Doctor on call: In-home healthcare for elderly during pandemic

Between senior citizens being asked to stay indoors to protect themselves from the pandemic and an overwhelmed public health sector, it is easy for the elderly to be overlooked.

Even before the pandemic came to TT in March, Dr Jaeon Bobb decided there was an urgent need to address the needs of the elderly – something he considered a major gap in the healthcare system. The pandemic, he told Business Day, left this already marginalised group even more exposed.

Bobb, 30, and his team moved forward with the opening of a new private health care facility, Nexus Care Ltd in the heart of the pandemic – a risk when considering that so many businesses in several other sectors are being affected. Bobb, medical director of the clinic, said the team felt now, more than any other time, despite the challenges, was the best time to focus on healthcare.

Although the team recently opened an office front in Bon Air Village Plaza, Bon Air Gardens, Arouca, the business started in 2019. "We wanted to fill some of the gaps we noticed in the healthcare system and bring back the culture of compassionate healthcare.”

The business started with in-home patient care for the elderly. “We actually started there because older people started reaching out to us and we realised there is a need for services within the home.”

Bobb said for some, there are challenges in getting patients out of the house to seek care, either due to lack of mobility or other issues related to their health. "It would be easier for health services to come to them.”

The clinic has partnered with several nurses who can be called upon to assist with in-home visits. "We source their medication and bring it to them. They don't have to do anything," he said, adding the nurses also assist with preparing meals and putting the patients on a diet suitable to their condition.

"The nurses will go to the home, check up on them, make sure they have their breakfast and have taken their medication. Their vitals are checked two to three times a day and if there are any issues, a doctor will come and assess the patient to decide if they need further treatment."

Nurses also assist with tidying up the area and if they are able to move around, take the patients on a walk around the house to keep them mobile.

Bobb said sometimes the nurses get personal with their patients and go out of their way to offer manicures and pedicures, if possible. "It's just for them to get a little pampering and feel comfortable," he said.

Although their services have expanded and are no longer limited to the elderly, the clinic still provides in-home health care services for those in need. “We also provide in-home caregivers, particularly for the family members of the elderly so they have the peace of mind of knowing someone is caring for their loved ones in a familiar environment. A lot of people are not comfortable with sending their family to a home.”

Bobb has been working for four years since attaining his medical degree from the University of the West Indies. Having spent time in the public health care system, he said, while doctors and staff are doing their best to cope with the changes caused by the pandemic, it is still a bit overwhelmed at the moment.

“It is impossible to see everyone in a short space of time with the manpower and resources available to them.”

He said he realised that in the past few months, people are also not as comfortable going to the public healthcare facilities as people prefer to avoid crowded public spaces for fear of contracting covid19. He said there are benefits for patients to visit private facilities because they prefer to reduce their interaction with the public.

“The wait time is shorter in getting appointments and even for walk-in services. You also get to spend more time with your doctor, rather than seeing a large volume of patients…It is easier to control the environment in a small clinic setting rather than a hospital or health centre.”

Bobb said the team was also keen in bringing quality health care to east Trinidad. The office at the Bon Air plaza is near the bus route for easy access to travelling patients. He said it was also important to the team to bring a sense of community to the business and people in the area have responded positively to their arrival.

He said east communities are usually underserved when it comes to quality healthcare services. “We wanted to start here (because) the further east you go, the fewer options there are.”

Despite a few setbacks, the team pushed on with their plan to open this year.

“We were supposed to open in April, but the pandemic caused some issues and there was a setback in attaining the space.”

There were also issues in setting up the space, having to re-evaluate how they conducted their business to suit the new covid19 regulations.

Bobb also said at one point, preparing the space for the opening stalled when two members of the team were quarantined due to exposure to covid19. "We were in the middle of getting medical supplies and outfitting furniture as well as painting and cleaning, so that had to be put on hold for two weeks."

One of their biggest setbacks was getting supplies, as some of their suppliers were unable to import the resources they needed in a timely manner, due to closed borders.

Bobb explained that in order to finance the project, personal investments were made by the team's three directors: himself, marketing director Monifa Derrick-Bobb and managing director Giselle Mitchell. They were also able to avoid a commercial loan with the support of four silent investors.

Eventually, the clinic was able to open its doors to the public at the beginning of October.

The clinic is not doing covid19 testing at the moment and patients exhibiting symptoms must be redirected to authorised covid19 testing facilities, but Bobb said all their patients are screened for signs and symptoms during their visit. He said the clinic uses a covid19 screening form which will help determine if the patient has been exposed to someone with the virus.

"If we have any concerns, we will do a covid19 serology blood test and then we recommend if they need to be swabbed." A serology blood test checks for antibodies that suggest the patient has been exposed to the virus. "If you have antibodies that means you were exposed, which could indicate past exposure or if you are actively fighting off the virus."

Although the core team comprises the three directors, an administrative staff member and a nurse, the clinic has partnered with several specialists and five other general practitioners to provide a wide range of services including physiotherapy, company medicals, vaccinations, child wellness checks, in home nursing and doctor visits, in-home physical therapy and diagnostic testing. Diagnostic tests are outsourced.

He said the clinic is still in talks with other practitioners to come on board to provide more services to the public, who can be made available to visits and consultations at the Bon Air plaza.

"When we do the assessment of the patient, we will decide who will be the best person to deal with the patient. We want the patient and the specialist to mesh well together."

Patients can call the clinic to make an appointment at 240-3437. Appointments can also be made online through their website clientcare@nexuscarett.com. The team can also be reached through social media or by email at nexuscarett@gmail.com