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Can Home Care Be the Eyes and Ears of the Larger Healthcare Team?

The Q2 2016 PX Advisor is focused squarely on Non-Acute Care. This post excerpts an article By Karen Sorensen, Associate Vice President, National Initiatives, HealthStream, in which she interviewed Sharon Brothers, co-founder of the Institute for Professional Care Education (IPCed). As the former owner and operator of assisted living communities in Oregon and California, Brothers is well acquainted with the issues of staff turnover and training in Non-Acute Care.

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The number of Americans requiring help with daily living at home is expected to more than double from the current 12 million to 27 million by 2050. AARP reports that nearly 90% of seniors want to stay in their homes for as long as possible (AARP, 2011). Home care workers are in high demand as the U.S. population ages, and more seniors are staying in their homes instead of nursing homes. Yet the workers tasked with caring for this vulnerable population are largely underpaid and untrained. Consequently, home care companies’ ability to attract and retain qualified workers is difficult.

What are the top challenges for the home care industry?

The most significant challenge is a shortage of workers. This segment of healthcare is not that glamorous and not that well paid. Because unlicensed home care workers are at the lowest end of the pay scale it’s difficult to attract and retain good people. With a rapidly aging society and more seniors desiring to stay in their homes, the demand is only going to grow. The flip side of that is the challenge of training and equipping the paraprofessional to be an extension of the healthcare team. These workers are in the home for several hours at a time, multiple times a week. They assist with everything from getting a patient out of bed to preparing meals, bathing, and more. Home care workers are seeing, touching, and observing the patient’s condition. If we can teach them what to look for and what to do when they notice even the smallest change, we have an incredible opportunity to improve the quality of life for patients and to keep them out of the hospital. If we can make the home caregiver the eyes and ears of the larger healthcare team, we can not only avoid unnecessary hospital readmissions, but catch situations before they become a health crisis. This is where post-acute home care can become an extension of the entire healthcare system.

Hospitals are facing severe penalties to prevent unnecessary hospital readmissions. Are they tapping into the post-acute caregiver to be part of the extended healthcare team? We’re still not seeing much collaboration between hospitals and home care. Right now hospitals are asking for readmission rates and data on patients who go from a hospital setting directly to home care. Data is important, but hospitals have not yet taken the next step to collaborate with home care in a meaningful way. That could mean having a point person at the hospital who the caregiver can call when with a patient and noticing the patient cannot lift his right arm or his speech is slurred, as an example. We are not seeing that partnership yet, and that’s a lost opportunity. Many home care agencies have no nurse or other medical personnel and only provide “non-medical” care, but their observations and interventions can have profound implications in the medical care of the patient.

Where do you see the post-acute industry in five years?

It will be a much more regulated industry because consumers will demand it. There will be training and credentialing requirements, and post-acute will be an integral part of health systems’ network. Discharge from acute care to post-acute will move from being just a hand off to a meaningful partnership in keeping patients out of the hospital. More than preventing costly readmissions, however, baby boomers are concerned about their quality of life. Despite any potential chronic conditions they still want to be active, and they are going to demand that the healthcare system support them in that. Hopefully, we’ll be in an environment where we’ve found ways to make that accessible and affordable for everyone.

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