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Even though they perform the same intimate tasks as nursing home and hospital workers, in-home health aides initially were left out of California鈥檚 vaccine mandate. They must be fully vaccinated by Nov. 30.
Kaiser Health News gives readers a chance to comment on a recent batch of stories.
The plan from high-wire negotiations would affect five key areas of health, but there will be further tense negotiations among Democratic lawmakers about specifics of the $3.5 trillion in funding. And all Senate Democrats will need to be behind the plan, because Republicans oppose it.
The covid pandemic and President Joe Biden's agenda 鈥 a planned $400 billion infusion of support 鈥 have focused national attention on the need to expand home- and community-based long-term care services designed to keep people out of nursing homes. But the need far outpaces the staffing.
Across the country, doctors report that those hospitalized with covid now are largely unvaccinated. New York City lags the rest of the nation in vaccinating people 65 and older, and its efforts to reach the homebound and disabled have been late in coming and disorganized.
The number of Americans 65 and older is expected to nearly double in the next 40 years. Finding a way to provide and pay for the long-term health services they need won't be easy.
In the latest sign that in-home acute care is catching on, two big players 鈥 Kaiser Permanente and the Mayo Clinic 鈥 announced plans to collectively invest $100 million into the company Medically Home to help scale up their programs.
Even as the nation has moved on to vaccinating everyone 16 and older, the vast majority of people homebound due to frailty or age 鈥 and among the most vulnerable to covid鈥檚 devastation 鈥 have not yet been vaccinated. California offers a sharp lens on the challenges.
Watch an intimate conversation about this workforce, which provides vital care to vulnerable people. Our panel included those doing the work and those who rely on them, as well as expert insight on improving the jobs, honoring the care and paying for it all.
Home health aides flattened the curve by keeping the most vulnerable patients 鈥 seniors, the disabled, the infirm 鈥 out of hospitals. But they鈥檝e done it mostly at poverty wages and without overtime pay, hazard pay, sick leave or health insurance.
These workers rely on public assistance 鈥 and, sometimes, a side gig to get by.
Hundreds of thousands of health care workers go into homes to provide important services for seniors and disabled people. But with the rising concerns about the danger of the coronavirus pandemic, especially for older people, these health workers could be endangering their patients and themselves.
If you鈥檙e told Medicare鈥檚 home health benefits have changed, don鈥檛 believe it: Coverage rules haven鈥檛 been altered and people are still entitled to the same types of services. All that has changed is how Medicare pays agencies.
Medicare has changed how it pays for services. In response, agencies across the country are firing therapists, limiting physical, occupational and speech therapy, and terminating services for some longtime, severely ill patients.
Fewer Americans are dying in a hospital, under the close supervision of doctors and nurses. That trend has been boosted by an expanded Medicare benefit that helps people live out their final days at home in hospice care. But as home hospice grows, so has the burden on families left to provide much of the care.
Harvard psychiatrist Arthur Kleinman shed his 鈥渧eil of ignorance鈥 during 11 years serving as the primary family caregiver for his wife, who had a rare form of early Alzheimer鈥檚 disease. In a new book, 鈥淭he Soul of Care,鈥 he offers suggestions for transforming health care 鈥 just as caregiving transformed him.
More baby boomers look forward to aging in place 鈥 in their homes, rather than in a care facility. But the costs of retrofitting a house is likely prohibitive for many Americans.
Facing billions of dollars in legal claims for the role its equipment has played in a spate of deadly wildfires, California utility giant Pacific Gas & Electric plans to step up efforts to cut power to broad regions of the state during high-risk weather conditions. The potential for prolonged blackouts has prompted disaster preparations by hospitals, nursing homes and home care providers.
Throughout her young life, Sylvia Colt-Lacayo has been told her disability didn鈥檛 need to hold her back. She graduated near the top of her high school class. She was co-captain of the mock trial team. In April, she learned she had been admitted to Stanford University with a full scholarship. Now, the struggle to fund the caregivers she needs to leave home is proving her toughest battle yet.
What changes are needed to bring home dialysis to more patients 鈥 especially older adults, the fastest-growing group of patients with serious, irreversible kidney disease? We asked nephrologists, patient advocates and dialysis company officials for their thoughts.
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