Why Being Proactive About Your Age In Place Plan Is Critical

A recent study by Vanderbilt University Medical Center found results that show the more Home Health Agencies (HHAs) that surround a hospital, the higher the readmission rate is.?What that means is that if you live in an area with a lot of home health agencies that are offer at home care to keep you out of the hospital, then you are more likely to return to the hospital if you have been recently discharged. This is against what most of us might think, considering HHAs have been around to help our parents stay out of the hospital.?Is this a result of the workforce challenges that have plagued this industry for over a decade or is it something much deeper that goes into the core of how HHAs fundamentally operate today??I took a deeper dive and met directly with the researcher that conducted the study, Dr. Kevin Griffith.?If you are wondering do the results hold true for Arlington County and Fairfax County hospitals as well with all the Home Health Agencies that surround them, the answer is yes, your older loved one is more likely to return to the hospital after being discharged in Arlington and Fairfax.

?

“If you have more HHAs (Home Health Agencies) in your area, you tend to have higher readmission rates.”

While this was not the core reason for the study, it was an interesting find that was a small portion of their published research that caught my eye.?Home care has not changed or evolved in the ten plus years that I have been closely following it.?Prices have gone up, difficulties have increased, but nothing else has changed or evolved for the better.?As our world changes and our parents desire to remain at home increases, we do not see the results going in the direction we want them to, that is why this study concerned me so deeply.

“Our thinking is that with this, it is associated with the frequent staffing changes”

Home Health Agencies have long experienced workforce challenges, they are the largest industry with the higher turnover rate.?Pay has been a driver of that along with the need to drive out to the home.?As costs to the families to engage home care continue to go up, families in fact do the opposite and cut the frequency of care.?Home care is a seesaw, one end is raising prices so they can have people to send to your home but the other end cannot afford the rise in price and cuts back.?This has happened before the pandemic and now has become worse.?Home care is hard, those who choose to go into the profession have exceptional qualities of care and compassion for others, but when those people can get paid more to serve coffee and leave to do so, do we expect that the quality of staff will remain the same when HHAs have to lower the bar to fill the ranks??When an HHA does find someone to come to your home and care for your parents, there is a 82% chance that person will quit and your older loved one will have to begin the cycle all over again with a new caregiver.?That repeated cycle of turnover and changes in who is caring for them does negatively impact your loved one.?When I asked Dr. Griffith, could high turnover rates add stress to clients??“When you have discontinuities in care, it is opportunities for the ball to get dropped” says Dr. Griffith.

?

?

“One it could be discontinuities in care that perhaps a ball gets dropped, but also if you are just coming into a new clinical relationship and you see something that might be concerning, you might tell them to go back to the hospital but perhaps this [behavior] is normal for the patient.”

?

Home health care today is not set up to handle the transitions between caregivers and the frequency with which it occurs.?This negatively impacts the older adult but this is not the only issue.?Home health care is reactive by nature, they see something, they do something.?If they arrive at client’s home and the client does not look well, they have them go to the hospital.?This happens because in the current model of home care, there is no data as to what happens in the home.?Home care today and for the last ten years or more have always been chasing issues, never ahead of them.?This problem will only get worse as the frequency of care decreases coinciding with rising prices as I stated above.?The more frequent you can visit a client and the more information you can have on that person on a day-to-day basis as it relates to their daily living, the more successful you can be at having them stay at home and out of the hospital.?But this is not how home care operates today and this is why we need proactive alternatives to age in place.?I asked Dr. Griffith, based on a lot of the data you had access to, on higher readmissions with more HHAs. How comfortable do you feel with home care to keep a family member out of the hospital today??“Who does this work best for, who does it not work best for and how can we council people so they can make more decisions informed by evidence and their likelihood of a successful recovery once they are discharged, I do not think that is done, at least not on a consistent basis, I’d be shocked if it is done anywhere” says Dr. Griffith.

?

The Main Conclusion

The more HHAs that surround a hospital to take care of your parents when they are discharged, the greater the chance that they will return to the hospital.?We need more proactive age at home alternatives to help combat this issue that is only going to get worse as prices for home care show no signs of decreasing and the challenges home care face get worse.?High cost for care at home, high turnover rates for the caregiver you get, lack of day-to-day data to understand the older adult and the inability to be proactive on issues all play roles in why older adults are returning to hospitals.?I encourage families to get involved to fill the gaps in home care where they can and if they cannot to explore alternatives to home care to help ensure a proactive age at home experience.?

#homecare #eldercare #ArlingtonCounty #FairfaxCounty #seniors #seniorcare #olderadults #olderamericans #readmissions #homecareagencies #careathome Vanderbilt University Medical Center #ageinplace #ageing #ageingwell #ageingpopulation #eldercareservices #elderlycare #elderly #olderpersons #proactivecare INF Care #AgeinPlacePlan