Diversifying the care circle to deliver care at home – MedCity News

During the pandemic, seniors and vulnerable populations became more dependent than ever on their care circles, including everyone from children and grandchildren to neighbors, professional helpers and healthcare providers. Care circles played a crucial role in help with errands, such as dropping off groceries, as well as nursing care, and offering that human connection they were no longer receiving from the outside world. Fearful of long-term care facilities and nursing homes, more older adults chose to receive care at home. The Wall Street Journal’s analysis of federal data found that U.S. nursing home occupancy rates dropped 15% starting at the end of 2019. What’s more, in a September 2020 AARP poll of adults over age 40, 28% of respondents said they were less likely “to opt for facility-based care” for an older family member.

Seniors and vulnerable populations also became increasingly reliant on easy-to-use technologies to interact effortlessly with their care circles from home during the pandemic. In a January 26 blog post, Peter Rinderud, senior researcher of statistics at Ericsson, said during the pandemic more seniors turned to the internet and their devices due to isolation and feelings of loneliness. This was on the tails of seniors already closing the “smartphone usage gap between them and younger generations,” he notes. According to Ericsson research of seniors in eight countries, including the U.S., “half of seniors browsed the internet daily in 2016; now as many as 81 percent do that daily.” More seniors are also instant messaging and using social media, watching videos, and doing video calls on a daily basis, according to the study. Internet skills will be critical for seniors moving forward as “more health appointments, services and products are migrating online,” Rinderud points out.

Technology has also been important for the many seniors who are part of “restricted networks” in which they have fewer sources of support and little interaction with network members. According a 2018 study in The Journals of Gerontology, seniors have four social network types, including restricted, child based, friend-oriented, and diverse. Friend-oriented networks are more common in Western and Northern European countries. Researchers say, “those with restricted networks tend to have the poorest well-being,” due to “few sources of support and little interaction with network members,” while those with diverse networks fare the best. Earlier research also suggests that as individuals age, well-being is determined by structure, function, and quality of social networks. However, for those with restricted networks, technology that connects to the outside world, perhaps has become even more important.

As we move into a post-pandemic world, it is becoming abundantly clear that there is a new normal for older adult and vulnerable populations—they prefer to continue to receive the majority of their healthcare and other services at home. With approximately 85% of older adults having at least one chronic condition and 60% having two or more conditions (according to the CDC), we can expect to see a pattern of continuing wariness of in-person visits to the doctor and the emergency room for the foreseeable future and thus a greater reliance on technology.

Beyond telehealth: Technologies that support safe aging in place

Moving forward, we must offer older adults and vulnerable populations multiple channels to connect with their care circles for healthcare services, medical emergencies, ongoing monitoring, and a chat with a loved one. The introduction of new care models and technology advancements over the last few years have opened up more options that enable an individual to age safely at home. We expect to see an acceleration of the following technologies as seniors increasingly choose to spend more time at home in a post-Covid-19 world. 

  1. Personal emergency response systems (PERS). During the pandemic, this technology became even more essential to home-bound seniors and vulnerable populations by offering immediate medical help and fostering human connections. Rather than being dependent on a cell phone, individuals can press a button via a device worn around their neck and get help for any reason. PERS systems connect to an operator at a call center within seconds. The technology allows the operator to send an appropriate responder based on a person’s needs, including emergency services, caregivers, family members, or neighbors. As seniors continue to spend more time at home, a human voice can offer a sense of security and safety that doesn’t happen through voicemail or text.
  2. Remote patient monitoring (RPM) and hospital at home models. Older adults with chronic conditions such as diabetes and high blood pressure, as well as more acute illnesses, are more likely to receive care at home moving forward due to the physical difficulty of going to a doctor’s office or hospital and the lingering fear of Covid-19. RPM and hospital at home models will play a critical role in their ongoing care. Over the last few years, RPM technology has become more advanced and simpler to use. For example, patients can easily take their blood sugar and blood pressure at home using wireless devices that transmit information to a dashboard and a medical professional who is watching and responding. The hospital at home model uses similar technologies to offer acute patient care.
  3. Prepackaged apps. We will also see mobile apps that bring together care circles, helping seniors, vulnerable populations, and other individuals become more engaged with loved ones, friends, and healthcare professionals. These apps will come pre-loaded with an individual’s care circle, allowing one-click texting and calling to access family and friends, shopping, and other activities. For instance, a person will be able to access news and events (like the daily weather) happening in the world around them to reduce social isolation.

The new healthcare ecosystem

The new ecosystem of providing healthcare and safety in the home is here to stay and will continue to evolve as more healthcare consumers ask for it. By 2030, one in five Americans will be 65 and older, according to the U.S. Census. Seniors, including Baby Boomers, will influence RPM and hospital-at-home growth trajectories significantly as their numbers swell. An AP-NORC Center study published in May 2021 finds that 88% of Americans prefer to receive care at home as they age. Only 2% say they want to receive care in a nursing home.

The broader healthcare system will also benefit as technology increasingly allows care to move more effortlessly into the home. For example, once patients leave the clinical setting, clinicians often lose visibility into a person’s health and safety. PERS and RPM technologies can fill these gaps by generating key patient data (on patient falls, calls into a call center, and chronic conditions, etc.) that lead to actionable insights and proactive intervention.

With access to more real-time patient information, clinical teams can coordinate care or change a plan of care based on these insights. One critical example of these technologies in action took place during the peak of the pandemic when PERS systems were able to identify Covid-related symptoms early on, leading to interventions before a person’s condition deteriorated and they ended up in the emergency room or the ICU. At the same time, providing care teams with actionable patient data frees them up to spend time on those who need it most while reducing hospital admissions and readmissions.

New healthcare technologies are taking the pressure off of the healthcare delivery model to provide costly, labor-intensive care in hospitals and doctor’s offices. Early interventions are reducing costs and helping individuals live at home with dignity and safety while supporting holistic, value-based care. As we head into the future, we will only see technology continue to play a more significant role in improving our health as we age, allowing us to live at home longer and even to age in place in our forever home.

Photo: AJ_Watt, Getty Images

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