Coronavirus and home care of the elderly

With many agencies fighting shy of sending their staff to the care-seeker’s home, the geriatric population faces a huge challenge

Updated - June 21, 2020 08:08 pm IST

Published - June 21, 2020 11:18 am IST - Chennai

W ith a broken femur that was on a slow mend following a medical intervention, Krishnamurthy Rajaraman's 80-year-old mother clearly needed a caregiver. With none on the horizon, Krishnamurthy was eaten by anxiety.

“I could not entrust my mother to the care of just a bedside assistant who would look after all her needs during the day but leave by evening,” says Krishnamurthy.

After some anxious wait, he was lucky to find a nursing assistant — thanks to Care Finder, a care provider for elders — who was ready to stay with the family in Medavakkam.

Krishnamurthy’s case was relatively less complicated, when compared with many other calls received by home care agencies and organisations offering services for senior citizens, during these times.

In another case, a family of three senior citizens that had tested positive for COVID-19 wanted a caregiver.

The coronavirus has exponentially pushed up the demand for home health caregivers.

While many senior citizens require the expertise of nursing assistants for services that range from geriatric to palliative care and regular check-ups, some of those who have recovered from COVID-19 seek post-hospitalisation care.

Increased demand

Agencies offering such services say they get many calls from the seniors themselves or from their children living abroad asking for caregivers. Many of these agencies are unable to provide them with caregivers, as the latter have left for their hometown or are absent due to quarantine or are not willing to take up the work due to the rising numbers of Cornoavirus cases.

“There is a shortage of home nurses or bedside assistants but it is also a time when we have to rise to the challenge,” says P.S. Srikumar, CEO, Care Finder.

The Chennai-based elders-care provider recently helped an NRI couple find a home assistant, for a senior in the family, a 79-year-old who was bedridden after being diagonised with cancer.

“A person from a homecare agency was looking after the father but he backed out after knowing that the couple came from the U.S. We arranged for a caregiver after speaking to a few agencies and explained to them that they are COVID negative,” says Srikumar.

Dr. Avinash Rajkumar, founder and head of medical operations, NORMS, says home care of COVID-19 patients is a new front and not many agencies are open to offering post-hospitalisation care.

He cites an example: An 82-year-old, who was admitted with fever tested positive for COVID-19 recently.

After undergoing treatment, he is going to be discharged on June 22 and the family contacted NORMS seeking post-hospitalisation care as the father and son stay in two different localities in Chennai.

Post-hospitalisation care

“We are open to accepting this request as he is stable but we do follow certain protocols which the family has to agree to for us to start the service,” says Dr. Rajkumar.

The challenge before NORMS is if the family wants the service to be offered for a period of 10 days.

“If we were to send a nursing assistant then we would prefer to have this service for the entire quarantine period,” he says.

Because the staff cannot be engaged with another client till they complete the quarantine period.

Among the requirements from the agency are: A separate room and a toilet for the nurse. The staff must be allowed to rest after every two hours as she is in a PPE suit. The cost of food and PPE suit must be borne by the family.

Dr. Rajkumar says because of the cost, safety protocols and shortage of manpower, post-hospitalisation care is yet to open up in a big way.

For instance, he says, in the last two to three weeks many of his staff have returned to their home town due to family pressure.

Most of the agencies that we spoke to say they are wary about offering even home health care (not under COVID-19 criteria) during these times.

GeriCare is following a cautious approach before sending any of their nursing assistants to a resident's home.

“We have a database of 150 nurses but almost 50% of them have gone to their home towns.

A small section of the remaining are not interested in taking up home visits now,” says Dr. R. Senthil Kumar, COO, GeriCare.

Much of the consultation for senior citizens is done digitally but if they have to send a nurse home they follow a number of precautions including asking the staff to wear PPE suits and making sure both the individuals don't display any COVID-19 symptoms.

“Prior to the COVID-19 pandemic, we offered a 12-hour service. Since we want to limit exposure, we have 24-hour shifts,” says Dr. Senthil.

Running errands

Anvayaa, which offers end-to-end services for the elderly in Chennai, Hyderabad and Bengaluru, has attended to close to 1000 families, all under quarantine, in the three cities since the lockdown began.

“The number of visits paid to a particular family has gone up because all of them were under quarantine, which means we run errands for them and also offer pharmacy and diagnostic services,” says Prashanth Reddy, MD, Anvayaa.

For those seeking home health care services, the company makes it a point that the caregiver is quarantined for at least one week before attending to another person. Reddy agrees there is a shortage but Anvayaa has been able to manage as it works with more than 35 partners.

Alserv has also been refusing home care service for those tested for COVID-19 positive.

“We have been supplying food to senior citizens including supply to quarantine homes, which is a big help in these times; but due to the restrictions imposed on account of the lockdown we serve the two meals of the day by 12.30 p.m.,” says Atul Jagadish, vice-president, business development, Alserv.

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