Home Health Care Patients and Safety Hazards in the Home: Preliminary Findings

Introduction: Home health care is the fastest growing sector in the health care industry, with an anticipated growth of 66 percent over the next 10 years and with over 7 million patients served each year. With the increasing acuteness of care provided in home health care and the increasing number of frail elderly that make up this patient population, it is important to identify risk factors that affect patient health and safety in this setting. Methods: A convenience sample of 1,561 home health aides, attendants, and personal care workers completed a risk assessment survey. Items addressed personal, patient, and home characteristics and health hazards. All activities had prior Institutional Review Board approval. Preliminary Results: Ninety-five percent of home health care workers (HHCWs) were female with an average of 8 years experience. The majority of clients were elderly, with a smaller percentage of adult (26 percent) and pediatric (7 percent) cases. HHCWs reported the following exposures at their clients’ homes: cockroaches (33 percent), cigarette smoke (30 percent), vermin (23 percent), irritating chemicals (17 percent), and peeling paint (15 percent). The following conditions were also described: clutter (17 percent), temperature extremes (9 percent), unsanitary (12 percent) and unsafe (6 percent) conditions in the home, neighborhood violence/crime (11 percent), and aggressive pets (6 percent). Two percent of respondents reported the presence of guns in the home. Additionally, 12 percent of HHCWs reported signs of abuse of their clients. Conclusion: Both HHCWs and home care patients appear to be at potential risk due to a variety of health hazards/exposures in the clients’ homes. Given the growing population of both HHCWs and recipients, it is important to document this risk as an important first step in prevention and management.