A recent JAMA study cites lower readmission rates, lower admission rates for long-term care, longer treatment durations and lower incidence of anxiety and depression during treatment as the main benefits of hospital-at-home.
When utilizing hospital-at-home care, clients receive personalized attention in their most comfortable environment, as opposed to hospitals where they’re surrounded by unfamiliar staff members in an unfamiliar environment.
The opportunities that may result from hospital-at-home and other acute care programs abound. They not only present a space for home care providers to flex their muscles, but also to educate clients and families on the boundaries and scope of care at hand, and, when necessary, to find the right partners to assist with these acute-care needs.
Educating families and clients
There needs to be more information regarding the difference between personal care services and medical home care services. When family members inquire about personal care services, they may oftentimes want someone to help administer medications or use a feeding tube, though these tasks fall outside of the nonmedical scope of care that many home care agencies practice.
I can recall when I was a scheduling coordinator and on a call with a hospice provider for a mutual client. They wanted me to relay a message to our caregivers that would “allow” them to give syringe medications when they noticed agitation and anxiety in our client. I explained that we needed medications on a schedule or family approval before caregivers could administer them. These regulations differ based on the state and individual agency levels.
After receiving that phone call, it was difficult to redirect this client’s entire care team about the strict boundaries that we adhere to. Some caregivers were not comfortable administering medications at all. Those caregivers were well within their rights to object to administering medications, and we respected that. Ultimately, this led to educating the client’s family on how we operate by providing office staff like myself with more opportunities to check in with clients, families and caregivers in the field.
The partnership opportunities for hospital-at-home programs are boundless for home care. Now is the time to educate your community on what nonmedical means, and to secure strong partners that can perform tasks that you aren’t able to do currently. If you can’t clip toenails or administer medications, have a trusted power partner that can step in and help out.
Assist unpaid family caregivers
The goal with acute care initiatives is to improve the client experience on all fronts and to serve your clients better. Don’t forget about the unpaid family caregivers working behind the scenes. They’re not bound by any scope of care and are forced to complete any tasks that their loved one(s) need — skilled and nonskilled alike.
The Committee on Family Caregiving for Older Adults noted, “Family caregiving is more intensive, complex and long-lasting than in the past, and caregivers rarely receive adequate preparation for their role.” More intense family caregiving tasks like IV infusions, PICC lines, speech therapy, physical therapy and occupational therapy all fall under the medical or skilled side of home-based care.
If you can pilot a family caregiver training program, you can develop a warm relationship with potential prospective clients and their family members. If for some reason the family caregiver’s responsibilities become too much or they need to tend to their children and bring in outside home care and acute care help as a result, they would have a connection to you for services. Educate, inform and assist your caregivers so that they are prepared and armed with a plan.
The benefits of the shift toward home- and community-based care hinge on your ability to empower your community to remain educated, informed and dedicated to providing individuals with the choice to thrive-in-place. The goal is to help clients enjoy their lives at home and not just to age in place!
Jennifer Lagemann is a former family caregiver, as well as a professional caregiver and administrator at home care agencies. She works as a writer and researcher, helping care providers to create patient- and family-friendly websites, articles and marketing literature.
