Home for the holidays
Steve Wogen, CareCentrix
The holiday season is a festive time when we gather with family and friends to celebrate life, enjoy each other's company, and take stock of the year that's ending while looking ahead with optimism and anticipation to the year that's about to begin.
For families with loved ones in hospitals or post-acute care facilities, the outlook of the season is often much different. For them, the holiday's hustle and bustle can be replaced with emotionally-drenched days, unsure whether the entire family will be at home, together, over the holidays.
The holidays may be particularly challenging for those caring for the terminally ill. In what's known as the “holiday effect,” researchers believe terminally ill patients often have a will to live through the holiday season. It is only after the festivities that they feel ready to say goodbye to loved ones. Social scientists speculate the holiday effect may be one reason for the increase in people passing during the first few weeks of the New Year.
We must do more to help patients go home.
Many years ago — before I was entrenched in the healthcare industry — my view of what it means to provide comfort to loved ones nearing the end of life was shaped by my family's experience.
After a battle with cancer, my grandmother was fortunate to pass away surrounded by her family and in the comfort of her own home. My grandfather's care was much different. Without home care options, my grandfather spent his last days in a skilled nursing facility.
The contrast between both experiences convinced me that we can and should do more to help patients understand the resources available to them to heal, age, and in the end, to die peacefully and without pain, where they'd rather be – at home.
Changes needed to support the path home
Improving the path home should be easy, but it's often not. The use of home care as safe and reliable benefit option is often misunderstood, if knowledge exists at all, by the patient, caregiver, and even the physician community. Coordinating the services needed in the home can become a challenge. Finding the right in home care team, and then ensuring it can be paid for under the patient's benefit can be daunting.
These challenges are easy to overcome, but require a multi-faceted management approach. First, benefit designs must promote the use of home care as an alternative to costly acute care settings, when appropriate. Second, reimbursement must support care at home. Third, care coordination applications and tools to find the ‘right match' of both services and in-home providers need to be widespread and transparent to patients, families, and physicians. Finally, patients and caregivers must be connected through technology platforms that alert the care team to changes in condition and provide remote access to care teams.
Our goal at CareCentrix is to address these opportunities comprehensively.
Taking care of each other
In a patient's palliative or post-acute care treatment plan, it's important not to forget caregivers, as they are often placing a patient's needs ahead of their own. Caregivers can suffer from excessive stress, sleep deprivation, poor eating habits, and failure to maintain their own health.
According to AHRQ's report Patient safety and quality: An evidence-based handbook for nurses, health professionals' lack of explicit attention to caregivers is a serious gap in health care concluding “caregivers are hidden patients themselves, with serious adverse physical and mental health consequences from their physically and emotionally demanding work as caregivers and reduced attention to their own health and health care.”
Appropriate caregiver support models, including education on in-home care options, coordination of necessary in home services, technology support and collaborative, customized care plans with near instant access to a care support team or nurse navigators will reduce the stress and responsibility caregivers today often carry alone.
As we celebrate the holidays this year, let's also commit to building the support systems that allow patients to go home. Collaboration and communication are the keys to bridging the care continuum.
Steve Wogen is the chief growth officer at CareCentrix.