from the virus,” says Frank. Consequently, at-risk individuals are growing increasingly reluctant to allow “strangers” or home healthcare workers into their homes out of fear of infection. Similarly, individuals that require elective surgery are pushing operation dates into the future, with the hope that COVID-19 will be less of a threat at the time of their treatment. With fewer home visits and surgeries taking place, the need for home care workers is shrinking.

Shortage of PPE and Respiratory Services

Personal protective equipment (PPE) is equally necessary for home care workers as it is for doctors, nurses, and other healthcare professionals that tend to patients. “Obtaining sufficient quantities of PPE has been challenging,” says Frank, “shortages experienced in other settings like hospitals and skilled nursing facilities have received a greater level of attention.” As primary caregivers for the most vulnerable populations, home care workers shouldn’t have to worry about equipment shortages threatening themselves and their clients. In general, health providers need better access to PPE, including gloves, facemasks, N95 respirators, eye protection, and gowns. One CBC article notes that desperate home care staff has even gone as far as purchasing their own masks and gloves, so they feel protected when they go into someone else’s home. Meanwhile, the CDC has developed a number of strategies for optimizing the supply of PPE during widespread shortages.

HomeAssist specializes in a wide range of services, including physical therapy, occupational therapy, speech-language pathology, medical social services, and home health aides. As a result, home care providers may participate in a variety of tasks, from wound care to monitoring individuals with unstable health conditions. “At the bare minimum, patients request that caregivers wear masks while in their home,” says Frank. While staff members typically experience full schedules, the pandemic has left skilled healthcare providers with gaps in their calendar. Frank De-Levi admits that many clients have cancelled or postponed their services; at the same time, aides are uncomfortable meeting with new clients during these uncertain times. With adequate protective gear available, home care workers and their patients would both be more at ease, allowing fragile individuals to receive the care they badly need.

Reliance on Telehealth

Treating patients in long-term care facilities is becoming less feasible as a result of the pandemic. In New York, the epicenter of COVID-19 in United States, there are only 23,000 hospital beds available. As a growing number of individuals contract the virus, non-COVID patients must accept treatment for their ailments elsewhere. “Home-based care is the obvious solution,” explains Frank, “it’s cheaper and more convenient for individuals to be treated at home than stuck in an unpleasant hospital room.” Furthermore, as patients and caregivers become aware of the risks of close contact, communicating via Telehealth technology is helping to transform healthcare.

The New England Journal of Medicine defines Telehealth as “the delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies.” For instance, live video conferencing, mobile health apps, and remote patient monitoring are examples of effective technologies employed to care for patients from a distance. In addition to video chatting with patients in real-time, wearable devices can collect vital sign data like blood pressure, cardiac stats, oxygen levels and respiratory rates. “While Telehealth isn’t a perfect substitute for in-person visits, it makes it possible to deliver fast and effective healthcare during these unprecedented times.”

COVID-19 Screening

Roughly 4.5 million people used some form of home health services in 2016. This number doesn’t account for the fact that some patients require multiple visits from home care providers on any given day. Frank notes that some of their clients, especially those with debilitating illnesses like multiple sclerosis or Alzheimer’s disease, may need around the clock care. As such, some families cannot afford to suspend their home healthcare services. “At HomeAssist, we try to limit the number of private homes our health providers visit, thereby reducing the risk of exposure to the virus,” explains Frank.

Another way we protect our employees and clients is through aggressive screening. Screening typically involves asking patients a collection of questions to evaluate an individual’s risk for COVID-19. Inquiries may include but are not limited to a person’s exposure to the virus, recent activities, travel history, and contact with individuals who have tested positive. For our employees, effective prevention measures start with a thorough understanding of the symptoms associated with COVID-19, such as fever, dry cough, and tiredness — to name a few. “Ultimately, we conduct regular phone calls with clients and providers to gauge whether or not they are at risk for spreading the virus,” says Frank.

The CARES Act

The House of Representatives passed a bill in late March, known as CARES, or the “Coronavirus Aid, Relief, and Economic Security Act,” which offers several advantages for home health care agencies. First and foremost, the U.S. Department of Health and Human Services has promised to allocate $100 billion to medical expenditures, lost revenue due to COVID-19, and uninsured patient care. In addition to providing much-needed financial aid, the Act gives agencies better flexibility to cope with and respond to the pandemic. In the past, only physicians were allowed to certify home health services. Thanks to the Act, nurse practitioners, physician assistants, and clinical nurse specialists can decide patients’ eligibility for home care and establish a treatment plan. “This change will free up hospital capacity, reduce patient wait times, ease eligibility requirements for various care settings, and improve patient outcomes,” explains Frank. While the bill was born as a result of the growing COVID-19 crisis, home health providers like Frank and Kristina believe that these new provisions will leave a lasting impression on the home health industry.

Conclusion

Home healthcare is an essential service that millions of people rely on around the world. Agencies like HomeAssist Home Health Services are doing everything in their power to ensure their employees and clients are safe during these uncertain times. “Perhaps one of the outcomes of this horrific pandemic is the ability to identify problems in our health system and develop solutions for how we can improve care now and in the future.”