Are Aging Life Care Professionals Essential Workers?

By Liz Barlowe

The question of whether Aging Life Care Professionals® are considered essential workers seems to be a question many ALCA members are contemplating. The Association has been asked to weigh-in on this topic, as well as consider supporting and advocating a position one way or the other. The considerations are numerous, so my assumption for this article is that the question is being posed in order to determine if Aging Life Care Managers can visit clients who reside in facilities when most facilities may be refusing an ALCM entry.

First and most importantly, although we require members to adhere to our Standards of Practice and Code of Ethics, ALCA has supported the autonomy of its members to develop their own practices. For example, ALCA has not dictated what types of clients members should accept as they may not have the expertise to assist a certain population. Similarly, ALCA cannot tell members when or when not the situation is safe to serve a particular client.

The definition of “essential workers” varies from state to state. It is important to review and understand a state’s particular language. In Florida, our policy specifically includes “caregivers, social workers, and nurses” among other professions as essential workers. Personally, I can easily make the argument that my staff and I fit into at least one of these criteria. In fact, there is no doubt in my mind that Aging Life Care Professionals are essential workers. If your state includes language that confirms this designation, how you decide to use that determination is the more challenging question.

As you think through how to best serve your clients in this difficult time, especially when many may reside in care facilities, we recommend you consider the following questions:

Can you be certain you will not bring infection into a facility? The CDC continues to state limiting the number of people any of us encounters as the sole variable that can prevent the spread of COVID-19. As ALCP’s we often work with the most medically compromised individuals, so does the risk of you being a carrier outweigh the benefit of visiting your client in person at a facility? As I stated, in Florida, we are essential workers. However, I have made the decision to honor the social distancing and stay at home guidelines in my community as not to risk the spread to my clients, my staff, and the communities caring for them. What is the motivating factor for considering the risk to yourself, client, and facility residents and staff? Is it life threatening that you cannot get facility staff to attend to; or to ensure the client is getting their needed medications; or fear of the effects of social isolation on your client; or worried that they aren’t receiving showers, disposables being changed, rooms cluttered, linens aren’t being washed, etc.; or is it that you want to ensure you are demonstrating your value to families that at some point may decide their loved ones have made it without your personal visits and discontinue your services; or is it solely a fiscal concern, that you need to visit for your business to survive? You must be very clear on the “why” you feel it necessary to complete a personal visit as you consider placing yourself and others at risk.

What are the facilities policies on visitation and outside essential personnel? This crisis has made me re-evaluate how I and my staff introduce ourselves and interact with facility staff. We have agreed we can do a better job of explaining how we fit in the overall care team while developing mutually respectful relationships with facility staff. Now don’t get me wrong, we have a few facilities that are so threatened by our presence – we may never get past the ability to report our observations and request their assistance – but we are committed to trying harder. Forcing your way into a facility that has denied you access may do more harm long-term in developing the best path for positive outcomes for your client. Offering support to facility staff while ensuring your client’s needs are being appropriately addressed may be a better strategy but something you must weigh given your client’s needs.

If you feel the benefit prevails over the risk, what can you do to protect yourself, client, and the facility residents and staff? N95 masks are hard to come by but obviously are best for protecting you and others, as well as following other precautions outlined by the CDC for health care workers. If you decide personally visiting your facility-bound client is crucial, it is absolutely necessary that you have the proper equipment to protect yourself and those you come into contact.

Finally, learning new ways to assess, engage, and serve our clients during this new normal is essential. ALCA is working on providing additional Member Forums to discuss helpful technology and best practices of assessing individuals from a distance. Stay tuned as these strategies roll out to help you continue your valuable work. The bigger question than are we “essential workers” is what that means in providing our services in the “new normal”, which may last for a long time.

As you struggle with what makes sense for your practice, clients, and community, ALCA is committed to supporting its members by providing opportunities to exchange best practices and advance the work of our profession.

Please send any comments or feedback to jwagner@aginglifecare.org.