Vulnerable Populations Face Higher Risk, Fewer Personal Care Attendants Due to COVID-19 | KBIA

Vulnerable Populations Face Higher Risk, Fewer Personal Care Attendants Due to COVID-19

Apr 28, 2020

Kelley McMillen is a personal care attendant, or PCA, for multiple clients in Columbia.
Credit Diane McMillen

For hundreds of elderly and disabled residents in Missouri, personal care attendants, or PCAs, are a lifeline that stave off isolation and help them stay out of nursing homes. The field was already facing a shortage of workers before the COVID-19 pandemic began, but now, things are even worse.


PCAs are a lifeline for their clients, according to Melinda Cardone, the executive director of Independent Living Resource Center in Jefferson City. To her, such assistance gives clients the chance to live independently.

“It's that basic civil right, of being a part of the community and active members of where they live,” Cardone said.

But being a PCA means you may be exposing yourself to the coronavirus, as many PCAs visit multiple clients in different buildings, and their tasks could include thing like going shopping for basic necessities.

PCAs help their clients with many of the activities of daily living – cleaning, cooking, laundry or grocery shopping – and some are also involved with bathing, grooming, and other personal care tasks. Whatever the client’s needs demand. Meaning PCAs are in very close proximity with their clients.

Kelley McMillen is one such PCA, who works for multiple clients. He said he’s being extra careful to wash his hands to protect his six clients in the Columbia area from COVID-19.

“All of them do have a disability of some kind, and I'd say most of them, you know, that they that they are pretty vulnerable to it,” McMillen said.

McMillen typically sees two or three clients a day, and he said he’s had some difficulties completing routine tasks. During the pandemic, it’s difficult to find some basic commodities, like toilet paper.

So, not only are PCAs having to find simple ways to keep their clients safe and deal with shortages at grocery stores, they’re also having to deal with the shortage of PPE, or personal protective equipment. Things like masks, gloves or hand sanitizer.

Jessica Macy, the executive director of Services for Independent Living in Columbia said it can be difficult to procure personal protective equipment for PCAs, which is necessary due to the very close contact with clients who may have limited mobility or be in a vulnerable population. But she said her agency is trying to help by providing hand sanitizer and cleaning products to their PCAs.

She said some of their clients have also been worried about the fact that PCAs have to come into the home, thus furthering an individual’s risk of getting COVID-19

“So, we've had to get creative a few times with finding attendants to fill in in those cases,” Cardone said, and one of those “creative” ways is to hire family members as PCAs. She said relatives may be able to step up and do PCA during the pandemic because it’s much easier for them to quarantine with clients. Especially if they already live together.

Attendants are paid by Medicaid for their services, and so family members can potentially get compensated for the caretaking they are already doing. Due to the coronavirus pandemic, Missouri recently loosened restrictions related to family member background checks: relatives can begin giving care while they’re waiting on background check results.

In Columbia, McMillen said coronavirus is limiting his ability to see some of his usual customers. They’re pausing services to avoid exposure, or they live in buildings that don’t allow visitors because of the pandemic.

Still, McMillen looks on the bright side. “I'm pretty happy I still have a job during this time whereas other folks are filing for unemployment are struggling and things like that,” he said. “I'm pretty fortunate.”

Cardone added that people who have recently lost their jobs may be able to find PCA work by checking with their local independent living centers for job postings. “I've seen several of the center's listing job openings for PCAs throughout the state, and this would be a great time to get into that field right now,” Cardone said.