As a hospice nurse in Seattle, Diane Speer said giving out hugs to patients and family members was a routine part of home visits.
But in the midst of the coronavirus pandemic, she now tells family members to keep their distance.
"There's no touching hands or handshakes," said Speer, who works for Renton, Wash.-based Providence St. Joseph Health. It's "time for a virtual hug."
Hundreds of thousands of health care workers like Speer go into homes around the country to provide vital services for seniors and disabled people. But with rising concerns about the coronavirus and the particular danger it poses for older adults, those workers could be endangering their patients and themselves.
"There is the knowledge that these are health workers who have skills that can benefit you, but the fear is the health care worker: Who is the last person they saw and where have they been lately and are they bringing something into my home?" said Dr. Thomas Schaaf, chief medical officer for Providence St. Joseph's Home and Community Care division.
Hospice and home health nurses, home care aides and temporary nurses are stepping up protective measures. These include calling patients at home before they visit to see if they or anyone in the household have a fever or other symptoms of COVID-19, the disease caused by the virus. They're also washing hands in front of patients and wearing masks and other protective gear to reduce infections and to make patients more comfortable about their precautions.
Still, home health providers say they're seeing some patients turn them away for fear of getting the virus.
"It's been quite a challenge -- we've had patients discharged from the hospital for a home health referral who have refused to have our caregivers come in," Schaaf said.
Providence nurses visit patients at home, nursing homes and assisted living facilities. Visits are often critical for wound care, to ensure patients are taking their medications and to assess if a patient's housing is safe to minimize falls and other dangers.
He said his large health system has been trying to move care visits -- such as those done by social workers or chaplains -- to phone or video conferences.