Gap in home care leaves seniors exposed
LTC workers tested every two weeks, but not those entering private homes
Since the beginning of the pandemic, Kelsey Schmitz has been carefully limiting her contact with other people so she can continue to see and help care for her father, Dave, as he lies in bed with an autoimmune disease that puts him at high risk of complications should he get COVID-19.
Last week she heard the news she’s been dreading — that he had been exposed to COVID-19 by one of the people who helps care for him. She suspects part of the reason is that his care is taking place at home, a setting where the workers who help him aren’t required to do COVID-19 tests.
“It’s outrageous that there are people working with the most at-risk folks, special needs kids who aren’t getting tested,” she said. “We should be protecting people in their homes and in their spaces.”
In long-term care and in the hospital, the government has implemented additional protections, such as mandatory COVID-19 testing at least once every two weeks for staff and family caregivers, and an accelerated vaccination program.
But more than 700,000 Ontarians are receiving regular, publicly funded health care at home — a piece of the care sector promoted by the Ontario government for more than a decade but which has received far less COVID-19 regulation.
Ontarians receive home care for a variety of reasons, which range from temporary help with physiotherapy to longterm personal support for people with chronic conditions.
The latter group, generally vulnerable to COVID-19 because of advanced age and other health conditions, comprise about 74 per cent of home-care visits in Ontario in 2016.
Kelsey’s father has myasthenia gravis, a disease that causes muscle weakness and, in his case, issues with breathing and his heart. Kelsey’s mother, Julie, is his main caregiver, but he also needs extra help from nurses, and from personal support workers twice a day.
In total, Schmitz said, about 10 different people enter her parents’ home in Cornwall every week to help Dave.
The workers are employed by Bayshore Health, an agency that connects workers to families such as Kelsey’s for care that is billed through the Ontario Health Insurance Plan.
Reached by the Star, Bayshore said it follows “strict COVID-19 infection and prevention guidelines” and that it has used “an active screening and personal protective equipment process” since January 2020.
Still, despite serving 250,000 clients, Bayshore and other private home-care providers are not held to the same standards as long-term-care homes when it comes to COVID-19 protections.
One area where that’s especially true is in testing. Ontario introduced strict testing procedures at the beginning of this year, which require all longterm-care workers, and family caregivers entering the facilities to be tested at least once every 14 days.
Kelsey Schmitz said she understands why long-term-care facilities have been the first priority for the government in terms of limiting COVID-19 spread, but she doesn’t understand why a policy on testing does not apply to home care, too, where workers interact with multiple vulnerable people like her dad every day.
“Our PSWs are telling us that it’s not mandatory for them to be tested and if they want to be tested they have to do it on their own time,” Schmitz said. “This became a big concern, because I knew that there could be a moment when my dad could be exposed to COVID because of this.”
That moment came last Sunday, when a worker came into her parent’s home and tested positive for the coronavirus the following day.
Schmitz was waiting Monday for the result of her parents’ own coronavirus test. She said they were feeling OK.
She wants to see the province require testing of all personal support workers, including in home care. She said the personal support workers themselves, who make low wages and work long hours, should expect to be paid for the testing time as part of their job requirements.
“But one would think that would be a provincial requirement,” she said. “The least you could do is ensure your employees are safe.”
Bayshore, for its part, said 10 of its clients have tested positive for COVID-19 after exposures from staff.
Lynn Steele, who founded the Canadian PSW Network, agreed that while it’s important for the government to focus on long-term care, the lack of attention paid to communitybased personal support work means there’s a gap in the province’s COVID-19 protection strategy.
She said the rules around testing should apply to home care personal support workers too — and that they should also be prioritized for the COVID-19 vaccine.
“Take ‘PSW A’ who works in long-term care. They’re continually tested. They’re tested for symptoms at every shift,” she said. “You’re not getting that in home-care. ‘PSW B’ who works strictly in the community may have been to 12 other houses, with six family members (and never be tested).”
“(PSWs are) all doing their best. But there isn’t the same amount of oversight and consciousness as there is in longterm care,” Steele said.
In a statement sent to the Star, the Ontario Ministry of Health said it has a public document guiding home and community care organizations on COVID-19 prevention strategies.
“The ministry guidelines recommend that care providers delivering home and community care services use surgical/ procedure masks during the entirety of a home and longterm care visit,” a portion of the statement reads.
The guidance also calls for self-monitoring for COVID-19 symptoms by home-care providers, but does not call for regular testing.
“Our PSWs are telling us that it’s not mandatory for them to be tested and if they want to be tested they have to do it on their own time.” KELSEY SCHMITZ