Medical devices and technologies have been rapidly moving into people’s homes in the last couple of decades. There has been a shift into a bigger role for managing your own health, for your family and community. My personal opinion: I’m pro home health care USA. But it has to be under the correct circumstances. So there are a whole host of benefits to home healthcare that we’ll discuss. I’ve gathered data from a variety of sources to help support my claims.
I’m very keen on home healthcare because of my brand: Honey Gusto. Now we don’t facilitate the complex medical devices like pacemakers or have experienced medical professionals come to your home. But we do supply medical devices, and home healthcare incorporates the use of such items.
And especially if you live in the U.S. it makes sense to go this route. Literally, it’s the only industrialized/first world country on the planet that doesn’t have universal public healthcare. Which, by the way, isn’t working out too well for you guys…
And according to Medicare and Medicaid, in 9 out of 10 cases home healthcare is cheaper, more convenient and just as effective as a hospital setting. FYI, in a nutshell, Medicare is the U.S. federal programme for medical care if you’re 65+, or have a disability; Medicaid is a federal medical programme for low-income persons.
So, let’s dig a little deeper into the movement of home healthcare and the benefits it has over a hospital setting. But just as important, we’ll touch on when it’s perhaps not the best option for you. At the end of the day, if you require complicated surgery, or there’s a medical emergency, the hospital is the only option.
Recent trends in home health care USA
It is quite ironic that half a century ago, home doctor visits were the norm. In fact, a doctor would spend half his/her time visiting patients in their homes. In recent times, home healthcare has gained a lot of momentum, and it’s come full circle.
The majority of home healthcare recipients are 65 years old over, and will typically receive such treatment after being discharged from hospital. It’s essentially a rehabilitation programme. They’ve been discharged from a hospital but still require certain medical services during their recovery, or perhaps indefinitely.
The U.S. healthcare system is a $3 trillion dollar sector. This would actually make it the 5th largest economy in the world! So home healthcare still forms a very small chunk, but the reported figures are likely to be an underestimate because of the managed care plan system. This is paid for on a per person basis and not per service.
So home healthcare is on the rise, but why? Well, it’s thanks to an aging population. Naturally, elderly folk are more likely to have chronic health issues and require rehabilitation programmes at home. Take a look at this:
Quite surprisingly, a lot of people don’t know home healthcare exists until they themselves, or a family member is afflicted. Their doctor will recommend it after hospital discharge, nursing home or rehabilitation advise it. There are many challenges with homecare, such as dealing with patient’s chronic illnesses. These people need ongoing help, especially those with disabilities and the elderly. They may gain back some independence, but is it enough to be fully self-sustaining? Probably not – so nurses are really working with the family members to care for their sick loved ones more independently.
The family members will be able to recognize symptoms of ill health and when to seek professional help, the dosage schedule and how to administer the drugs. It’s up to the family members once the typical 30-60 care plan has lapsed. The key is to make sure they are not alone, and help is always close at hand.
What exactly is home health care?
Honestly, there is no hidden meaning here – it’s medical care provided in the patient’s home. That’s it. It’s the healthcare you need within the comforts of your own home. You’ll receive home healthcare if your doctor says it’s appropriate, which could be if you’ve just been discharged from hospital, but need some extra care until you’re independent again.
Your healthcare provider will work with your doctor to set up a specialized treatment for you, and then nurses or other skilled medical professionals (e.g. physical therapists) will come to your home. All of this is aimed at getting you back on your feet, so to speak; becoming as self-sufficient and independent as possible. The medical staff could literally care for you in a million and one ways. But examples could be administering your prescription pills, giving injections, caring for surgical wounds and intravenous therapy.
And as shown in the above the pie chart, the majority of home healthcare is from federal medical programmes. Medicare will deem home healthcare appropriate when your doctor can identify (to the best of their knowledge) your condition will improve over time with home healthcare. You must also be homebound, which means you aren’t physically able to leave your house without medical assistance. This isn’t to be confused with bedbound. It’s almost like a rolling/updated service. Medicare will cover home healthcare for 60 days before your doctor will review the plan, and perhaps extend it if necessary. So you can actually find yourself with home services for quite some time.
I think on occasions, people get a bit confused on home healthcare and nursing care homes, so lets just clear that up. Firstly, they are actually quite similar because you still have trained medical professionals tending to you either way. Therefore, the main differential is a nursing home will have multiple nurses and patients under the same roof.
Why is home healthcare so great?
Because it benefits so many people and provided in each of the three schemes:
- Veterans Administration – caring for the brave men & women who have served in the military. They can receive long-term care, and for more severe injuries sustained in combat (say the loss of a limb), they’ll receive full healthcare programmes and medication at no charge. Government subsidies are available if your injuries are less severe and you exceed the income threshold, but ongoing monitoring, routine assessments, and preventative care is available
- Medicare –covering the 65 and over, disabled people and those with ESRD: end-stage renal disease. Medicare covers the full spectrum of health services in the home: 1. Speech-language pathology (e.g. learning to talk again after a stroke), 2. Occupational therapy, which assists in getting you doing your day-to-day tasks again. It could include teaching you how to make a cup of tea with one hand! 3. Physical therapy that could involve massages and basic bodyweight exercises to strengthen the muscles. 4. Nursing care.
- Medicaid – people on a low income, whether that be children, pregnant women, elderly or disabled. You qualify if you’re below 133% on the Federal Poverty Level and/or you’re a single parent, blind, or disabled. These programmes can even assist you with transportation to access medical care, especially important if you’re blind.
Home healthcare is great because family members don’t have to shoulder the burden of caring for loved ones themselves. 65 million Americans do this on a daily basis: work, care for their kids and tend to sick loved ones. Therefore, home healthcare can help by providing an affordable solution, allowing the sick to remain in the comforts of their own home. Some of the benefits include:
- Medical professionals will be there when you cant be
- You’ll regain independence quicker if you’re being assisted in your own home
- Your complex medical needs can be met in the comforts of your own home
- The services will cover all your needs: from medication management, nutritional advice to supplementation. Your recovery is just as good if not better than a hospital
- Affordable alternative: the National Association of Home Care states the average cost is $132/day, yet $544/day in a nursing facility
- And the greatest perk of them all – home-cooked meals…
Potential risks in a hospital setting
Hospitals are deemed the safest place to be if you’re sick. But is this always the case? In actual fact, if hygiene best practices aren’t used, there can be pretty serious health risks for patients. This can be fixed with pretty simple solutions. Of course, it’s not just hospital malpractice: they are places that house the sick after all, and so people can transmit infections to one another. And each year, 10% of all hospital patients contract an HAI – Hospital-Acquire Infection. That totals 1.7 million people, and 100,000 people sadly die because of it.
Some of the dangers of hospitals are:
- Psychological harm: think about it, it’s not exactly ‘natural’ to be bedbound in a hospital, with beaming lights, beeping machines and doctors coming to draw blood from you every morning. It’s a complete breakaway from your normal routine, and that can mess with you mentally. Coupled with sleep deprivation (because the hospital bed certainly isn’t as good as that king-size you’ve got back home) and medication, most people aren’t feeling themselves
- Physical harm: this is kind of a double-edged sword. You may need to take sedatives, which will disrupt your balance and you could fall over. Or, you may be bedbound for the hospital stay, but your muscles are weakened from a lack of movement. This can be solved with assisted walking in the hospital corridors with a nurse if it’s safe to do so. But it may be a question of has he/she got the time to assist you in walking?
- Preventable illness: medical errors do unfortunately occur in hospitals, such as the patient receiving the wrong medication. Now, of course, this can happen in a home environment, but you’d have to think the chances are greater in a hospital where a nurse may be tending to 12 or so patients simultaneously. It’s not quite like one-to-one personal care, where the environment is calmer where you can make calculated decisions more easily.
- Hospital discharge: if you aren’t given home healthcare, then you’ll be more at risk of continuing problems after discharge. This is especially the case if you have a chronic condition and/or spent a long time in the hospital (>30 days). You may have a hard time readjusting, and if you don’t have an occupational therapist or a language pathologist (e.g. to help swallow medication), you may really struggle to do your daily activities
But thankfully, the CDC shows that HAI’s are declining, showing the infection-control systems are working. And hospitals are making other small changes that have a profound impact, such as allowing the patients to walk about each day to prevent muscle deterioration. Or it could be an early discharge – what great news that is! Simple improvements can have great impacts.
When home care isn’t appropriate
Essentially we can break this down into 3 areas:
- Geographical location – is your house situated in an area of the world where home healthcare is sustainable?
- Structure of your home – can your house accommodate the medical supplies and equipment?
- Are there safety hazards within your home? – There could be many in-house limitations
For the geographical location, your home healthcare may not be available if you live in a rural village. So, there could be more power outages in rural areas, which is inadequate if you have electrical medical equipment. Maybe your local water source isn’t of a suitable quality to be used for medical devices. What if a device needs cleaning – will it need extra equipment filters to remove VOC’s for example (volatile organic compounds). You may have particularly ‘hard water’ that is more prone to depositing limescale that could block devices. Or perhaps you live in an area that’s prone to flooding, or natural disasters? I don’t think your insurance company will willingly set you up with home healthcare in this instance…
The structure of your home is a major factor because it could limit what equipment can be accommodated. Let’s say you live in an old high-rise flat with no lift, it may be difficult to get the kit up to you. Now it may be they can preassemble it once they’re up to your apartment, but what about your room sizes? What if your rooms are too small for the equipment or there aren’t enough electrical outlets? Also, you could add in the corridor sizes and width of doors. What if you’re supplied a wheelchair but it’s a struggle to fit through you’re front door and maneuver in corridors. Or even worse, there’s no lift…
Safety hazards are a big one because there are many things that can interfere with your devices:
- Pets – they could chew through some wiring and you’ve got the more subtle effects of fluff buildup. Naturally, pets will increase dust and detritus buildup, which could block tubing and small openings of devices over time. You may not notice it until there’s a problem in functionality of the device
- Perhaps you’ve got a lot of clutter in your home – adding in your medical devices and possibly medical supplies are only going to add clutter (even if it’s life-saving clutter), and adding to trip hazards
- Some people, unfortunately, live in particularly deprived housing. There may be damp, which could effect the electrical circuits of devices
- Disposal of medical waste- you could probably put this one under geographical location as well. So think about your local county, district or states regulations on putting used medical equipment in the bin. It may be against state law to put things like syringes in your ordinary bin and could require a special disposal location. Supposed it’s a considerable distance from the home and impractical for your location
- Children and toddlers– need I say anymore? Maybe a little – they could innocently tamper with buttons and configurations, chew on wiring, etc.
But even if you do get a pass for home healthcare, it’s important to be aware of some disadvantages. So just like with anything in life, there are the pros and the cons. Some disadvantages are:
- Financial – but you just said that it’s a cheaper alternative!? Well for the most part it is. But if you are treating for a chronic illness requiring long-term care, those costs will add up. Now, of course, paying for a long-term illness is going to cost you either way, and home healthcare is no exception. And all, the National Private Duty Association states the average cost is $22.37/hour for home healthcare
- Isolation – there will, of course, be many instances where the afflicted will have the care and attention from medical professionals and loved ones. But on occasions, family members may not be able to visit as frequently, and the nurse may only visit for an hour/day. It could make for a rather lonely recovery period
- More likely exposed to abuse– now this will be rare. Most human beings are good people, and medical professionals do what they do because they love to help people. But it’s not like a nursing home in that if there’s no family around to monitor the staff member, who’s to say they couldn’t be abusive?
- Burden on family – a sick loved one will only add to your chaotically busy lifestyle. As such, you could end up getting very little rest having to commute to their home every day after work. You might find yourself burning out very quickly
So that’s about it. I think home care is an excellent service for so many Americans and others across the globe. It can be so personalized because it’s one-on-one care. It’s great that both Medicare and Medicaid provide such services; the care is just as good as a hospital setting. Yes, it’s not perfect but the same can be said for hospitals and nursing homes. The important point is the services are always improving. I’ll leave you with this video on how we can continually advance patient safety in the home:
IHI: Institute for Healthcare Improvement video
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