Pandemic-fueled shortages of home health aides strand patients without care

Many seniors are going without needed assistance during the pandemic.

(CNN)Frail older adults are finding it harder than ever to get paid help amid acute staff shortages at home health agencies.

Several trends are fueling the shortages: Hospitals and other employers are hiring away home health workers with better pay and benefits. Many aides have fallen ill or been exposed to Covid-19 during the recent surge of omicron cases and must quarantine for a time. And staffers are burned out after working during the pandemic in difficult, anxiety-provoking circumstances.
The implications for older adults are dire. Some seniors who are ready for discharge are waiting in hospitals or rehabilitation centers for several days before home care services can be arranged. Some are returning home with less help than would be optimal. Some are experiencing cutbacks in services. And some simply can't find care.
    Janine Hunt-Jackson, 68, of Lockport, New York, falls into this last category. She has post-polio syndrome, which causes severe fatigue, muscle weakness and, often, cognitive difficulties. Through New York's Medicaid program, she's authorized to receive 35 hours of care each week. But when an aide left in June, Hunt-Jackson contacted agencies, asked friends for referrals, and posted job notices on social media, with little response.
      "A couple of people showed up and then disappeared. One man was more than willing to work, but he didn't have transportation. I couldn't find anybody reliable," she said. Desperate, Hunt-Jackson arranged for her 24-year-old grandson, who has autism and oppositional defiant disorder, to move into her double-wide trailer and serve as her caregiver.
      "It's scary. I'm not ready to be in a nursing home, but without home care there's no other options," she said.
      Because comprehensive data isn't available, the scope and impact of current shortages can't be documented with precision. But anecdotal reports suggest the situation is severe.
        "Everyone is experiencing shortages, particularly around nursing and home health aides, and reporting that they're unable to admit patients," said William Dombi, president of the National Association for Home Care & Hospice. Some agencies are rejecting as many as 40% of new referrals, according to reports he's received.
        "We're seeing increasing demand on adult protective services as a result of people with dementia not being able to get services," said Ken Albert, president of Androscoggin Home Healthcare and Hospice in Maine and chair of the national home care association's board. "The stress on families trying to navigate care for their loved ones is just incredible."
        In mid-January, the Pennsylvania Homecare Association surveyed its members: Medicare-certified home health agencies, which provide assistance from aides and skilled nursing and therapy services, and state-licensed home care agencies, which provide non-medical services such as bathing, toileting, cooking and housekeeping, often to people with disabilities covered by Medicaid.
        Ninety-three percent of Medicare-certified home health and hospice agencies and 98% of licensed agencies said they had refused referrals during the past year, according to Teri Henning, the association's chief executive officer.
        "Our members say they've never seen anything like this in terms of the number of openings and the difficulty hiring, recruiting, and retaining staff," she said.