While the quarantine took place in different styles and magnitudes, all professional voices rose to put on the map of concerns the number of people who abandoned, postponed or are not giving attention to ailments other than the coronavirus. Many of these older adult patients were included among the risk groups, which further limits them in their care decisions, as their ailments multiply.
With fear and, in many cases, product of the official indications themselves, the patients of the world preferred not to go to their consultation, not to take a new one or resort to home care, with the many limitations that this point presents. A document prepared by a team from the Division of General Internal Medicine at Weill Cornell Medicine in New York addressed the hypothesis of What are the experiences of home health workers caring for older adults and chronically ill patients during the pandemic?
During the past months, this group of professionals experienced challenges that increased their vulnerability as a workforce.l. Comprised of home and personal care aides and home aides, they care for adults living in the community and therefore play an important role in supporting people with COVID-19 confirmed and presumed that they should have remained at home.
Unlike other healthcare professionals, whose interactions with patients are relatively brief, home health care workers spend hours or days with patients, helping them with activities of daily living (such as bathing and dressing), instrumental activities of daily living (preparing meals and cleaning), and medical orientation tasks (for example, vital signs and wound care). In addition, these workers often provide companionship and emotional support. The COVID-19 pandemic brings many potential challenges to this caregiver role given the risk of transmitting the virus to both patients and community workers.
Despite being an integral part of patient care, home health workers, “who are mostly middle-aged women, people of color and immigrants, are often an invisible and vulnerable workforce”, as detailed by the specialists in their document. According to New York figures, 1 in 6 workers lives below the federal poverty line. These conditions often lead to high turnover rates and a shortage of labor. As the COVID-19 pandemic intensifies and home health workers continue to care for elderly patients, medically complex patients at home and the increasingly likely demand for home care applications in virtue of reluctance to attend medical centers and clinics, so this workforce is likely to become increasingly vulnerable, both physically and financially.
In this context, the present study aimed to understand the experiences of workers compared to others who have focused on the experiences of patients in professional hospitals and health employees. Among the disciplines they have had to deal with are daily care for patients with chronic diseases, monitoring patients for symptoms of COVID-19, applying precautions to prevent COVID-19 at home. They faced fears of transmitting virus to patients or of contracting it themselves, discounting that the numerous home visits that have multiplied during this time increases the risk of spread.
The fragile situation indicated that the medical bodies began to make their anguish visible. Thus, for example, Peruvian health personnel have already held a 48-hour strike to demand from the government a series of reforms in budget, working conditions and biosafety. “Since the pandemic started we have seen how consultations in homes have been increasing. Generally, a doctor in our country did one or two check-ups per week, but now there are four and up to six consultations in a period of five days, ”says Dr. Carmen Sivira, an internist and specialist in critical medicine from Venezuela. In Chile, meanwhile, different communes invested in developing new home services, such as La Serena’s “Doctor in Your House in times of Pandemic” program. “It is a time when the community needs a lot of support, not only in the health area but also in the psychological and emotional aspects,” said Dr. Midalys Caña, specialist in charge of implementation. From Malaga, the newspaper El Sur portrays a similar picture: street doctors answer about 80 calls and daily visits.
All these circumstances coincide with the data obtained by the aforementioned New York report. Among the difficulties they expressed are the incomplete information available to them regarding COVID-19, which, in many cases, has been imprecise or even contradictory. They have mentioned the limitations in protective equipment and in specific training on coronavirus. They deal hand in hand with processes of anguish, fear, misinformation and depression of the patients they visit. Another point that stands out in the study is the resource for obtaining data through unofficial means, such as the media or social networks, an issue that contributes to its fragility without having a secure battery of head support.
“It was very revealing,” says Madeline R. Sterling, professional in charge of the study. verify that they were not only treating a vulnerable population of patients, but that, due to a high dependence on public transport, they were at high risk of contracting COVID-19 and to transmit it to their patients, other workers and their own. However, many could not afford to stop working and others continued working out of a sense of duty ”.
The additional stress placed on workers by the pandemic, coupled with their already fragile position as minimum wage workers, exacerbated this stress. “Additional efforts are needed to support the physical and mental well-being of workers during the pandemic,” they stated in the document.
While Hospitals have provided information to doctors and staff regularly, this transmission of knowledge to home health workers has varied according to the prepaid service or the hospital to which they belong, which may reflect uncertainty regarding guidelines in the long-term care sector. “Our findings suggest that an approach that integrates information alongside COVID-19 specific training should be systematically implemented.