Home Healthcare Presents New Challenges in Era of COVID-19

Mel Namnama received a gift basket from BAYADA Home Health Care, the company he works for in Hilo, as part of Nurses Appreciation Week in May. PC: BAYADA

The COVID-19 pandemic has changed the professional lives of nurses everywhere, including those who work outside of traditional hospital settings.

Mel Namnama has been working for BAYADA Home Health Care in Hilo for three years and said the arrival of the virus in Hawai‘i has brought with it unique challenges.

“It’s changed the way that we schedule and plan home health care visits,” he said. “There is a high number of elderly in our community, many with underlying medical conditions. They trust in us, and they rely on us to provide safe home health care.”

Before COVID-19, each BAYADA nurse was caring for 20-25 patients per week. That number has dropped because such patients are primarily in the high-risk, elderly demographic. However, Namnama said the company continues to serve its critically-ill patients and those with conditions like paralysis.

“My main concern was how do I decrease the possibility of getting my patients sick? How do I control my environment?” Namnama explained. “Home health care is not a controlled environment. We can’t control who comes in or out of the household.”

New operating procedures called for more education on personal protective equipment, limiting the number of health care workers with whom each patient interacts, and necessitated that nurses now call ahead to conduct verbal screenings with each patient household.

“There’s the stress of not knowing how to … combat this infection,” Namnama said. “It’s always in the back of your mind — do no harm.”

Thus far, BAYADA has been fortunate to see low COVID-19 infection numbers, as has Hawai‘i County and the state as a whole. Namnama said he’s aware of just one patient BAYADA has cared for who tested positive for the virus. That patient has since recovered.

One reason for the low infection rates is new home care policies. Another is that patients are, in general, more fearful and more emotionally fragile, which has limited interactions and changed the paradigm of care in culturally meaningful ways.

“Hawai‘i is a welcoming place to live,” Namnama said. “It’s all about hugs and aloha. Because of COVID-19, (we’re practicing) six-foot isolation and wearing masks all the time.”

While the virus has changed standard health care habits and practices, Namnama doesn’t believe adjustments and emerging trends will remain confined to the present.

“I’m expecting after this COVID thing is under control, our numbers will pick up,” he said. “I’m anticipating a higher need for home health care in the future.”

As a gesture of thanks for the work they’re doing in an unprecedented time for public health, BAYADA delivered gift baskets to each of its employees. The baskets were delivered as part of Nurses Appreciation Week in May.

“I’ve been a nurse for 28 years and worked in a hospital for almost 25 (years),” Namnama said. “This home health care work is a different type of nursing, but it’s definitely just as needed and as important, especially on this island, where we have one hospital that serves the entire Hilo side. Home health care is not going anywhere. It’s going to be an increased need.”

“I hope that our community stays safe, and we can all pull through this together,” he added. “We will be back.”