11/30/2012 11:03 am ET Updated Jan 29, 2013

Home Health Aides: Living Lifelines in Sandy's Hobbled Communities

Manning the Frontlines of Care

Lilly Hill spent the days before Hurricane Sandy trying to persuade elderly residents in a windswept housing complex on Seagirt Avenue in Far Rockaway to evacuate. But, mindful of what they saw as fruitless and disruptive evacuations during the less-intense Hurricane Irene, many remained in place.

So they stayed as the pre-Halloween storm crashed onto their shores, lapped into the lobby of their building and cut off electricity, running water and heat. And Lilly, a 25-year veteran home health aide with Partners in Care, stayed with them, overnight, without a break for four days.

By night, Lilly slept on a cot she set up in the building's second-floor Partners in Care Office. By day, she knocked on doors to check on clients and their aides, who had volunteered, as she had, to stay over. "Unless someone comes to knock on these people's doors, no one comes to see them," she says.

Along with other aides, Lilly ferried containers of water up and down stairs, managed supplies and helped the city unload trucks of food and water to supply the building. They organized transportation for residents who wanted to evacuate after the storm as temperatures dipped and food and medicine ran low. And they banded together, along with family members, to transport wheelchair-bound residents down as many as 14 flights of stairs to evacuate to local shelters or family members' homes.

Trained home health aides are skilled, compassionate caregivers who man the vital front lines of health care for vulnerable seniors and others not stable enough to be on their own. To help keep at-risk individuals out of the hospital and living safely and as comfortably as possible in their homes, aides help with cooking, dressing, laundry, bathing, toileting and other activities of daily living.

Their mission is all the more urgent when elevators in a 25-story building stop working, there is no running water to drink or flush toilets, food grows limited, medications run out, and apartments and stairwells are dark and cold. Personally and professionally, I could not be more proud of our resourceful aides who went above and beyond the call of duty before, during and after Hurricane Sandy, spending days and nights serving as a lifeline to the most vulnerable New Yorkers.

Home Health Agency as Transportation Central

The subway, too, is a lifeline for many New Yorkers. So when a subway shutdown loomed the Sunday before the storm, many of our employees -- from finance and account people to marketing and communications staffers -- set up a command central at our midtown offices to make sure our home health aides could get to the front lines of care they so ably deliver.

We had almost 100 people from across our organization manning phones in the office and remotely from home to make sure first and foremost that the most frail and vulnerable clients were covered, to make logistical and travel arrangements for aides in a hobbled city, and to monitor supplies on hand and supplies needed (including flashlights and candles) so no client would have to go without. With many of us staying night after night at "command central," we arranged car pools (who had enough gas?), tracked down vans (who would go to the Rockaways?), and called on aides to leave their own homes (which, for many, were also in harm's way) to be in place for their clients. The aides packed a bag, extra clothes and extra food, bid goodbye in some cases to elderly parents or newborn babies, and went to work Sunday before 5 p.m. to be in place Monday morning at 8 a.m. sharp.

Home health aide Oladipupo Ahmedhad, who had a 3-month-old baby at home, jumped in the subway Sunday night before the subway shut down to get to the Upper West Side and be by his client's side when the storm hit. And there he remained without a break until Wednesday. With no way to travel back and forth from Weehawken, N.J., home health aide Rosendo Inoa stayed for days with his client in Manhattan after the storm hit.

As home health aide coordinator for the Seagirt Avenue building, Lilly asked who would volunteer to stay overnight with clients whose care plan called for only daytime hours. "Almost all the aides said yes," she says. "They love their patients. And the patients were most happy." One elderly patient who is nearly deaf was immeasurably grateful to have her aide with her. "She knows nothing that's going on unless she can see it," Lilly recounts. "So here it is, pitch black, and she is constantly asking, 'What's going on, what's going on?' It's important that her aide could be there with her."

Aides often serve as another set of eyes and ears for clients who suffer limitations of age and chronic conditions. A well-trained home health aide is much more likely to notice changes in a patient's behavior or well-being and act immediately and appropriately. Aides may notice that a client is particularly anxious, having trouble eating or sleeping after the disruption of the storm and all the hardships and uncertainties that follow. Aides have received many hours of training for just such emergencies and know to remain calm, assure clients that the aide is there for them, and alert a supervisor to day-to-day changes. This helps the client's care team follow up with measures that might include behavioral health care, a change in medication, or other measures to get back on track.

Team Care "Can Work Miracles"

During and after the storm, aides shared rides to cope with gas shortages and mass transit shutdowns, took over each other's patients when proximity and logistics demanded, and shared supplies, support and stories. Many aides cooked extra meals during their shifts so oncoming aides would not have to worry about cooking. When an aide in Brooklyn could not leave her family overnight to get to Manhattan, she was able to care for another aide's client in Brooklyn.

The hurricane amplified the power of teamwork that many experts believe is the future of home- and community-based care, among aides as well as across a diversified team of caregivers. At Partners in Care, aides are part of a nurse-led care team that, along with those working with our affiliate, the Visiting Nurse Service of New York, also includes social workers, rehabilitative therapists, behavioral health workers and dieticians.

When Sheila Linden, a social worker with VNSNY CHOICE, volunteered at a shelter near her own darkened house on Staten Island, she found one of her clients there, an elderly woman dependent on oxygen, wheelchair-bound, suffering from dementia and needing round-the-clock care from a team of home health aides. The client and her husband, recently diagnosed with Hodgkin's Lymphoma, evacuated to the Tottenville High School shelter when their flooded house was knocked off its foundation. Within days -- with much legwork from family members, Sheila and emergency workers -- the couple relocated to an apartment on Long Island, where their home health aide Cynthia could join them. After making the long trip from Brooklyn, Cynthia agreed to stay overnight when it became clear that the night-shift aide from another agency would not be able to make it. "Her home health aide means safety and security," Sheila says of the client. "Cynthia and another Partners in Care aide Beverly give insight to the whole care team because we are not there on a daily basis and they are."

That insight, as well as the continuity of care, will be all the more critical in the weeks and months to come, given the client's uncertainty, dislocation and anxiety following the storm. "There was no pause in the continuation of care, no room for red tape," Sheila adds. "Sometimes we can work miracles."