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Home-Based Care Provider Perspectives on Care Refusal During the COVID-19 Pandemic
Journal of Gerontological Nursing
|January 3, 2023
Summary
Older adults refused home health care during COVID-19 due to infection fears, impacting chronic disease management. New tools are needed for home-based care providers to support patient decisions during pandemics.
Area of Science:
- Gerontology
- Public Health
- Home Healthcare
Background:
- Healthcare delivery is increasingly shifting to home-based models for acute and chronic disease management.
- Limited literature exists on maintaining home-based care services during public health emergencies like pandemics.
Purpose of the Study:
- To explore older adults' decision-making processes regarding the continuation of home-based care services during the COVID-19 pandemic.
- To understand how fear of infection influenced these decisions and the responses of home-based care providers.
Main Methods:
- Semi-structured telephone interviews were conducted with 27 home-based care providers (HBCPs).
- Participants were from Medicare-certified home health agencies across eight U.S. counties.
- The study focused on older adults' decisions about continuing care during the COVID-19 pandemic.
Main Results:
- Four key themes emerged, detailing older adults' decisions to refuse care and HBCPs' reactions.
- Fear of COVID-19 infection led older adults to refuse necessary home care, even after receiving provider education.
- Decisions made by older adults were often incongruent with their actual health needs.
Conclusions:
- Older adults' fear of COVID-19 significantly impacted their decisions to continue essential home-based care.
- There is a critical need for enhanced support tools for HBCPs to navigate patient decision-making during pandemics.
- Improved strategies are necessary to ensure continuity of care during infectious disease outbreaks.
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