Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Geriatric Research, Education, and Clinical Center (GRECC), James J. Peters VA Medical Center, Bronx, NY, USA.
Veterans Emergency Management Evaluation Center, Department of Veterans Affairs, North Hills, CA, USA.
J Am Med Dir Assoc. 2022 Dec;23(12):1990-1996. doi: 10.1016/j.jamda.2022.09.012. Epub 2022 Nov 4.
COVID-19 has demonstrated the essential role of home care services in supporting community-dwelling older and disabled individuals through a public health emergency. As the pandemic overwhelmed hospitals and nursing homes, home care helped individuals remain in the community and recover from COVID-19 at home. Yet unlike many institutional providers, home care agencies were often disconnected from broader public health disaster planning efforts and struggled to access basic resources, jeopardizing the workers who provide this care and the medically complex and often marginalized patients they support. The exclusion of home care from the broader COVID-19 emergency response underscores how the home care industry operates apart from the traditional health care infrastructure, even as its workers provide essential long-term care services. This special article (1) describes the experiences of home health care workers and their agencies during COVID-19 by summarizing existing empiric research; (2) reflects on how these experiences were shaped and exacerbated by longstanding challenges in the home care industry; and (3) identifies implications for future disaster preparedness policies and practice to better serve this workforce, the home care industry, and those for whom they care.
COVID-19 凸显了家庭护理服务在通过公共卫生紧急情况为社区居住的老年人和残疾人提供支持方面的重要作用。随着大流行使医院和疗养院不堪重负，家庭护理帮助个人留在社区并在家中从 COVID-19 中康复。然而，与许多机构提供者不同，家庭护理机构通常与更广泛的公共卫生灾难规划工作脱节，并且难以获得基本资源，这危及了提供这种护理的工作人员以及他们所支持的医疗复杂且经常处于边缘地位的患者。家庭护理被排除在更广泛的 COVID-19 应急响应之外，这突显了家庭护理行业如何与传统的医疗保健基础设施分开运作，尽管其工作人员提供基本的长期护理服务。这篇专题文章（1）通过总结现有实证研究，描述了 COVID-19 期间家庭保健工作者及其机构的经历；（2）反思了这些经历如何受到家庭护理行业长期存在的挑战的影响和加剧；（3）确定了对未来灾难准备政策和实践的影响，以更好地为这一劳动力、家庭护理行业以及他们所照顾的人服务。
