In 2009, just under half of those needing long-term care and assistance in Connecticut lived in nursing homes, with only slightly more getting care in their own homes. Today, that breakdown has drastically changed, with less than a third getting care in nursing homes, and 69 percent in their homes, the setting they prefer most.
In Connecticut, an estimated 25,000 people receive long-term services and supports in the community that are state funded, a number that does not include the tens of thousands of people paying for their own services to stay at home.
The impact of the shift to home-based care is enormous. In addition to those needing long-term support (non-medical) at home, in 2022, there were 12,500 home health care workers, providing a wide range of skilled, medical services.
[RELATED: The CT home care industry is growing. Oversight is lacking.]
Skilled home health services include post-acute care after hospital or nursing home rehabilitation stay for medical or surgical issues, as well as chronic disease management, promoting self-care with the goal of keeping patients in their home.
Chronic disease management is the most extensive work. It includes medication management, wound care, diet and nutrition education, managing respirators, feeding tubes, oxygen and IVs. It also includes hospice care and non-skilled personal care aides, who provide care for bathing, transfer assists, dressing, exercise and meal preparation.
But while the market and demand for home care have evolved, our system of properly funding services and protecting home care workers has not kept up.
The recent murder of visiting nurse Joyce Grayson while making a medication management call has highlighted the deficiencies of our system. By all accounts Joyce was a dedicated and experienced nurse, who had been making home visits for 15 years.
[RELATED: Murder of visiting nurse ignites demands for stronger home care protections]
Home and community-based service providers are facing severe work shortages. At the same time, Medicaid rates have not kept up with rising costs and do not cover the work of social workers who are crucial to our work to guide clients to available resources. Connecticut lawmakers must increase rates for both home health and non-medical home care providers. More and better paid home care providers helps everyone.
In terms of safety and security, we are long past the days when a home care provider could ask the police to accompany them on a challenging call. Police departments simply don’t have the manpower to provide the support for the explosion in need for home care. And in other cases, the home health care provider may not have the necessary information about the patient to even know what to expect before a visit.
With thousands more private homes being visited every day, home health care providers must have all available information about the patient and the environment before they walk in. While some organizations provide background information, there is no requirement and no uniformity in referral documents. The General Assembly must require transparency for referral information for every home health care patient.
We also call on the legislature to fund personal protective alarms that would allow a front-line home care provider to discretely call for help in an emergency. The technology is available, and this simple tool could save lives.
We need to do better for our home care providers, who help people live in the comfort of their own homes. They deserve to be well-prepared, safe, and to be adequately paid. We owe it to Joyce Grayson and every other care provider walking into a private residence.
Tracy Wodatch is President & CEO of the Connecticut Association for Health Care at Home.