On the Frontlines: A Home Healthcare Worker Fears for Her Patient and Herself

Photo © Home Helpers 8

The Honduran native is up before the sun and gets ready for work. Six days a week, her mornings are exactly the same, even now in the time of COVID-19. She rides the 6 train from her home in the Bronx to the 103rd Street stop and then walks another two blocks to her workplace. At work, her companion is a 71-year old woman suffering from kidney failure. Taking care of her companion is her job. A mother of five and a grandmother of five, this woman, who does not want to reveal her name because she is an undocumented immigrant, is good at providing care.

Gov. Andrew Cuomo mandated New Yorkers in non-essential jobs to stay home two weeks ago, but home healthcare workers are considered essential, so she keeps showing up to tend to her patient on the Upper West Side, every day. The Honduran-born woman is one of 191,820 home health care workers in New York State, who are mandated to continue working as an essential workforce. And she is afraid.  She worries her patient might get the deadly virus and fears she too might be  infected simply because she has to travel daily on the subway. She is also upset because she says her agency and the state have not provided workers like herself any gloves or masks to protect themselves; she buys them with her own money.

“I am very, very disappointed and very scared,” she said, “We’re left to our   own devices to find these things when there is a scarcity.”

Each day she bathes her patient, who is in a wheelchair, cooks her three meals a day, and cleans her apartment. Two to three times a week, she accompanies her to a clinic for dialysis appointments, even now during the COVID-19 crisis. Two weeks ago, while they were outside, the patient’s wheelchair broke. She had to support the weight of both the patient and the wheelchair to get them back home. Her body still hurts, two weeks later.

The woman, who is also nearing the age of retirement but does not wish to disclose her exact age due to fear of workplace retaliation, has worked as a home health care aide for the past 15 years.  Until last year, she worked 24-hour shifts up to seven days a week. It didn’t bother her to work those hours because she lives alone. The money she earns supports her family in Honduras. She considers it her obligation to support them. Recently her grandson back home was struck by a car and she has been paying his medical bills.  She’s also funding the construction of her family’s home in Honduras.

Her work routine has occupied her so fully that she was unaware of what was happening with the coronavirus. In fact, she says, until the federal government issued its social distancing guidelines two weeks ago, she’d heard nothing; not from her employer, a home healthcare agency. She will not reveal the name of the company since it hires undocumented workers like herself.

According to this worker, the agency never advised her to take any protective measures amid the outbreak in New York City. At first, anyway. When the governor issued the stay-at-home order on March 22, however, the aide said she noticed something different when she called into the agency system to clock out: the recording instructed her to use personal protective equipment (PPE). It was the first time her employer had acknowledged COVID-19.

The agency did not provide her with any PPE, however.  According to advocates from National Mobilization Against Sweatshops, a New York City-based organization that raises awareness of and fights against national labor abuses, many home healthcare agencies have been telling workers to buy their own gear and are continuing to provide hundreds of seniors with care without any further enforcement or protocol.

The Bureau of Labor Statistics predicts the home health care industry can expect a 36.6 percent increase in job openings over the next nine years.  A majority of these workers are immigrant women of color; many are undocumented. Under New York State law, home health aides who work 24-hour shifts are paid only for 13 of those hours. The law deems that for the remainder of the time they are eating and sleeping and that does not constitute as work.

Legislators and advocates have been fighting alongside workers for compensation for every hour worked and to end the 24-hour shift by dividing around-the-clock care into two shifts of 12 hours. In September 2019, Assemblyman Harvey Epstein introduced legislation to end 24-hour shifts for home health care workers. It would cap their shifts at 12 hours and the workweek at 50 hours. They will be paid for every hour worked. If the legislation does not pass and these working conditions continue, Epstein said he fears that workers will “continue to provide worsening care and continue to be abused by a system that doesn’t pay them for 11 hours of their workday.”

Without protection, workers fear not only for their lives, but also for their patient’s. The Honduran-born aide, for example, worries about her patient getting infected, particularly during her dialysis treatments. “I give her my own gloves to wear to dialysis appointments,” the aide said. She is also scared, she says, that her patient’s hygiene is out of her control once she clocks out.

The aide has another fear: her own survival. “It really pains me that I have to choose between my health and surviving, just being able to survive with the fear of losing my job,” she said. Although the recording on her agency’s phone line says that workers should call if they experience symptoms, she is worried if anybody calls in with symptoms, they would likely lose their job without compensation.

She also worries about her immigration status. When she came to the U.S. 15 years ago, she thought that life would have been easier, that there would be greater opportunity to support her family. She never imagined life would be this hard in a country known for its democracy. As an undocumented worker in New York City, she says she’s often felt like she lives in the shadows. But with the emergence of COVID-19, she says she now feels that she is completely in the dark.

“I feel exploited especially because I’m undocumented,” she says. “ But I pay taxes like any other citizen. I’m in the shadows without protection, risking my life.”