When it comes to natural disasters, shutting down healthcare simply isn't an option for most providers. But Texas' recent winter weather and power outages posed particular challenges for home care providers as many roads were impassable and clients were trapped at home.
In the greater Austin area, Deborah Garcia runs a small nonmedical home care agency, Texas Home Care Partners. Some of the company's caregivers have stayed at clients' homes since Monday, taking shifts with family members to care for clients. In other cases, families have taken over caregiving until the roads clear.
"In cases where the client absolutely can't be alone and doesn't have family there, we have to stay," Garcia said.
Home care patients often require assistance with daily activities like bathing, dressing, making meals and remembering to take medicine, and some require 24-hour care.
"It's not easy, and it takes a village for sure," said Brenda Riordan, executive vice president of strategic operations for Encompass Health's home health and hospice division. "Certainly, we never want to go through a disaster but when we do go through a disaster, we learn every time."
Encompass, which operates home health and hospice services in 31 states, has emergency plans in place for every patient. When it becomes clear there's going to be an impending hurricane or a winter storm, they reach out to every patient to make sure they have updated contact information and can assess who will need in-person care during an emergency, Riordan said. Employees call daily to check in on patients and use telehealth whenever possible.
"Our staff rises to the occasion and makes it out to those patients with critical needs," Riordan said. "We've had staff members who have had no power and outages who have found a way to stay connected."
Those with four-wheel drive drove to the homes of patients, while others walked if they could.
In Tyler, Texas, one licensed practical nurse had a pharmacist meet them at a closed pharmacy to get medication for a diabetic patient. And in Cleburne, Texas, a therapist found a during a morning check-in call that a patient didn't have access to water and worked with the local police department to have a case of water delivered.
"Storm and disasters bring the worst situations but also the spirit of healthcare," Riordan said. "We've got so many people out there who are healthcare heroes."
Even if the roads are passable, some grocery stores are running low on food, and only some pharmacies are open.
"Fortunately, none of my clients have run out of their meds, but it's a possibility," Garcia said.
All of Garcia's clients, have had power restored by Thursday. But one client was without electricity for 30 hours, she said. For her clients, who are in their 80s and 90s and are on oxygen, a loss of power means resorting to back-up oxygen cannisters, if they have them or can find them.
While the beginning of the week was hectic, now that caregivers are in place, things have calmed down, Garcia said.
The most pressing concern now is water. Parts of Austin have been advised to boil water due to low pressure.
St. David's South Austin Medical Center had to transfer some patients out of the hospital Wednesday after losing water pressure and subsequently boiler-powered heat and asked employees on shift to stay at the hospital, according to KUT, Austin's NPR station. Likewise, Ascension Seton locations in the Austin area also were facing water shortages.
Garcia expects to see the situation in the Austin area improve over the next few days. In the meantime, she is paying workers overtime and hazard pay and offering them extra days off next week.
"It's going to have a hit on me, I know that. Some places we don't have caregivers. Other places, it's all time and a half. Clients are going to have to absorb the majority of that cost," Garcia said.
Riordan said obviously some visits were missed because staff can't get to patients, which will affect the business.
"But we anticipate, in the recovery, getting back to all of the patients. I think it's a temporary situation," Riordan said.
The National Association for Home Care and Hospice said in a prepared statement, "NAHC is concerned about the situation and the welfare of America's homebound population. I have no doubt the Texas home care providers are doing everything in their power to care for their patients."