COVID-19 Changes Caregiving at Home Care Facilities

//// By: Annette Murphy, BA, MSW, C-ASWCM ////

The challenges of COVID-19 and the fundamental change it’s bringing to caregiving and our healthcare system will be felt for years to come. Social isolation, hard to find supplies, and worry over the advisability of face-to-face medical visits are just some of the concerns of family and professional caregivers.

The stark differences in today’s caregiving world and how we overcome these new challenges are a topic of conversation at the local, state and national level of the Aging Life Care™ Association (ALCA) and its Aging Life Care Professionals®

Experts in aging well, these professionals are adjusting to a landscape that is shifting for the seniors they serve and in their work life. In this “high touch” profession, the biggest hurdle is not being able to access clients face-to-face.

“You can learn so much face-to-face. By assessing how our client looks, reviewing medications and observing the home environment, we can see indications of decline, functional problems or regressions. With the lockdown, we are making phone calls and relying on observations by home health aides. It’s not the same.

So much of how we support our elders is in activities of daily living like grocery shopping. I can’t go into their home, access the food in a refrigerator and purchase what needs to be restocked. I’m asking them to really think ahead about what groceries they need, including pet food, because when I shop online for them, delivery dates can be weeks out.

Then there are systems in place for things like medication management that are no longer working. Getting the correct medication, in the correct format to clients can be a challenge. It’s required adjusting how the meds are dispensed and how the client gets them, but we make it work.

5 things you should know about your aging parentsIt’s difficult on a personal level as well. We know our clients so well. It’s hard not to be able to interact and give them a hug.” Wendy – Care Manager at Springpoint at Home

Parents Aging at Home“The one thing that has surprised me is how creative we can be in working around not being able to see people. We are demonstrating that a lot can be done using technology, from counseling, service recommendations to telehealth visits. I’ve been impressed with the dedication of everyone to ensure that clients continue to get the best care possible despite current challenges. It’s proving that people who are isolated can still be helped, supported and have an improved quality of life with these types of services.” Mary Ann – Care Manager at Springpoint at Home

Technology is helping much of society to overcome isolation barriers. But technology is often problematic for the people these care managers help. Few of them have cell phones or computers that allow for Skype and Zoom video visits. Many are living with dementia and don’t have the capability to use these technologies, regardless of availability.

Like many professions, the impact COVID-19 is having on aging life care services is occurring at two levels simultaneously. Everyone from national ALCA staff to local agencies are still grappling with these challenges. The more difficult ones are those happening TO them. Client hours are down, there are less hospital and doctor visits and staffing changes can be daily. At the same time, there is a need to shift service and client interaction models.

“As we figure out how to best serve our clients, care managers and staff during these unprecedented times, I am grateful for the 2,000-strong Aging Life Care Association®. This year is the 35th anniversary of ALCA and I am struck by how appropriate our “Better Together” theme is for the time we are in right now.

As Co-President for the NJ Regional Chapter of ALCA, I’m impressed by how all these amazing professionals are working together to embrace change, serve our clients and keep them safe. We are sharing resources on everything from procuring and normalizing protective equipment for our Alzheimer’s clients, to tips on successful telemed and telecounseling sessions.

I always thought of my field as being high touch and low tech. But there is a shift in my thinking that technology is a disconnect. The fact that a fragile elder can see a doctor with telemedicine without going out in bad weather or sitting in a waiting room during flu season is a good, safe alternative. The fact that an isolated elder can push a button and get an LPN on the other end to answer a question is great. I hope the shift in payer sources being open to these options continues.

Some changes are likely to stay beyond this outbreak. Many families live at a distance and user-friendly technologies like Skype or Zoom keep them connected. It means our care managers might use their own device for the meeting, but it is proving to be an emotionally connective tool for families.

There are some things I don’t believe we will go back to any time soon. The days of our care managers visiting 15 nursing homes in a week, meeting with 100’s of people and shaking hands are some of them. It means we can’t be paralyzed by these changes; we have to embrace them.

One of the hardest challenges for me is the sense of collective grief we all feel. In this business, you expect to lose clients and we have coping mechanisms. But the volume of elders we are losing across this nation in a short amount of time is hard. We are powerfully connected to the people we serve through our long-term relationships and it compounds the collective grief. It helps to be a part of a dynamic, experienced group of leaders. When we share stories, experiences and memories, it makes me realize we are better together and it’s OK to be optimistic.

About the Author: Annette Murphy, BA, MSW, C-ASWCM. Annette is the Director of Home Care, Springpoint, and has over 20 years of experience in a variety of healthcare settings. Prior to Annette’s current role as director of home care, she worked as a geriatric care manager and supervisor for Springpoint at Home. She is a licensed clinical social worker, a certified advanced case manager, and a member of the National Association of Social Workers. Annette serves on the Board of Directors for the Aging Life Care® Association of New Jersey, is the New Jersey Chapter Co-President, and is an avid community volunteer. She is a member of the Springpoint Senior Living Ethics Committee and attends the Mercer County Workforce Development Committee meetings.