TY - JOUR
T1 - Home Health Aides’ Increased Role in Supporting Older Veterans and Primary Healthcare Teams During COVID-19
T2 - a Qualitative Analysis
AU - Franzosa, Emily
AU - Judon, Kimberly M.
AU - Gottesman, Eve M.
AU - Koufacos, Nicholas S.
AU - Runels, Tessa
AU - Augustine, Matthew
AU - Hartmann, Christine W.
AU - Boockvar, Kenneth S.
N1 - Publisher Copyright:
© 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
PY - 2022/6
Y1 - 2022/6
N2 - Background: Home health aides are important but often overlooked members of care teams, providing functional and emotional support to patients. These services became increasingly important during the COVID-19 pandemic as older adults faced disruptions in in-person medical services and family caregiving. Understanding how aides supported healthcare teams is important for informing emergency planning and better integrating home health services with primary care. Objective: To describe aides’ roles in supporting veterans and working with primary care teams during COVID-19 and identify COVID-related changes in tasks. Design: Semi-structured interviews. Participants: Eight home health aides, 6 home health agency administrators, and 9 primary care team members (3 RNs, 3 social workers, 3 MDs) serving veterans at a large, urban, Veterans Affairs medical center. Approach: Combined deductive and inductive analysis to identify a priori concepts (aide roles; changes in tasks and new tasks during COVID-19) and emergent ideas. Aide, administrator, and provider interviews were analyzed separately and compared and contrasted to highlight emergent themes and divergent perspectives. Key Results: Participants reported an increase in the volume and intensity of tasks that aides performed during the pandemic, as well as the shifting of some tasks from the medical care team and family caregivers to the aide. Four main themes emerged around aides’ roles in the care team during COVID-19: (1) aides as physically present “boots on the ground” during medical and caregiving disruptions, (2) aides as care coordination support, (3) aides as mental health support, and (4) intensification of aides’ work. Conclusions: Home health aides played a central role in coordinating care during the COVID-19 pandemic, providing hands-on functional, medical, and emotional support. Integrating aides more formally into healthcare teams and expanding their scope of practice in times of crisis and beyond may improve care coordination for older veterans.
AB - Background: Home health aides are important but often overlooked members of care teams, providing functional and emotional support to patients. These services became increasingly important during the COVID-19 pandemic as older adults faced disruptions in in-person medical services and family caregiving. Understanding how aides supported healthcare teams is important for informing emergency planning and better integrating home health services with primary care. Objective: To describe aides’ roles in supporting veterans and working with primary care teams during COVID-19 and identify COVID-related changes in tasks. Design: Semi-structured interviews. Participants: Eight home health aides, 6 home health agency administrators, and 9 primary care team members (3 RNs, 3 social workers, 3 MDs) serving veterans at a large, urban, Veterans Affairs medical center. Approach: Combined deductive and inductive analysis to identify a priori concepts (aide roles; changes in tasks and new tasks during COVID-19) and emergent ideas. Aide, administrator, and provider interviews were analyzed separately and compared and contrasted to highlight emergent themes and divergent perspectives. Key Results: Participants reported an increase in the volume and intensity of tasks that aides performed during the pandemic, as well as the shifting of some tasks from the medical care team and family caregivers to the aide. Four main themes emerged around aides’ roles in the care team during COVID-19: (1) aides as physically present “boots on the ground” during medical and caregiving disruptions, (2) aides as care coordination support, (3) aides as mental health support, and (4) intensification of aides’ work. Conclusions: Home health aides played a central role in coordinating care during the COVID-19 pandemic, providing hands-on functional, medical, and emotional support. Integrating aides more formally into healthcare teams and expanding their scope of practice in times of crisis and beyond may improve care coordination for older veterans.
KW - COVID-19
KW - geriatrics
KW - home health
KW - home health aides
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85126837440&partnerID=8YFLogxK
U2 - 10.1007/s11606-021-07271-w
DO - 10.1007/s11606-021-07271-w
M3 - Article
C2 - 35319082
AN - SCOPUS:85126837440
SN - 0884-8734
VL - 37
SP - 1830
EP - 1837
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 8
ER -