Post-Acute Care: Hospice and Home Health
March 10, 2021
The population of the US is aging. Baby Boomers are the second largest generation, behind Millennials, and are turning 65 in large numbers. This older population is prone to multiple illnesses and, as a result, requires professional medical care both in the doctor’s office, in hospitals, and as part of post-acute care. Hospice and home health considerations are of great concern to those in the medical field as well as to the individuals and their families.
A Population in Need
According to the Society for Post-Acute and Long-Term Care Medicine, approximately a fifth of the population in the US will be 65 or older by 2030. Of that age group, over half have at least three medical problems. As the Baby Boomers age, the population of individuals over the age of 85 is projected to increase to 14.1 million by 2040. The Society estimates that 30,000 geriatricians will be needed to care for this group by 2030 and, to meet that need, 1,500 geriatricians will have to be trained every year over the next 15 years.
A patient who is released from the hospital after long-term care or surgery typically needs follow-up care. Known as post-acute care, this next step in the patient’s care plan can take place in a rehabilitation facility, a skilled nursing facility, a hospice center, or at home, among other options. Understanding which is best for the patient depends on that particular patient’s situation, including their medical diagnosis.
Post-acute care is growing along with the growth of the aging population. It is considered an essential health and social service and accounts for over $2.7 trillion spent on personal health care. Post-acute care accounts for almost 15% of total Medicare spending. Since post-acute and long-term care patients are a unique and vulnerable population, they need the care of qualified professionals trained specifically for their situation. They may experience multiple comorbidities as well as cognitive impairment and face difficult choices for their care.
Benefits of Being Home
Post-acute care provided through home health services enables the patient to be in the place where they may feel most comfortable while they recover. Depending on the individual’s living circumstances, home may actually be more beneficial to them than a nursing facility or rehab center. The Centers for Medicare and Medicaid Services (CMS) tends to agree, as it took a step in September 2020 to support care transitions to home-based settings from long-term care facilities.
The CMS Administrator at the time, Seema Verma, stated in making the announcement, “The tragic devastation wrought by the Coronavirus on nursing home residents exposes America’s over-reliance on institutional long-term care facilities. Residential care will always be an essential part of the care continuum, but our goal must always be to give residents options that help keep our loved ones in their own homes and communities for as long as possible.”
CMS has provided $165 million in supplemental funding, designed to jump-start a migration toward home-based care. As Verma added, “Home- and community-based care is not only frequently more cost effective, but is preferred by seniors and adults with disabilities seeking to maintain the dignity of independent living.”
Home health care is typically less expensive and is more convenient for the patient and their families. It can be just as effective as care received in a hospital or a skilled nursing facility. Home health services can include patient and caregiver education, wound care, intravenous or nutrition therapy, and monitoring serious illnesses and unstable health status. Home health care can help the patient regain their independence, become as self-sufficient as possible, and improve or at least maintain their current condition or level of function, depending on their medical needs.
Home Health Drawbacks
Post-acute care provided in the patient’s home has many benefits, but those all depend on the patient’s particular living conditions and on the quality of the healthcare services being provided. There are some drawbacks to consider as well. The home may need to be fitted with ramps, chairlifts, or railings, which may be costly. The care provider may change from week to week, which could be unsettling to the patient and to the family.
In addition, the patient may not trust someone from a home health provider coming into their home. They may feel vulnerable and alone. Reassuring them that the care provider is qualified and trustworthy will help reduce their anxiety in this area. Some people may also actually prefer the socialization aspect of a skilled nursing facility or other residential care option.
How Hospice Helps
Hospice as a post-acute care option usually comes into consideration when the patient is expected to live for another six months or less. Hospice care offers support for the family as well as comprehensive comfort care. Hospice professionals provide support, but a patient’s day-to-day care in the home is typically provided by family members and friends. A member of the hospice team will visit regularly, and someone is available by phone 24/7.
Everyone on the hospice team works with the patient and with family members and caregivers to provide the emotional, spiritual, and medical support needed. Most families say they are more satisfied with the end-of-life care that was provided through hospice, as opposed to those who did not have hospice care, particularly as the patient is more likely to have their pain controlled while avoiding additional or unnecessary tests or medications.
Effective and Timely Assessment of Patients’ Health Problems
At IntellaTriage, our focus continues to be on providing the highest level of care for clients, no matter the time of day. We have more than a decade of experience providing nurse triage calls and patient engagement services for those in post-acute care.
Our phone triage nurses and aftercare professionals, all Registered Nurses, provide sound medical advice for patients concerned about a home healthcare issue. We integrate with our providers’ systems to ensure consistent, high quality care for hospice patients. Contact IntellaTriage today for more information about our essential phone triage and aftercare services.