Collier EditionCOVID-19Sarasota Edition

Unmet Home Care Needs Correlate with Increased Mortality

The Risk of Turning Away Home Care Aides During COVID-19

During the COVID-19 outbreak in the U.S., McKenney Home Care is one of the many agencies experiencing resistance to care from clients. Families and the elderly generally exhibit concern about hospital and community transmission of the novel SARS-CoV-2 virus. Surprisingly, many of them are turning away their home care aides. They are making the calculation that allowing an aide in the home is riskier than enduring unmet needs for assistance. However, it is likely that people are unaware of the risks of forgoing home care.

Non-medical home care supports clients in activities of daily living (ADLs) such as nutrition, medication adherence, safe mobility, safe bathing, etc. To some, this may sound like a luxury service, but make no mistake. These healthcare services are of vital importance. Unmet home care needs correlate with mortality increased by 37% to 96%.1,2

For instance, Gaugler et al. found that among patients with dementia and who had a family caregiver, unmet needs for assistance with two or more ADLs correlated with a 37% higher mortality rate and a 77% higher institutionalization rate. Additionally, researchers from Purdue found that among a general Medicare population, a single unmet ADL need correlated with a 96% increase in mortality risk.2 This increased mortality likely stems from a combination of lack of supervision, increased fall risk, decreased medication adherence, reduced nutrition, etc. For instance, Manias et al. find that a lack of social support increases the risk of medication discrepancies 171%, making a lack of social support the number one modifiable risk factor in medication discrepancies.3

Furthermore, companionship services prove important in the preservation of cognitive and emotional wellbeing. Social disengagement and hobby disengagement triggers cognitive decline among the elderly.4,5 Similarly, staying socially active and engaged with hobbies seems to convey a protective effect against loneliness, depression, declining quality of life, and cognitive decline.6,7

In addition to considering the risks of refusing home care, it may also be worthwhile to denote the safety of non-medical home care. Aides from licensed home care agencies have specific training in standard precautions. At McKenney Home Care, this training is reinforced at least annually under normal circumstances, and that training is currently heightened. Unlike other healthcare professionals, non-medical home care aides tend to support patients with chronic disabilities, rather than sick patients. Patients tend to be homebound, and McKenney aides tend to one or two clients per week. Compared to other healthcare and other sources of social support, these factors mitigate the risk of healthcare-associated infections.

What’s more, private-duty aide services include shopping and errands, further reducing the need for seniors to have community contact. It is possible that there is no safer person to help a senior than a private-duty home care aide. It also possible, if not likely, that turning away established aide services has the opposite of the intended effect – increasing the risk of morbidity and mortality rather than decreasing it.

McKenney Home Care in Naples, FL hosts a Lewy Body Dementia Support Group on the first Wednesday of every month.  This ongoing support group is approved by the Lewy Body Dementia Association in Atlanta and is in affiliation with the Parkinson’s Association of SWFL and the Alzheimer’s Support Network.

For Individuals with neurodegenerative disorders, McKenney Home Care delivers enriched specialized training for its caregivers working with Dementia Patients. In addition to specialized videos and manuals, McKenney educates the caregivers through the use of the Virtual Alzheimer’s App. This virtual reality experience helps caregivers understand the feelings and experience of those suffering from Alzheimer’s and other forms of Dementia.

Along with their medical expertise, McKenney Home Care is a certified Music & Memory Agency. Providing help for Dementia Patients; this specialized music therapy program is highly personalized and has been shown to reduce the need for anti-anxiety and antipsychotic drugs by up to 50%, while brining joy to the lives of patients who have Dementia.

If you or someone you know would like more information about McKenney Home Care or the LBD Support Group, please call McKenney Home Care at 239-325-2273, or visit

1. He S, Craig BA, Xu H, et al. Unmet need for ADL assistance is associated with mortality among older adults with mild disability. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences. 2015 Sep 1; 70 (9): 1128-32.
2. Gaugler JE, Kane RL, Kane RA, Newcomer R. Unmet care needs and key outcomes in dementia. Journal of the American Geriatrics Society. 2005 Dec; 53 (12): 2098-105.
3. Manias E, Annakis N, Considine J, Weerasuriya R, Kusljic S. Patient-, medication-and environment-related factors affecting medication discrepancies in older patients. Collegian. 2017 Dec 1;24(6):571-7.
4. Bassuk SS, Glass TA, Berkman LF. Social disengagement and incident cognitive decline in community-dwelling elderly persons. Annals of Internal Medicine. 1999 Aug 3; 131(3):165-73.
5. Iwasa H, Yoshida Y, Kai I, Suzuki T, Kim H, Yoshida H. Leisure activities and cognitive function in elderly community-dwelling individuals in Japan: a 5-year prospective cohort study. Journal of psychosomatic research. 2012 Feb 29; 72(2):159-64.
6. White H, McConnell E, Clipp E, Branch LG, Sloane R, Pieper C, Box TL. A randomized con-trolled trial of the psychosocial impact of providing internet training and access to older adults. Aging & mental health. 2002 Aug 1; 6(3):213-21.
7. Fokkema T, Knipscheer K. Escape loneliness by going digital: A quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults. Aging & Mental Health. 2007; 11 (5): 496-504.

McKenney Home Care
239-325-CARE (2273)
9655 Tamiami Trail North #201, Naples, FL 34108

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