For this installment, we spoke with Aveline Dowling, a home health occupational therapist (O.T.)
Dowling has practiced O.T.
for 13 years and worked in home health for the past four years.
MclittleStock/Adobe Stock
Since mid-April, she has been helping many people recover fromthe coronavirusin their homes.
(This interview has been edited and condensed for clarity.)
SELF: Why did you decide to become an O.T., and specifically a home health O.T.?
Aveline Dowling:I became an occupational therapist because it is about treating patients as a whole.
I help people do the things they want and need to do.
may work in a variety of parameters.
I worked at hospitals, acute, and subacute rehab, but felt something was missing.
I was burnt out working at these controls.
Then I tried home health and I loved it.
The flexibility of the work hours is also important because I have three young children.
I find home health really meaningful.
I go into patients homes and help them achieve seemingly simple goals that have profound impacts on their lives.
Sometimes its being able to shower on their own.
Little things like a special can opener or writing aid can make a big difference.
What was an average day like for you as a home health O.T.
I would see an average of six patients a day for 45 minutes each.
I make my own schedule, which I love.
The patients I typically see are those coming fromhospitals, or those discharged from rehab to home.
I started noticing changes in my work environment toward the end of March.
The COVID-19 spread throughout New Jersey was rapidly increasing.
What were the initial changes in your work like?
This was because elective surgeries were canceled, and normally we get a lot of those orthopedic patients.
Since March, we dont get those anymore, unless its from an emergency surgery.
But then in mid-April, I started getting referrals to treat people who had recovered fromCOVID-19.
Theyre doing a lot better.
As a home health O.T., we are kind of the final step in the process.
What are the main things youve noticed about treating patients who have recovered from COVID-19?
The COVID-19-recovered patients I work with mostly have pulmonary issues.
COVID-19 really, really affects a personsbreathing and lungs.
A lot of these patients have lost so much of their endurance.
I have been implementing a lot of pulmonary rehab and breathing techniques.
This looks likedeep breathing, stress relief, and relaxation exercises.
Overall, when the patient is home, you focus on their goals and regaining function.
What that looks like differs on a case-to-case basis.
Laundryis a big deal for these patients too.
They have to figure out, where do you put the basket?
Or do you just drop it all down?
We have to be creative.
What kind of precautions are you taking while caring for these patients within their homes?
I donpersonal protective equipment(PPE): gown, goggles, mask, and gloves.
I also use aface shieldwhen we have reason to think theres a greater risk the patient has COVID-19.
Even if I know a patient is negative, I still wear the gearits the policy.
I dontget testedregularly, just if Ive had an exposure.
Another thing I do is I always disinfect my shoes.
I spray the bottoms.
I make it a habit to do that before I go to different homes.
I dont know if its just me, but it makes me feel like Imcreating less risk for infection.
I dont let my kids hug me or kiss me.
I go to the shower straightaway.
Is it hard to work with all your PPE on?
It is definitely hard to work with all this gear on, mainly because its hot!
And it takes longer to put it on.
But Ive been very, very careful.
Wearing all this PPE as a home health worker affects more than just me.
People in the neighborhood talk, and they get scared.
Sometimes I feel like Im almost spreading fear.
So I really take into consideration what the patient feels.
Its also our policy that the patient has to wear amaskduring the home treatment.
And if theyre very short of breath already, its so difficult for them.
I have to explain its our policy to protect each other.
Its not only protecting you, its protecting me.
Are you worried about transmitting the virus between patients homes to yourself, or to your family?
The patients I work with in their homes have come from either the hospital or a rehab facility.
Hospitals are great about testing for the coronavirus before sending patients home.
But a lot of patients who have been in rehab are not tested.
So in home health, we have had cases where the patient was asymptomatic but actually positive for coronavirus.
This creates a whole chain of possible infection.
That happened to me.
The patient was asymptomatic and fell when they opened the door for me.
So I had to stop working and get tested.
This was really difficult because I live with my three kids and also my mother, who isimmunocompromised.
I tried to stay away from her and the kids and kept my mask on at home.
The whole time waiting for the results, I treated myself as positive.
Thankfully, the waiting period was only two days, and my test was negative.
How has working as a home health O.T.
with patients who have recovered from the virus affected your own mental health?
The coronavirus didaffect my mental health.
I think that frontline health care workers at hospitals and rehab facilities have a harder situation.
But I have still faced challenges.
For instance, Im worried about my mom, and shes worried I will bring the virus home.
Another thing is my three kids are now homeschooled.
Im very fortunate my mother is here to help out.
Finally, what is keeping you positive with everything going on?
Im usually not that easily overwhelmed.
I think thats my personality.
And its a good personality trait to have right now.
After all that you go through, sometimes you just have to laugh about it.
I cant just stress and worry about it.
I have to also laugh.
If I get it, I get it, but I did my best.
