It seems like just a blink of an eye ago, but 1981 – the year I officially stepped into the home care arena with my own in-home care agency – was truly, technologically speaking, a lifetime ago. Although it’s incredible to realize, since 1981, we’ve lived through the invention of IBM’s very first PC, soft bifocal contact lenses, Cabbage Patch Kids, DNA fingerprinting, disposable cameras, and Prozac. And that’s just in the 1980s alone.
And through all of that, I’ve watched, waited for and witnessed firsthand the emerging acceptance and appreciation for what many of us in this industry have realized all along:
Home care is of great value in the care continuum.
Care navigation/care management leads to better outcomes.
Most recently, at the 3-day Post Acute LINK conference, these points were reiterated again and again, from payors, physicians, and everyone in between. With over 400 attendees, mostly the largest providers of healthcare at home and associated industry services vendors, it was an incredibly well-executed event. If you missed it (and I hope you didn’t!), here are some of the main takeaways for savvy home health and home care agency owners to keep in mind:
Use creative partnering and collaboration to be able to provide both specialized and a broader range of services to consumers.
Offer a variety of payment options.
Ensure the highest quality of care, striving to be the top provider in your market.
Be open to changes inherent to cultural shifts.
Capture, track, and make adjustments based upon data.
Lincoln Healthcare’s President, David Ellis, who facilitates HomeCare 100 and LINK conferences, shared his prediction that, not surprisingly, the need for home care will continue to escalate, and that most health systems will under-compete in value-based care.
I heard, for the first time, physicians and payors discuss the role of ADLs and IADLs in determining risk and not just disease states. I actually heard the words “social model” used when discussing the best ways to follow up and follow through post-acute.
It’s heartening to know that the benefits of professional in-home care, allowing frail elders to safely age in place where they’re most comfortable, is finally beginning to get the recognition and understanding it so deserves. And I tip my hat to those of you who continue to sacrifice so much to make it a reality for the older adults you serve. The industry is on the brink of exponential growth. Are you ready?
Whether you are simply just aging yourself or are a frontline member of the aging care community, it’s important that we take every opportunity we can and share our stories, insights and concerns with those who can make a difference. And the annual White House Conference on Aging provides the ultimate chance for us to take what we know and our suggestions on the future of aging care straight to the top.
This year’s conference will take place on July 13. I’m letting you know about the conference now, not only so you’ll set aside that time on July 13, but also so you have time to participate ahead of time. The conference website, WhiteHouseConferenceonAging.gov, lists six different ways you can get involved, and I hope you’ll consider some if not all, of them. The following ways to get involved, however, may be particularly relevant to anyone in the home-centered care business:
Provide Your Thoughts About the Issues: The conference takes a look at four policy briefs related to caregiving, on retirement, about elder justice, on long-term services and support, and healthy aging. You can read the briefs online and are encouraged to provide your own online comments. If you read through what’s already there, you’ll see several caregiving organizations have already offered their insights and concerns.
Join the Twitter Chat: By now you may know what a firm believer I am in the intrinsic value of social media. Well, the White House Conference on Aging knows it, too, and that’s why they have a Twitter page dedicated to the conference. The White House encourages members of the caregiving community to Tweet their questions on caregiving using the hashtag #WHCOA. Your question may be chosen to be one answered by the panel of experts during the conference.
Host a Conference Viewing Party: The White House provides detailed information on how you can host a viewing party, including questions you can ask your viewers to facilitate and further the discussion of caregiving. Consider this part of your staff training, or part of a neighborhood or family event.
Don’t waste another minute. You can sign up now via email to receive regular updates on the conference as it approaches. This link also provides a wealth of other communication options in case you are interested in any sort of specific information on aging-related and disease related issues.
At corecubed, we’re all about getting you the latest information to move your business forward. The 2015 White House Conference on Aging is not one to be missed, and we look forward to learning from it and applying what we learn as we work with our marketing partner clients to grow their businesses.
Our experts specialize in the latest tools and information in aging care and marketing, to help your homecare and aging services business stay current and at the forefront of our field. We can help identify and bridge your knowledge gaps and provide an action plan for addressing the issues your business faces now, and in the future. To learn more about our various marketing services, contact us today.
Future predictions are for too many people needing to much care.
A new joint research study conducted by the National Alliance for Caregiving and the AARP Public Policy Institute, Caregiving in the U.S. 2015, released on June 4, highlights the challenges unpaid family caregivers and their loved ones face, and the caregiving solutions needed. Not only does this study build on previous such studies conducted by NACS and AARP in 1997, 2004, and 2007, these advocacy groups say this new research provides an even better baseline for identifying today’s family caregiver and changes to caregiving in the future.
Here are several emerging trends in family caregiving highlighted in the report, along with my insights on why your homecare business should keep these in mind:
Changing caregiver demographics: While women still carry the bulk of caregiving duties–the average caregiver is a 49 year old woman who takes care of an elderly relative—men now make up 40 percent of family caregivers, providing 23 hours of care weekly. And middle age caregivers no longer have a monopoly. As the parent-child age gap continues to rise, Millennials, those between 18 and 34, now make up 25 percent of family caregivers. And as we continue to live longer, though not necessarily healthier, there has been an increase in caregivers age 75 or older, usually caring for an ill spouse. These seniors often go it alone or seek help from friends and family.
Caregivers aren’t a single demographic and their needs aren’t a one-size-fits-all, which is why it’s crucial for your home care business to showcase the depth and breadth of services it offers, for both the caregiver and their loved ones.
The rise of higher-hour caregivers: This growing category encompasses caregivers who provide at least 21 hours a week of unpaid care, have been doing so for an average of 5 ½ years and are expected to continue providing such care for another 5 years.
Higher-hour caregivers can easily suffer caregiver burn out much more quickly than the occasional family caregiver. The study found 46 percent of higher-hour caregivers report high emotional stress. Home care agencies provide valuable services to these caregivers, in terms of not just daily task management, but also respite care. In order for family caregivers to continue clocking in these hours for the next five years, they need to all focus on themselves. The support of a respected home care agency and its well-trained staff can help these caregivers see that they should put themselves first, and give them the tools to do so, without compromising the level of care they expect for their loved ones.
Growing financial strains: The financial strain of caregiving continues to be a major factor in caregiver stress. Caregivers reported an average household income of $45,700. Higher-hour caregivers, specifically, reported difficulty finding affordable options within their communities, including affordable in-home health services. In addition, four out of 10 long-distance caregivers use paid services to care for their loved one, but 21 percent of those who lived more than an hour away reported feeling a financial strain.
It’s our job in home care to be seen as an ally on this caregiving journey, demonstrating that the benefits of our services far outweigh the costs. If a caregiver doesn’t feel she is getting what she paid for, that could compound her feelings of financial strain.
Home care reduces some of the burdens these family caregivers face. At corecubed, we help you market your homecare business more effectively to reach out to caregivers and meet their needs. We can also help with staff training, to help your business attract and retain the best and brightest so that your services are seen as a benefit, not just a cost. It’s not about lowering costs or offering the cheapest option available, but the best options and services available to assist these families where they are at, both financially and emotionally.
I hope you’ll take some time to read the full report, and contact us at corecubed today to find out how we can help you as the future of caregiving continues to change.
Stop avoiding hard discussions around end of life care.
As we age, perhaps the greatest single discussion we can have with our grown children is what we want done—or not done—to us, for us, and on behalf of us, as we approach our last decades, and the possibility of needing assistance, and the inevitability of our passing.
End-of-life care discussions not only give us peace of mind that our medical and health wishes will be fulfilled, but also give our children, or other caregivers, peace of mind on exactly what we would like to have done when they eventually face a myriad of healthcare decisions on our behalf, particularly if we develop a cognitive impairment that takes away our ability to make sound decisions for ourselves.
Many people nearing the end of life may not be physically or mentally capable of making their own care decisions. In addition, family members and clinicians may not be able to accurately guess what a person’s care preferences may be. Therefore, advance care planning is critically important to ensure that patients’ goals and needs are met. Although advance directive documents can be useful, they should allow health care agents and care providers to make informed decisions in certain circumstances and should not take the place of open, continuous communication. According to the IOM committee, the advance care planning process can begin at any age or state of health and should center on frequent conversations with family members and care providers.
Sadly, many patients and their caregivers haven’t had this critical discussion. You might expect your doctor to bring up end-of-life care issues, but many don’t or aren’t comfortable bringing up these issues, possibly worried that the patient or their caregiver will take it as if the doctor has given up on them.
End-of-life care discussions should include:
What you want your life to be like as you age?
Would you like to stay in your own home?
Who would you choose as your caregiver?
Who is in charge of your estate, and have you designated a durable power of attorney?
Who is in charge of your healthcare decisions, and to whom will you give your health care proxy?
Have you filled out a living will, being as specific as you want about your future health care and medical treatments (Do you want doctors to do everything possible to prolong your life, nothing at all in the event of a terminal illness, no artificial respiration, etc.)?
In the event of a heart attack or stroke, do you want to be resuscitated and have you filled out a “Do Not Resuscitate” form, otherwise known as a DNR?
For those who haven’t had the discussion, home care agencies offer a great starting point when the patient requests your services. With tact and grace, many home care agencies have home care social workers who can help facilitate the discussion and point clients to services they didn’t know existed while having a discussion they might have thought too difficult to have. In fact, I find the opposite to be true. In the absence of end-of-life care discussions and documents, patients and their caregivers are often left with difficult decisions during emergencies and even day-to-day tasks. Children often have opposing ideas as to what a parent would have wanted, and family issues explode in a time of crisis when a parent’s last wishes (unknown) are vehemently championed on opposite sides.
In many cases, end-of-life care decisions are left up to doctors, both those who do and don’t know the patient, with devastating consequences, according to a recent Boston Globe op-ed by Dr. Angelo Volandes, who is on the faculty at Harvard Medical School and Massachusetts General Hospital. Because doctors are tasked with saving lives, even those with a terminal illness without a DNR often go through the extensive trauma of resuscitation that does little to prolong their life but adds pain and misery to their final days.
Volandes tells of a terminal cancer patient who was resuscitated four times but died 48 hours later, of his cancer. But the process of “saving” him resulted in multiple broken ribs and “a tube or catheter in almost every part of his body, for a grand total of eight plastic intrusions, including an endotracheal tube (lungs), two central intravenous lines (veins), an arterial line, a nasogastric tube (stomach), a foley catheter (bladder), a rectal trumpet tube, and a tube placed in the sac of his heart to drain fluid.” He was “fixed,” Volandes writes in the op-ed, but at what cost to his suffering and that of his family?
These conversations aren’t easy, and indeed, there are those who want everything done to prolong their life and those who want nothing done at all, and a wide spectrum in between. Stating the who, what, where, when, and why makes the road ahead less difficult for the patient, the caregivers, and the extended family.
Knowing Consequences of Choices for Elder Care Just Mades Good Sense
Last year, a Forbes tech blog proposed that the senior care market may become the next billion dollar technology opportunity, with at-home elder care services the largest segment of a market expected to reach $319 billion in the United States by 2016. Many of these technologies, such as advanced home monitoring systems or body sensors to measure vital statistics, have the potential to benefit seniors and their caregivers and may help reduce costs and hospitalizations..
While these technological advances may help seniors stay in their homes longer or, perhaps, reduce the amount of hands-on caregiving that is needed, other technological tools under the banner of making senior care easier should really give anyone who is interested in care at home some pause for concern. Afterall, senior care is not one size fits all care.
We are already well into the Senior-Care-To-Go market via online tools and smartphone apps to book yourself or your loved one a caregiver. For those of us who have clients, patients or with loved ones who need care, we really should all slow down before jumping on this latest technology bandwagon. Care.com, an online selection, matching and scheduling tool which initially began as a way for parents to find babysitters for their children, also offers senior care (and pets). It’s a one-stop shop, but seniors have vastly different needs than children or the family pooch. There are so many variables that need consideration, and the greatest of these is a diminished mental capacity that sometimes occurs with age. Although not everyone who ages has issues with cognition, for those who do, getting a caregiver in the home is more than just a placement. There are safety concerns, not only for the elder person him or herself, but for the assets and “stuff” that has accumulated over a lifetime.
While Care.com’s website does offer a senior safety checklist you can pass onto the caregiver you hire, there’s no guarantee that caregiver will read it. Many home care agencies carefully vet, certify, and train their caregivers to provide seniors and their families with the best care. You can do background checks with Care.com, but how sure can you be of the training needed? How can you know what kind of care is needed? An absence of past malice shouldn’t be the only criteria used for determining the quality of care. Many home care agencies do the additional legwork required to ensure quality care is given. Care.com bought Breedlove services so they can now offer assistance with the complicated process of paying, withholding, etc of taxes and legal obligations of an employer. Home care agencies, however, for the most part also take care of that to reduce the risk of a family member getting stuck with unexpected payments that are legally mandated for employers, but that are usually not associated with the underground economy of caregivers.
CareLinx.com is another online start up that, as its own website states, “is disrupting the +$100 Billion in-home come care service delivery market” through connecting families and caregivers directly online. Home Hero provides similar services in California, with plans of expanding nationwide, offering video screening of potential candidates for in-home caregiving. Home Hero touts it’s the “fastest” way to find in-home caregivers for seniors. Sounds great, in theory. But caring for seniors shouldn’t be just price tags where the lowest price wins. Those of us with decades in the home care trenches know, it often takes time and a gentle hand, and face-to-face interaction between your loved one and potential caregivers to determine the right fit. And, it is not only the right fit, but backups for emergencies, training for care that is specific to the need, and assistance with activities in the home that are meaningful to the senior who needs the care.
While these new models may make securing your own caregiver more affordable and efficient, many of these models lack the adequate controls that are inherent with the traditional home agency model in keeping the frail elderly safe. In the end, if you can’t address the safety and security of your elderly loved one, you haven’t gained much in affordability and efficiency.
Elder care is not a one-size-fits-all solution. (Did I say that already?) Depending on financial ability to pay for services, support systems in place (family caregivers or others—neighbors, best friends, etc.), disease state, mental state, and location and access to services, the caregiving solution is different for most. Caregiving shouldn’t just be about scheduling ease, like booking a reservation at your favorite restaurant. Great caregiving should be about a comprehensive plan and backup plans to ensure the health and wellbeing of our often vulnerable loved ones.
So, finding a “match” online might work for some, but only if there is:
1. Supervision and monitoring of the situation for abuse–financial, emotional, and physical;
2. Oversight for daily expenditures and reconciliation of goods purchased versus goods consumed; and
3. Someone to fill in should the matched caregiver have an emergency and not be available or not show up at all
corecubed works with home care agencies to promote their valuable services that not just anyone can do. We also have a wealth of knowledge on operations and care provision, and assist our home care marketing clients provide a truly quality service.
If you have a home care company or know someone who does, let us know how we can help in this changing marketplace. Senior care shouldn’t be about dialing for dollars or the quickest way to book a caregiver. It should be about the human touch.
