Care at home during the COVID-19 crisis

Apr 8, 2020

Care at home during the COVID-19 crisis

Care at home during the COVID-19 crisis

Posted in : Dementia Care on by : Pooja Jain

This article focuses on the impact of COVID-19 (coronavirus) on the care at home sector, an extension from my previous blog that covered residential care homes. 

Care at home responsibility falls on informal carers (i.e. family carers) and domiciliary care providers that offer care services at home. These are carers who are overworked, either underpaid or not paid at all, and not getting the support they need and deserve. In the current situation, they carry the additional responsibility of looking after and protecting the elderly and the vulnerable from COVID-19. 

The care providers were struggling way before COVD-19 entered our lives. The care at home sector is a fragmented sector where some of these organisations are either small and run by independent providers or operated by big care groups and local authorities. The former have been left to the inexplicable changes of the market, while the latter have been dependent on cash-strapped local authorities. 

There are hundreds of thousands of people across the UK with long-term conditions like dementia, relying on family members for their care. This brings a lot of questions to the table in this situation – what support is offered for family carers who have to self-isolate to protect their loved ones? Who will bridge the gap in care that people need? How will the isolation and loneliness that impact conditions like dementia be managed? 

As you can imagine, domiciliary care services and informal carers are really important. If neither can get to the people who need support, they might not get to have regular meals, be washed or have much needed company. 

What challenges are the care at home sector facing?

Domiciliary care providers: 

Limited COVID-19 testing: Care workers visit multiple clients each day, which increases the risk that someone who contracts the virus will spread it to many people. With a lack of mass COVID-19 testing, some staff are self-isolating themselves when they might not need to while others are working in the dark, potentially contracting the virus from a client and passing it on to others. Without testing, care providers can’t protect their clients or staff properly. 

Personal Protective Equipment (PPE) delay: Following on from the previous point, providers struggle to get PPE for their staff. Care providers have to decide whether or not they take on more clients, as they do not want to put existing clients and staff at risk from the lack of required equipment. 

Longer visits and more admin: It is likely that home care visits will take longer than the usual time to use and dispose of the protective gear and care for the extra complications clients might be facing. There could also be more administrative work as a result of reorganisation of client visits and reallocation of care staff. More flexibility will be required over how the organisation operates and prioritises the care visits. This is to provide the best support in response to challenges COVID-19 brings. 

Financial crisis: Care providers, that were already financially vulnerable, are worried they could become even more vulnerable and potentially go out of business as the pandemic continues. Costs are piling up, funds are required to train new staff, pay staff that are sick or self-isolating, buy new equipment – just to name a few. The care providers that are paid by the local councils, receive their payment at the end of the month and only for care delivered. They will not pay for care workers who are prevented from working. 

Increase demand with fewer staff: These providers don’t have enough staff to provide support to everyone, partly because the NHS are freeing up beds by discharging long-term patients who are medically fit into the community. This puts massive pressure on families, friends, neighbours and the social care sector in general. 

Informal carers: 

Self-isolation: The biggest challenge carers face is the choice between looking after the person they care for and potentially exposing them to COVID-19 or self-isolating and leaving them without the support they need. Of course, they should isolate themselves if they showcase symptoms, but that is a heartbreaking choice. 

Isolation & loneliness: If an informal carer has to self-isolate this means that the person they are looking after may be home alone with minimal social contact, which is likely to impact on both their physical and mental health 

Parents & kids: The ‘sandwich generation’ is stretched emotionally and financially as they are left looking after kids who no longer have school and looking after their parents or older relatives in need.  

What is being done? 

Domiciliary care providers:

  • All staff have been given a refresher training on infection control and how best to keep themselves and their clients protected 
  • It has been suggested that care providers electronically share information with local partners and work together to address the challenges of COVID-19. For example, by sharing the workforce between home care providers, local primary and community service providers and volunteers. 
  • Care providers will be receiving personal protective equipment for free
  • Care bodies want the government to reform the way local authorities pay social care companies – upfront, rather than at the end of the month.  

Informal carers:

  • Most carers who can no longer look after someone with a long-term condition because they are presenting with COVID-19 symptoms or are self-isolating, are relying on other members of their family, friends and neighbours to help out while they recover. Others are using Facebook support groups where community members are volunteering to help those in need. 
  • If the carer has no one else to turn to, there is support that is provided for the extremely vulnerable. The government has set up a dedicated portal for vulnerable people seeking additional care – arrangements are being put in place to refer vulnerable people self-isolating at home to volunteers who can offer practical and emotional support. 
  • It was recently announced that a network of community hubs will be set up across the UK to deliver medications, food and any other necessary items to the doorstep of vulnerable people who have been told to stay at home for 12 weeks.  
  • It is advised that carers write a contingency/emergency plan that documents what happens if they have to self-isolate and can no longer care for their loved one. 
  • No One Left Behind Digital Scotland: An initiative, which is mobilising a national digital emergency response team to find, equip, train and support households who currently lack access to the internet at home (no broadband or mobile access and / or device)

What else can we do?

  • Create community-led Facebook groups that offer support in the form of shopping or picking up medications for the people who are self-isolating. If you have extra time on your hands, join these groups and offer to provide this support. 
  • Check in with neighbours – are they okay? Could you offer them your help?
  • If you have lost your job, consider applying for a job in social care
  • Organisations should make sure that government legislation also covers social care
  • Stay in touch with people – phone friends/colleagues/neighbours you think might be lonely


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