Working as an in-home care provider in the time of Covid-19

  It is Covid-19 times, and you work as an in-home care provider, in and out of the rooms and apartments of low-income, vulnerable, disabled, and medically fragile San Francisco residents. You are helping your diabetic client take his insulin. As you get a new, clean needle from the box where he keeps them, you prick yourself on the old needle he’d used and dumped, casually tossed back in the box instead of discarded properly in the SHARPS  container as he is supposed to do.

It is covid times, so you are wearing a mask, a shield, full PPE, and now you have to worry about HIV and Hepatitis C, as well as covid.

For in-home care provider Meredith Hardesty, 34, that was almost the last straw in a very, very, very hard year on the job.

“When I got that needle stick, six months ago, my company would not ask the client if he was HIV or HEP C Positive; they said it was a HIPPA violation. They said they could not make him disclose if he was HIV positive, they would not ask, so I had to take antivirals, and I was really sick from them. I got migraines the whole 28 days that I was on them, but I was not about to risk getting HIV or HEP C. The agency paid for my antiviral meds, and I got worker’s comp. But the client was sarcastic and flip, he said to me, ‘At least HIV don’t live in the air that long.’   That’s when I applied for another job, but decided to stay, ’cause I truly love this work.”

She had already taken one for the team. Last August, she went into Kaiser ER,  gasping for air, with her oxygen saturation levels at 80 percent. 

She and her partner had tested positive for covid a few days earlier, and had been quarantining at home in their one-bedroom apartment on the 10th floor of their Mission Street apartment building. She assumed her four-year-old son, Skylar, had it too, and pulled him out of daycare. But they were doing OK.  

“The services were amazing: Kaiser called us constantly to check on us. The Public Health Department called us every day to check on us, the SF Food Bank delivered food every day and left it outside our door.  I didn’t want to be Miss Picky Nicky, but there was a lot of meat, which we don’t eat, so I asked for more vegetables, and on Day 4 we got soooooo many carrots: I made carrot cake and carrot soup and I cleaned the apartment like never before!  We were sick and bored.“

Then, on the fifth evening, suddenly, she couldn’t breathe. 911. Paramedics.

“They told me in the ER they would not ventilate me. They stabilized me and sent me home. Luckily it was just that one time.” 

She recovered completely, and did not hesitate to resume working full-time, providing a wide range of services to a disparate group of clients.

“I have clients from their 30s to 90s. We provide home-care services like cleaning, simple food prep, shopping, help with dressing and grooming and bathing, and medication reminders, with the goal to keep them in their own homes, and out of nursing homes, institutions or facilities. We are trained by a nurse to do gastric tube feedings, even colostomy care, to empty catheter bags. Our model is client-centered care: whatever they need. Most of them are alone. I work with everyone, including the most difficult clients, individuals that only I can get along with. My boss always says to me, ‘Where did you come from?’ ”

Hardesty came to San Francisco at 14 as a runaway from the Fresno area. She lived between the streets and homeless shelters for years, and is a survivor of trauma and abuse.  “With my own diagnosis, there is heavy stigma, like with my history, who gets better, right?  Read about my history in my casefiles, and you go, whoa.

“My whole perspective is that my record, what is on paper written about me, is not me. I have sat in a state hospital in front of psychiatrists who said, NO WAY, you do NOT have schizoaffective disorder, which was on my chart. I come from an insane amount of trauma; abused since I was two. So because of my history, that’s why I can handle even the most behaviorally challenging clients that no one else in our agency will work with. I have been a client myself, been helped by great San Francisco non-profits, but WORK, it’s work that has stabilized me. A lot. “

Hardesty has, in her own words, ocean-blue eyes. In conversation, she is brisk, no-nonsense, direct, clear, and devoid of self-pity.  She quickly names the many organizations that helped her when she was younger and on the streets: Larkin Street Youth Services. The Homeless Prenatal Project. UCSF Citywide Case Management. The Tenderloin Housing Clinic. St. Martin de Porres House of Hospitality.

“Martin de Porres on 15th and Potrero always served great, healthy vegetarian lunches, and the staff is so welcoming. I even found out I was pregnant outside the Martin de Porres. They had a mobile outreach medical van in front, and I did my pee test with them. Then I had to get serious about looking for housing. I did not want to raise a baby in an SRO. Tenderloin Housing Clinic helped me get an apartment, but I have lived in many of the places where I now have clients. You know some are so difficult that no one wants them, we are the last resort for them, before Laguna Honda.”

Hardesty is matter of fact, explaining why she kept working during the pandemic: 

“There is nobody to take our place. Most of our clients live in public housing and can’t function without us. Some are hoarders, I have one client who,  well, I can’t even get my thigh in his front door! I prefer the clients with complex medical problems though. It’s more work, but its more interesting. I get bored with just cleaning, and the mental health patients can be pretty manipulative.”

Now that she is vaccinated, work is almost back to normal.

 She sees two or clients a day, for an intense three to four hours each. 

She can go back to simply being wary and vigilant of the threats she can see, unlike viruses.

“I have walked into an environment where the client had weapons out. Active weapons. Just out. I see the gun, I call and report it to my supervisor, and walk right out again.

 I’ve had clients who ask me to do, you know, extra.” She laughs.

“Nope, I say, I don’t know what you are talking about. Your care plan says I can do this and this and this. I don’t do extra.”