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Struggles of care home staff during COVID-19 first wave revealed in Whatsapp messages

An analysis of social media messages shows scant guidance for things like infection control and proper PPE usage.

Jeff Lagasse, Associate Editor

An analysis of social media messages among home care staff on the COVID-19 front lines reveals their growing concern over how to manage in the face of the coronavirus.

The results are found in "Seeking Answers for Care Homes during the COVID-19 pandemic," published in the journal Age and Ageing and shared in EurekAlert. The article focuses on messages sent and received via Whatsapp, a secure messaging platform for mobile phones.

Thousands of Whatsapp messages between 250 home care workers during the first coronavirus wave show workers often asking questions that went unanswered due to a lack of proper guidance. Staff asked where to purchase PPE, whether guidelines existed for isolating residents returning from the hospital and how they could access testing.

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But guidance either did not exist, was conflicting or staff was not aware of it.

WHAT'S THE IMPACT

Home care staff formed the messaging group themselves in partnership with colleagues to offer support during the first wave. As group members, researchers analyzed the questions and uncertainties raised.

They found most of the questions were about infection control and prevention and could have been tackled immediately through timely, responsive and unambiguous fact-based guidance.

But their analyses revealed scant guidance, meaning these basic needs were unmet.

This highlights the isolation of home care staff and the shortcomings of the commissioning of these services, and speaks to the need for more informed research to improve the outcome of those receiving care, which authors said can only be achieved through much closer collaboration.

The social media messages revealed staff concerns over residents' wellbeing and relatives' anxieties; uncertainties over which symptoms predicted the need for self-isolating; and questions about how long staff with symptoms should self-isolate.

Other questions concerned the most effective strategies for resident and staff wellbeing, recruitment, communication and organizational impact, which need further research.

THE LARGER TREND

The study was conducted in the United Kingdom, where care homes are identified as both nursing homes and residential homes.

Under the Patient-Driven Grouping Model in the U.S., spending on home healthcare services is down way down. In fact, according to an analysis from health economics and policy consulting firm Dobson DaVanzo and Associates, spending on home healthcare is down 21.6% from the initial projections.

DDA largely attributes this to incorrect assumptions made by the Centers for Medicare and Medicaid Services when it comes to provider behavior under PDGM as compared with the old Prospective Payment System, which ended a two-decade run on Jan. 1.

Meanwhile, professor Philip E. Auerswald of George Mason University recently contended that removing labor market barriers and technical barriers to entry is vital for realizing the benefits of in-home healthcare, including telehealth. Home healthcare, as Auerswald describes it, comprises medical house calls, health agency care, technologies such as remote patient monitoring devices and telehealth.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com