Should home care workers wear a face mask at their client's homes during the COVID-19 pandemic?

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Should home care workers wear a face mask at their client's homes during the COVID-19 pandemic?

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There are two home care workers who come to my parents' home (one during the week and the other on the weekend), and neither of them wear a face mask in my parents' house. Both of these workers are around other people outside of my parents' house, because they go to the grocery store, they share their home with their spouse/boyfriend, children. However, there's no rule in our state requiring that home care workers wear a face mask.

Should the workers be wearing face masks as a precaution to prevent spreading the virus in the homes of their elderly clients? If you are a home care worker, have you been wearing a face mask at your client's home? By the way, I realize what a pain it is to wear a mask: they are hard to breathe through, they get hot, they're annoying & can be uncomfortable. But this is about protecting the clients (who are already isolated in their homes during the virus) from outside exposure.

Coronavirus Home Care Home Health Care

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Yes they should, especially if your parents are in a high-risk group. You don't mention their age, but assuming they are north of 70, which means they are higher-risk. If they have any underlying conditions (immune compromised, diabetes, cancer, copd, etc.) they are very high risk. If the workers are from an agency or the county they need to be reported.

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Why do the workers need to be reported? The OP says there’s no mask requirement for home care workers where they live.

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Are your parents wearing masks?

If you prefer that the workers wear masks, tell them. If they won’t, you can relieve them of their services.

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My parents aren't wearing masks, but they've been at home for this entire pandemic so far. Should they be wearing them? Then they'd have to wear them for 8 to 9 hours a day, 7 days a week. I'm not sure if wearing them for those long periods may have a negative impact on their health at their ages, especially since my dad has had some heart issues and has fainted. I'd have to get the OK from his cardiologist.

I cannot request that the workers do anything, no matter how nicely I ask. They will not answer to me, even though my parents want me to be fully involved. I do not think that I can relieve them of their duties, since I'm not the POA.

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If your state has not mandated that home support workers wear PPE while on site, the best you can do is provide masks in your parents home with a sign requesting that all visitors wear a mask.

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I agree with Tothill.

At home, I'm asking people who come in to wear masks (I provide disposable masks if they don't have one), to wipe off their shoes in my improvised foot bath and spray their hands with alcohol. I say it nicely like "I know it may be an inconvenience but I hope you understand that we have vulnerable elderly people in the house."

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If your parents are able to talk with you, the POA can't keep you from speaking to the Home health aides. And I think talking to the POA is not an options for you, either? Is this a sibling?
Hope you find your answers but I think it should be mandatory and your parents are at risk. Just my opinion. Keep looking into it.
take care

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The official information here in OZ is that masks prevent the wearer from spreading germs if they have them. It takes much more complex masks to assist the wearer from catching germs in the air – eg like the industrial masks that protect workers from dust. For me, that would mean that parents who have been isolated for some time don’t need to wear a mask, though it might make them less likely to touch their faces. Workers need to wear one if there is a real likelihood that they may be infected. This probably depends on how prevalent the virus is in your area. And of course if workers have symptoms, they shouldn’t be working in your house.

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My mother has an RN visit each week. I asked if she would wear a mask while treating my mother. This was at the start of the pandemic. No problem with nurse wearing a mask. I put a mask on my mother while she is being treated. I would asked the home health workers to wear a mask, it is in the best interest of your parents safety.

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"This was at the start of the pandemic."

You've been very wise. It is so sad thinking that just people who were extra careful and made sure to use their individual common sense from the very beginning instead of relying on WHO's and governments' suggestions (remember? "Masks only protect others, you don't need a mask, only doctors need one") have effectively protected themselves ( and others!) and perhaps saved many lives without knowing it.

How many more lives could have been saved if they told us the truth instead? ("Folks, masks will save your lives but we don't have enough, we need them for doctors and nurses")If they blocked the sale of masks for the general public, many more people would have stayed at home to feel safer. Or at least, they would have had that choice.

I remember reading an article in early March about the exact dynamics of COVID contagion on a bus in China. The article said the only person who didn't get contaged was wearing an N95 mask. Others who weren't wearing a mask, including people sitting at 8 meters(!) from the person who was already ill, got all contaged, then spread it to others.

This article was a game changer for me. I tried to tell as many people as I could, but you all know the rest of the story.

I still feel extremely sad about this. Talking about lack of transparency.

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Their home their rules. All they need to do, and I would do it in writing, is to tell the woman in charge that they are allowing you to talk for them. You could type up something and have them both sign.

I like Tothill's answer. Provide masks and tell them they need to wear them.

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Mooncatazz, I wouldn't agree that the contact has to be limited by the nurse running a business out of her home to only your parents, or a proxy under a POA. Those I've had for my family address business, legal and financial issues, with general authority.

I don't recall if they have any reference to medical care or decisions, which normally would be addressed in a Living Will or medical POA.

Your parents want you to be involved; that business owner needs to consider that and adjust her attitude. I would be assertive and have a discussion with her, with your parents present, indicating that they wish you to be involved, and she, your parents, and you need to work this out if she wishes to continue providing services.

If you like these caregivers and don't want to switch, don't threaten, but do establish that your parents make the decisions and they want you to be involved. She needs to respect that.

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I live in a IL apt complex close to my mother. All healthcare workers, delivery ppl, or any other type workers wear masks at all times. Im in central Florida. In addition to the masks they are required to wash their hands for 30 seconds upon arriving and every hour while they are with patient ( home health ppl) Sure hope you can get this situation corrected. Even if there is a no mask in place, it is just common sense that the workers wld not want to expose your parents like this....

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Wow, that's an excellent way to help keep people safe. I hope I can get this corrected soon, too.

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Short answer is, absolutely yes!!

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I agree, the more I think about it.

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Our caregiver is required to wear a mask the entire time she is w my mil. She does but my mil does not like it. My mil is not able to understand and hear her through the mask.

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Yes, I believe they all should....

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I am about to engage with the manager at the IL where my elderly mother lives: residents are isolated, family can't come in our out, residents can't leave, they have cancelled all activities, and the staff (including the manager) is not wearing gloves or masks around the residents. They obviously know better.

I am scrupuplous about wearing a mask and gloves when out of the house, and I wash my hands frequently and well yet I am not allowed near my mother. Any health care worker knows to follow these guidelines. They are being lazy and you should correct this before either of your parents gets seriously ill.

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I'm a healthcare professional with my own home care service and I require my workers to wear mask. The clients are isolated in their homes so we really don't have to be worried about them giving us anything. They should be fearful of us coming into their homes. We are the ones out there in grocery stores, shopping, going to different homes, around other people so to answer your question; YES, they should be made to wear mask. They are working around elderly people with heath issues and an already compromised immune system.

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Most definitely!

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Absolutely yes! If they are from an agency, I would recommend you call and ask the agency how they are educating, screening, testing, and training their staff when it comes to COVID-19. How are they limiting risks of exposure to their clients? Are these workers wearing disposable gloves? Are they supplied with masks? What kind? Do they wash their hands immediately upon entering the home before donning gloves? Do they take their temp before work? Are they sure not to come to work even with a "cold?" Are they keeping the same workers with the same clients and not shuffling people around? Nursing Homes (such as where I work as a healthcare provider)and Assisted Living Facilities went into lockdown with no visitors with people isolated in their rooms and still the infection rate soared and continues to do so. That must mean that there are many asymptomatic carriers of the virus eluding the screening process and passing the virus when providing care. Until there is a fast, reliable and widely available test for the virus, and/or a vaccine, care providers must do everything in their power to minimize transmission of the virus both at work and in their personal lives. They bear an added responsibility because they provide care to a vulnerable population. This is a new world, and if they don't take this seriously, you might want to consider switching to care providers who are making steps to meet this challenge. A mask may play a part in lessening the chance of spreading the virus, but there's more to it than that.

If your care providers are not from an agency, they will have little access for education, support, screening or PPE. I advise you to check it out.

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Thank you for this post.

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yes but the virus can also be spread with hands and even bringing in groceries

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Absolutely. If they live somewhere else, encounter other people, travel, and shop, they can be exposed to Covid-19.

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They should absolutely wear masks and I would insist on it.

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Yes. I would request of them to please wear a mask. If anything to protect your parents. If not themselves! they of all people should be required to wear face masks, especially with caring for the elderly. It should seriously be common sense.

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Yes, it is out of courtesy for others that a facemask be worn, especially if in the same room together.

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Yes. They need to wear a mask. Buy a pack of masks and hand them one when they come in each day. Old people can die from this virus.

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My 91 year old dad is in late stages of dementia and frail although he has no other co-morbidities. I have hired (privately, no agencies) a team of 4-5 caregivers who work various shifts caring for him 24/7.
I provided clothe masks that they must wear anytime they are within 6-8 feet of him, especially during up close contact such as shaving him or preparing his food. However, we also provide sanitizing spray such as MicroBan which caregivers use 2x per shift on any surfaces my dad might touch such as doorknobs, sink faucets, etc.
I discourage glove use because if not handled correctly, they do more harm than good re: cross contamination. I do NOT recommend putting a mask on a frail man at anytime he is in his home and not showing any sign of illness.
I have Nanny Cams in areas where my dad spends time other than bathrooms and guest bedroom where caregiver sleeps. Our team knows that I can “peek” in at anytime to hold them accountable re: wearing the masks as required. They have all been wonderful at following this guidance. I do not require them to wear the masks when they are spaced away from him by at least 6 feet. We even provided clips for them to clip masks to their own blouse so it’s handy for putting on quickly if they need to tend to him.
Lastly and important: the masks I provided them are for at my dad’s home ONLY and they are to be washed daily. If they want masks for any other place they go such as grocery stores, they have to wear one of their own.

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Well done!!

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Yes.

The type of PPE depends on the type of the care needed, these are the best guidelines I've found so far:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/884165/Domiciliary_guidance_England.pdf

https://www.youtube.com/watch?v=ozY50PPmsvE&feature=youtu.be

Surgical masks should be enough unless the patient is ill, they are less unconfortable and lighter than N95 / 99, breaks in care should be assured so that the carer won't have to wear a mask for more than 2/3 hours at a time.

I'm having the same problem atm, will follow your thread.
Thanks to everyone who's posting here, this is very useful.

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Yes people that come into the house should wear a mask.
If your parents have not been out of the house they really do not need to wear one.
But it can help if they are willing. Double protection is best.
Face masks do pose a problem when dealing with people that rely on facial expression to understand conversation. And people with dementia have a difficult enough time trying to recognize faces and with a mask it would be impossible.
There are plastic face shields that would solve both of these problems. I have seen some made from the plastic sheets that are used as protectors for pages in a binder and there are other firmer plastic sheets that can be used, once cut it can be attacked to a baseball cap.
And if any personal contact is necessary I would require gloves as well as clothing cover. (cover for clothing should be laundered and not put on until the caregivers comes into the house. ) And they should wash their hands prior to starting and when gloves are removed hands should be washed, and washed before putting on a clean pair of gloves. (if hand washing is not practical prior to putting on gloves hand sanitizer should be used.)

If your parents leave the house they should wear masks when caregivers are present as well.

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To me it seems like a given that they should be wearing a mask. Not knocking your question, more the oversight of requirements. Fragile population, wear a mask.

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My husband has a caregiver who only comes to our home daily during the week. She has no other clients. The agency requires her to wear a mask anytime that she is closer to him than 6 feet. And gloves if she caring for him directly.
Sandy

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Yes they should ! As the owner of my Home Care Agency ALL of my employees MUST wear face mask and gloves when going into a client's home while providing services. We want to make sure everyone is safe in every direction.

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I work for a Home Care agency and we are required to wear a mask in our clients homes. We also have to answer questions regarding where we have been, if around others with the virus, if we have traveled and are to take our temperatures daily. It should be required with all Home Care workers. The elderly are very vulnerable and need to be protected. I would tell your agency that you require the workers to wear masks and take their temperatures before entering your parents home. My parents have assistance and their worker wears a mask but if in a situation where she is at least 6 ft apart, then takes it off for awhile but most of time it is on.

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I manage the operations of a Home Care Agency, and all of our caregivers have to wear a mask, wash hands and report if they have any symptoms. We even go as far as providing gloves and hand sanitize so there are no excuse. There is also a free course on homecarepulse that offers free covid-19 training on how to handle the whole thing. It's worth the time spent on it- perhaps 45 minutes, not much.

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Should home care workers wear a face mask at their client's homes during the COVID-19 pandemic?

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