Home healthcare is entering an intriguing new era.

By Diane Alter

Average life expectancy in the United States has risen by 5.5 years in just the last decade—the most significant increase since the 1960s. With all the distressing news about the overall health of Americans, that’s good to hear. Unfortunately, there is a dark lining to this silver cloud. Living a half-decade longer increases the likelihood that you or someone in your family, will need some kind of long-term healthcare, accompanied by all the financial, logistical and emotional stress that entails. Indeed, 2018 U.S. Department of Health and Human Services data notes that a majority of Americans turning age 65 this year will at some point require it. 

In dollars and cents, that could range from the current annual median cost of $18,720 for adult daycare to $100,375 for a private nursing home room, according to Genworth’s 15th annual Cost of Care Survey. Americans currently spend more than $300 billion a year on long-term care and services, with costs increasing across all care settings, according to David O’Leary, President of Genworth’s U.S. Life Insurance division.

“We strongly advocate people at all stages of life begin planning now for the very real possibility of needing care as they grow older,” O’Leary says. “Starting a conversation about potential long-term care needs and the issues of aging isn’t easy. But honest conversations are essential to making sure that people can live life on their own terms as they grow older.”

If you do any significant TV-watching, you’ve probably noticed a proliferation of advertisers offering to help families navigate the complex issues surrounding long-term care. That’s because there has been a proliferation of choices and options in this industry, as the number of Baby Boomers “aging out” continues to grow. Needless to say, getting on the right path can be stressful and confusing, but it’s crucial, too.

One option that has gained traction over the last decade is the in-home care option. Indeed, more and more families are looking at ways to keep their parents, grandparents and elderly loved ones at home for as long as possible. With the right type of help, the pros vastly outweigh the cons.

Start Talking Now

Conversations and plans should ideally occur before home healthcare is needed, so that when it is needed, family members and loved ones are ready to step up and step in—and those in need of care are prepared for the change. These are not easy conversations. They require a level of pragmatism and honesty that is not always part of the family culture. Also, that elderly loved one may not want to budge. On anything. The main objection tends to be a lack of privacy. Most in-home care involves a trained aide or companion, on a schedule that might also involve neighbors, friends and loved ones. That can be viewed as intrusive by someone who has lived independently for 50 years.

David Moore, Director of Sales at New LifeStyles, an online site providing information on senior care options across the U.S., confirms the fact that a high percentage of seniors will fight the in-home care idea at the beginning. That’s only natural. But families should be aware of the signs that the time for home care has come. They range from subtle changes in appearance and mood to more obvious clues—including forgetfulness, confusion, unexplained bruising, a lapse in personal hygiene, clutter, and changes in weight gain. Having seniors engaged from the start, says Moore, will make a transition easier.

“Still, it’s a sensitive subject with no easy fixes,” he admits. “Do your homework. Read the fine print on any contract. The devil is in the details. For peace of mind, I recommend installing webcams to appease everyone’s concerns.”

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Linda Fodrini-Johnson, Executive Director and Founder of Eldercare Answers, suggests that, when searching for home healthcare, make sure the placement agency is licensed and has been in business for at least five years. Also, ask what kind of accreditations it has received. The company’s website offers an advanced search option that provides this information.

“But keep in mind that names appearing first are not always the best,” she says of searches. 

“Also, guidance from an objective professional is crucial. You want to make sure the person you are bringing into your home to care for a loved one is the best.”

The Pros

Assuming a senior’s current living situation is safe and secure, the advantages of an “aging in place” strategy are many. They include:

  • Comfort and Familiarity
  • Greater Sense of Independence
  • Personalized Attention
  • Faster Recovery from Injuries
  • Potential Cost Savings
  • Less Stressful Environment
  • Tailored Plan of Care
  • Greater Family Involvement
  • Less Structured Family Time
  • Keeping Pets
  • Maintain Neighborhood/Building Friendships

These are the primary reasons why families are looking at new ways to keep their loved ones at home as long as possible. Options to consider are full-day, half-day, four-hour, overnight, and 24-hour home healthcare—usually as part of an evolving plan. Caregivers should have some kind of medical experience, a driver’s license, and come with references. Needless to say, for the companies in this business, keeping clients in their own homes is a top priority.

Take Care Companions, which places caregivers all over New Jersey, strives for just that.

“We offer companionship and assist in areas of meal planning, personal care, medication reminders and daily activities,” explains founder Theresa Kellner. “Our aim is to offer clients independence, quality of life and dignity, without overstepping.”

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Kellner says her goal is to find the “perfect” person for each situation. She does that by meeting the client and the family to assess what is going on and what is needed—now and in the future, as those needs change. This intimate involvement also prevents cultural and personality clashes. “If I wouldn’t put a caregiver with my own mother, I will not put that caregiver in anyone’s home,” she says.

The future of home healthcare in some respects is difficult to predict. In most ways, however, it is not. The number of aging Americans is growing and they are living longer. That will serve as an accelerant to technical innovation driven by artificial intelligence (AI). It’s here now and it is poised to soar throughout the space in the years ahead. Voice-based virtual assistants, wearable sensors and fall-detection monitors are growing in acceptance and right around the corner are fixtures and appliances that will double as diagnostic tools.

“It’s still early days and widespread adoption is years off, but the potential exists for AI to keep elders in their homes longer and safer,” Moore notes. “Further, these devices will help researchers better understand the aging process and to assist in creating methods to delay the process.”

Fodrini-Johnson is also excited about the prospects of AI in healthcare. Still, she believes nothing will ever replace the need for constant hands-on human intervention: “To be sure, caregivers provide respect, compassion, a sense of humor, and know when a warm hug is just the right and only thing needed.”

House Calls

Although in-home caregivers are trained to spot issues of concern, they are not doctors. That is where “telemedicine” promises to play an important role. Right now, Trinitas offers its employees access to physicians and mental health practitioners for face-to-face “examinations” online—for diagnoses, prescriptions, referrals for subsequent testing, and more—under a partnership with Horizon BCBS. Trinitas is also encouraging its own medical staff to make themselves available to see patients via the same service, Horizon CareOnline, powered by American Well, the leading national telehealth provider. For more info on this service visit horizoncareonline.com.