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Evolving to Meet Community Need

Home Care Providers Adapt to Providing Care in a Pandemic

by Mary Beth TeSelle, Special to The Union
Use of home health care services declined for the first year of the pandemic, but is rebounding now as more patients seek out home services to prevent hospital readmission and avoid visits to outpatient clinics.

For the team of nurses, therapists, social workers and aides at Sierra Nevada Home Care in Grass Valley, the past 18 months have been a rollercoaster.

“When the COVID-19 pandemic first started, many patients declined home health visits except from nurses, or discontinued our services altogether,” says Barbara Boyer, BSN, RN, Manager at Sierra Nevada Home Care. “Referrals for service also declined as people wanted to protect themselves and limit who came to their home.”

Boyer says her team quickly recognized that the world of home care was changing. They adopted new protocols to ensure that both patients and staff would be protected.



“We initiated having staff mask for all visits,” she explains. “We also began screening our patients via phone prior to visits, similar to the screening at hospitals and physician offices. We began instructing all patients, families and caregivers in infection control practices of handwashing, disinfecting surfaces in their homes, masking and how to make a mask, social distancing and where to find information about COVID-19.”

While Boyer and her team saw fewer patients in the first year of the pandemic, this past March, that changed.



“We got very busy when hospitals resumed doing elective surgeries and procedures,” she says. “Our highest daily census [patient count] was 187 this past March. We have had an increase in physician referrals for patients who need care to help prevent them from being admitted to the hospital. Mainly for physical therapy services to address patient fall risks and instruct home exercise programs to get them stronger.”

Typically, Sierra Nevada Home Care sees patients with acute and chronic illness following discharge from a hospital or skilled rehab or nursing facility. Boyer says that patient segment has not changed during the pandemic. But they have seen an increase in patients with substance abuse problems, depression and patients failing to thrive at home.

While some aspects of providing care during COVID-19 have proved challenging for her staff (including the mandatory use of eye protection or a face shield, especially for staff members who wear eyeglasses), Boyer says the real challenges have been those experienced by their patients.

“Many patients are significantly affected by social isolation and separation from their families, especially those who live alone or in an assisted living facility,” Boyer explains. “Regular phone calls, Facetime, or Zoom check-ins are very important in preventing depression. Many of them are not into the modern technology, so going back to writing letters, cards and sending photos are important for their emotional and mental wellness.”

Boyer suggests families consider assigning different family members specific days of the week to check-in with their loved one.

She also points out how important it is to do whatever possible to protect the health of a vulnerable loved one.

“It is very important for family members to protect their loved ones by getting vaccinated, washing hands thoroughly, wearing masks, and practicing social distancing during visits to vulnerable family members,” she says. “Do not visit in-person when you’re sick or if you’re beginning to experience symptoms.”

She reminds family members that viral illness like COVID-19 are contagious at the onset of minor symptoms and that it’s important to pay attention at the first signs, including generally not feeling well, low grade temperature, sneezing, and coughing.

Boyer encourages family members to play an active role in the care of their loved one.

“Be involved in the care of the patient, be present when we admit them to services if able, and take part in the visits whenever possible,” Boyer says. “We are there to instruct and train patients and their caregivers in their care needs, to manage their chronic disease, and to improve their functional abilities and make them safer at home and in the community. Encourage them in that process.”

Taking caring of a loved one recovering from illness or injury or living with a chronic condition can be challenging. Boyer says it’s important for family caregivers to be sure they are taking care of themselves, as well. She encourages

you to focus on taking time for yourself each day and enlist the support of family and friends to provide regular breaks. If caregivers become overwhelmed, stressed, or ill, they are not able to provide the care their loved one needs.

Get to Know: Sierra Nevada Home Care


Sierra Nevada Home Care has been providing services to Westen Nevada County for the past 35 years. They provide nursing, physical, occupational and spaeech therapy, medical social worker service and certified home health aide services to our patients. The team at Sierra Nevada Home Care works in collaboration with physicians, patients, and families to help patients meet their health care goals.

You can reach Sierra Nevada Home Care at 530.274.6350.


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