A Covid Case Study
My Recollections as a Home Care Agency Employer during Covid
By Cheryl Rumley RN, BSN
Co-written with Sheri Mathieu
A memory that haunted me my whole life materialized in 2020.
In 1918 my great aunt Bess, 22 and pregnant with their second child, and her husband Howard died a day apart from each other during the outbreak of the Spanish flu. My great aunt Elizabeth adopted the family’s only survivor, their 18-month-old daughter Debra.
In early 2020 I was filled with the same fear and trepidation my aunt Elizabeth must have felt entering her sister’s home during a devastating pandemic, when I had to do the same for my clients at Apex Home Healthcare during Covid-19.
Recalling those tragic events, my deepest concerns were to keep my own son, Kurt, safe, who is my Director of Nursing at Apex, to keep my clients and caregivers safe and to keep myself safe, since I’m the CEO and captain of my home healthcare business.
The daily mission of my healthcare company is to go into the homes of multiple elderly and disabled clients, to fill medications, conduct admissions, bathe clients, take them grocery shopping and monitor their overall health and well-being, inside the comfort of their own homes. A mission that was complicated with myriad hardships during this pandemic.
At the beginning of this crisis, it was nearly impossible to get personal protective equipment.
Then, when it did become available, we literally spent days and thousands of dollars trying to buy gloves, face shields, masks and hand sanitizer. We invested in the rapid Covid-19 testing kits only to later discover that these tests were known to have false positives and negatives.
For the 17 months from the start of Covid-19 until today, if an unvaccinated employee called to say they had a sniffle, sore throat or headache we kept them home and made them get tested before they could come back to work. In the beginning the testing took 9 days to come back. This meant the employee would be out of work for almost two weeks whether sick or not. Our staff dwindled to half, as most of our employees, who are mothers, had to stay home to home school their children. We had no staff to replace the sick or vacationing employees, so administration went out and bathed clients, did grocery shopping and made phone calls to secluded elders who were lonely and depressed.
Employees tried to balance the stress of kids being home while trying to be faithful to their elder clients. To this day we have not filled many positions, and this has been a detriment to the elderly population in Western Massachusetts. These mothers are the backbone to home care.
After employees took their vacations, we mandated all staff traveling outside of the New England states deemed safe by the Governor to quarantine for ten days before returning to work. If an employee tested positive, we had sleepless nights until their clients were all tested. All came back negative, which was a testament to my employees following CDC guidelines with masks, gloves and proper handwashing.
Hazard pay and bonuses became a weekly enticement to keep employees going. Keeping up with the CDC guidelines, which were changing faster than we could get out the previous recommendations, were a constant effort. Making sure staff followed those guidelines was paramount and exhausting.
It was a nightmare trying to keep seniors safe, with no vaccine for a year and no idea how many symptoms to look for. And, as a business owner there was the risk of being sued for negligence if an uncontained outbreak occurred.
What was my saving grace during this all of this?
I kept telling myself that necessity is the mother of invention, and to that end, we kept trying to invent new solutions for this unprecedented pandemic, every single day.
For instance, for our clients in seclusion, we worked with a company to set up new technology — a telehealth tablet. This tablet could be turned on by one button and then my caregivers could see and monitor clients face to face. This tablet also reminded clients to take medications and conduct blood sugar tests on a timely schedule. We were able to get an agency from the Executive Office of Elder Affairs (EOEA) to contract for this tablet, then spent days getting the word out about these tablets to referral sources like the Councils on Aging, EOEA agencies, along with television and cable.
My caregivers soldiered through this pandemic like real heroes, despite all the hardships they had to endure. Through the use of new technology and their high-quality care I can proudly say that as of August 9, 2021, there has been no transmission of Covid-19 from staff to clients or from clients to staff.
I attribute some of our success to many things: My age, experience and wisdom which helped me weather this unbelievable storm. I have owned and operated this home healthcare business for over 22 years, I survived cancer twice since 1999, beat the 2008 recession and raised three boys. I used all my research and knowledge pertaining to pandemics and flus to maintain safety and compliance. We continuously educated our staff in online forums. I gave up a month vacation to manage the company through this storm in January of 2021. I was glad I did. Relief finally came during that month when homecare employees were eligible for the Covid-19 vaccine. We signed up 22 of our employees and several of our clients for vaccinations. As a member of the Massachusetts Home Care Alliance, I was able to keep up with all the new mandates and opportunities for agencies to keep safe and continue caring for our clients.
Like my relatives back in 1918, I had to step out into the dark to make difficult decisions to keep my caregivers and clients safe during this crisis. And like my great Aunt Elizabeth and her 18-month-old niece, we survived. We are emerging from this pandemic with our health intact and a higher set of safety standards to carry us through the end of this.
Personally, I will never forget the lessons learned from this tragic set of events. It has made us all more grateful to be alive and it has made Apex Home Healthcare a better company.