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Most home health aides 'can't afford not to work' — even when lacking PPE

By Eli Cahan, Kaiser Health News on

Published in Health & Fitness

In March, Sue Williams-Ward took a new job, with a $1-an-hour raise.

The employer, a home health care agency called Together We Can, was paying a premium - $13 an hour - after it started losing aides when COVID-19 safety concerns mounted.

Williams-Ward, a 68-year-old Indianapolis resident, was a devoted caregiver who bathed, dressed and fed clients as if they were family. She was known to entertain clients with some of her own 26 grandchildren, even inviting her clients along on charitable deliveries of Thanksgiving turkeys and Christmas hams.

Without her, the city's most vulnerable would have been "lost, alone or mistreated," said her husband, Royal Davis.

Despite her husband's fears for her health, Williams-Ward reported to work on March 16 at an apartment with three elderly women. One was blind, one was wheelchair-bound, and the third had a severe mental illness. None had been diagnosed with COVID-19 but, Williams-Ward confided in Davis, at least one had symptoms of fatigue and shortness of breath, now associated with the virus.

Even after a colleague on the night shift developed pneumonia, Williams-Ward tended to her patients - without protective equipment, which she told her husband she'd repeatedly requested from the agency. Together We Can did not respond to multiple phone and email requests for comment about the PPE available to its workers.

 

Still, Davis said, "Sue did all the little, unseen, everyday things that allowed them to maintain their liberty, dignity and freedom."

He said that within three days Williams-Ward was coughing, too. After six weeks in a hospital and weeks on a ventilator, she died of COVID-19. Hers is one of more than 1,200 health worker COVID deaths that KHN and The Guardian are investigating, including those of dozens of home health aides.

During the pandemic, home health aides have buttressed the U.S. health care system by keeping the most vulnerable patients - seniors, the disabled, the infirm - out of hospitals. Yet even as they've put themselves at risk, this workforce of 2.3 million - of whom 9 in 10 are women, nearly two-thirds are minorities and almost one-third are foreign-born - has largely been overlooked.

Home health providers scavenged for their own face masks and other protective equipment, blended disinfectant and fabricated sanitizing wipes amid widespread shortages. They've often done it all on poverty wages, without overtime pay, hazard pay, sick leave and health insurance. And they've gotten sick and died - leaving little to their survivors.

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