COVID-19 prevention top concern of home-care agencies, survey finds

Tens of thousands of Massachusetts residents depend on home care to support their health as they age or cope with physical challenges. That care often requires close personal contact, increasing the risk of contracting COVID-19 among both home-care clients and the aides who provide their care.

Findings from a survey issued today by the Safe Home Care Project at UMass Lowell and the Betsy Lehman Center for Patient Safety underscore the need to act now to sustain the safety of home-care services and protect both workers and clients.

"Home care is an important alternative to hospitals and nursing homes, especially for infection prevention during the COVID-19 pandemic. But keeping clients and workers safe at home carries different challenges than in hospitals. The findings of this report underscore the needs to incorporate home care into all health-care pandemic planning and to tailor educational materials, practice guidance and other resources for the delivery of care in homes," said Safe Home Care Project lead and report co-author Margaret Quinn, ScD, professor emeritus of UMass Lowell Department of Public Health.

According to managers at home-care agencies who participated in the June survey, potential exposure to COVID-19 is a significant concern among home-care aides and clients. A majority of agencies surveyed reported having both workers and clients test positive for COVID-19 or exhibit symptoms of the virus.

The survey findings also include:

• Provisioning staff with personal protective equipment (PPE) is both a top priority and a challenge for agencies;
• Guidance and policies to protect against COVID-19 are difficult to interpret and apply to the home-care environment;
• Inconsistent communication about COVID-19 exposure compromises prevention and safety efforts.

The results of the survey, along with the expectation that COVID-19 will continue to circulate until a vaccine is readily available, suggests that efforts to stem the spread of COVID-19 in the state need to account for the role of home care in the health care, disability and elder care systems by providing a framework for practice guidance and securing resources to prevent the spread of infection among workers and clients.

The authors of the report indicate that home care will be enhanced by affording the same consideration to agencies and workers that are given to other frontline health organizations and workers. That includes providing:

• Actionable information about COVID-19 infection status of clients;
• Access to and funding for PPE and disinfection supplies;
• Robust training on proper use of PPE including effective fit testing of N95s;
• Access to timely, free COVID-19 testing upon occupational exposure or development of symptoms;
• Informational resources on COVID-19 policies relevant to the home-care setting.