Home Care in a Pandemic

August 2020

The numbers shocked us. The stories shocked us even more. COVID-19 exposed the truth about long-term care homes – the places that are supposed to protect frail and vulnerable people, most of them seniors.

We know much less about how COVID-19 has affected the people – many of them also seniors – who were cared for at home. How frail were they? What services did they receive, who provided those services, and under what conditions were they working? How many clients and workers were infected with COVID-19, how were they infected, did they infect others, and who was hospitalized or died as a result?

Clients sometimes move between home care and long-term care homes. Workers come from similar backgrounds and face many of the same pressures. Home care workers don’t race between patients in close quarters, but race between clients’ homes, often taking public transportation. Many are older than 55 and members of racialized groups that are particularly vulnerable to COVID-19. They fear infecting clients, themselves, and their families. When they take time off, they may lose income. They need that income, often from several employers, to survive.

When faced with COVID-19, hospitals and then long-term care became the priorities; home care was neglected. Ontario is reviewing long-term care homes so that what happened will never happen again. Home care clients, their families, and the workers who care for them need the same protections.

Care Watch recommends that:

  • Infection prevention and control policies, procedures, and standards for home care be comparable to those for long-term care.
  • Masks be mandated for home care workers as they already are in common and public spaces.
  • Infection prevention and control standards be consistent across the province.
  • Testing for home care clients and workers be easily accessible.
  • Home care workers have the same equipment as those in long-term care.
  • Home care workers receive wages, benefits, and training that will support professionalism and a culture of safety.
  • All home care workplaces and employers be held accountable for meeting provincial standards.
  • Consistent, reliable, province-wide data on home care be collected and available.

Some facts about COVID-19

On March 11, 2020 the World Health Organization declared COVID-19 a pandemic. Here’s some of what we’ve learned so far.

  • COVID-19 is a viral disease with no single pattern or pathway. Symptoms vary greatly, and some people show no symptoms.
  • It occurs in both warm and cold environments throughout the world and, unlike the flu, doesn’t appear to be seasonal.
  • It is most commonly spread through respiratory droplets, close personal contact, or touching an item with the virus on it and then touching the eyes, nose, or mouth. The most effective protections are to: wash your hands; avoid touching the eyes, nose, or mouth; avoid close contact with people who are sick; stay home if you are sick; cough or sneeze into a sleeve; practice distancing; and wear masks or face coverings.
  • The vast effects on society have included loss of jobs, changes in work, failure of businesses, and restrictions on travel and immigration.
  • People in racialized and/or marginalized groups, as well as those with low incomes, have been affected much more than others.
  • Work is in progress, but treatments and vaccines aren’t yet available. When available, all must have access.

What can you do?

Premier Ford has said, “We will do whatever it takes to ensure every senior in the province has a safe and comfortable place to call home.”

  • Make him keep his promise. When the review recommends improvements in long-term care facilities, make sure home care has comparable improvements and investments.
  • Let’s not lose what we learn. Let’s keep home care clients and workers safe – with or without a pandemic.