Choices for Care and COVID-19

Town Meeting Day is feeling like a long time ago. Not even a week has passed since Vermonters voted – and showed tremendous support for the members of their communities served by local home health and hospice agencies. Thank you!

But since Town Meeting Day, COVID-19, the disease caused by the 2019 novel coronavirus, has dominated headlines – and by extension the conversations I’m having at work and with friends, family and people at the gym and the grocery store.

My city-dwelling mother is concerned, but not panicked. Her biggest hygiene challenge is that at nearly 80, she touches a lot of railings as she makes her way through her day running a full time real-estate business (people ask me where I get all my energy; there’s the answer). My city-dwelling young adult daughter got a little panicky and needed some help thinking through how to make decisions about subways, buses and social gatherings. My son and husband appear to have no concerns or questions at all and are getting increasingly tired of my handwashing reminders (there’s one way to solve that, guys . . .)

At work, what strikes me the most is that the role that home health and hospice agencies play in our communities every day takes on an increased significance during a public health event like this one.

Today in Vermont about 1,200 low-income, vulnerable Vermonters who would otherwise be in nursing facilities are living at home through Vermont’s Choices for Care program. They’re at home thanks to the work of countless caregivers, home health agencies, adult day centers and area agencies on aging. The individuals served by the Choices for Care program are especially vulnerable to COVID-19, and from a public health perspective, they are almost certainly safest at home. We know our partners in long-term care facilities and congregate settings are working hard every day to protect the people they serve. Our part is to prevent as many new admissions as possible.

Home health agency nurses and therapists also provide health care at home for more than 3,500 individuals every day. (For context, under normal circumstances, there are about 1,000 staffed inpatient hospital beds in Vermont – not all of them filled.) Home health nurses and therapists are always working to reduce preventable hospital readmissions and emergency room visits. This will be especially important if hospitals have to implement “surge” capacity plans to serve more patients than usual.

In response to COVID-19, home health and hospice agencies are updating their screening questions and emergency preparedness plans. The biggest concern is that an already stretched workforce could be impacted by illness or quarantine orders.

Luckily, home health and hospice agency leaders are some of the most practical and solution-oriented leaders I have ever worked with, and they are responding to this event with calm focus. I am always proud to help support their important work, and this event once again reminds me why. 

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