Most home-based care agencies have done their best to keep staff protected from the COVID-19 virus. They’ve worked endlessly to procure PPE and manage the threat of infection, all while lacking the ability to test workers and patients.
Now, agencies are starting to consider the mental health ramifications on their workers as well.
For clinicians and caregivers, the fear that comes with actively working during a public health crisis is one stressor. The inability to deliver hands-on care to complex or chronically ill patients is another — and one that is often even more mentally and emotionally draining.
“I’ve gone from direct bedside care and being able to touch my patients and whisper reassurances to them … [to now], where we’re more telephonic,” Michelle Tilton, a social worker for Androscoggin Home Healthcare & Hospice, said on a Wednesday webinar hosted by the National Association for Home Care & Hospice (NAHC). “It’s hard. It’s been an emotional journey.”
Maine-based Androscoggin Home Healthcare & Hospice provides home health care, hospice, palliative care and case management services to over 2,000 patients. It has over 475 employees in its network.
“I pride myself on being attached to my patients. For me, that’s what keeps me doing the job,” Steve Rogers, a care worker at Androscoggin, said during the webinar. “It’s been tough … I pride myself on having a good effect on my patient’s day, as much as I can.”
Home-based care workers are struggling to adapt to a post-COVID-19 world, one that they couldn’t have imagined when they entered the workforce to help vulnerable patients.
A lot of worry comes with that new world, Shelia Harlow, a newer nurse at Androscoggin, said.
“[There’s] a lot of worry over exposing my dad — he’s 70 years old — and myself. I am immunocompromised,” Harlow said, also on the webinar. “It’s a lot of stress and it’s scary … At first, I was very, very overwhelmed. I was like, ‘I don’t know if I can do this.’ Then I thought, ‘Well, if I don’t, who will?”
That bravery does not rid workers of fear, though. And they are still forced to rely upon screenings to make sure they’re not walking into a COVID-19-infected home when they’re not expecting it.
A lot of that relies on patients’ own accounts or family members’ accounts, which could be unreliable.
But that drastic shift in the way workers are now forced to communicate and care for their patients has also forced them to hone in on their skills.
“It’s really made me develop my skills quicker than most people would. We have to really think quickly on our feet,” Harlow said.
What seems to keep these front-line workers going is the mission and the trust in their employer. It is trust that — if they did their jobs and continued growing for their patients — they’d have the right resources there for them and be rewarded.
“The stakes have never been higher than they are now,” Leann Sebrey, Androscoggin’s chief clinical leader, said on the webinar. “That trust and that communication … there has to be [a sense that] leadership is listening and that our staff has access to our leaders — our front-line leaders as well as senior and executive leaders.”
Leadership has listened to their workers at Androscoggin and has also developed hazard pay for their front-line workers, which the provider calls “care pay.” Androscoggin was able to do so with the help of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
The company handed out payments of $800 and $500 to staff working on the front line last week. Androscoggin has also found new pathways for employees with less work opportunities during the COVID-19 crisis to ensure they can receive as full of a paycheck as possible.
Those creative pathways to more pay included telehealth monitoring opportunities, electronic medical record (EMR) implementation work and screening help for local businesses in need of assistance.
“You have to spend those funds on COVID-19 related matters,” CEO Ken Albert said on the webinar. “From my perspective, investing in our workforce — there’s no greater opportunity [than that when] investing in COVID-19 related matters.”