A rapid rise in senior home health care service is not likely to subside soon, not with an estimated 10,000 baby boomers retiring per day.
Alexandria Brown’s family got in on the ground floor of the fast-growing industry.
Brown is director of finance for a West Columbia-based franchise of international home health care service Right at Home. Her family, seeing a growing need, went into the business around 12 years ago, when there wasn’t quite as much competition as today.
“It has changed quite a bit,” Brown said. “Everybody’s realized where the need is, and that places like ours can make a difference.”
According to the Centers for Disease Control and Prevention, 12,400 home health agencies existed in the U.S. in 2014, in addition to 4,800 adult day service centers, 4,000 hospices, 15,600 nursing homes and 30,200 assisted living residential care communities. Almost 5 million patients received home health care in 2013, the CDC said.
That number has no doubt grown. A 2012 AARP study found that 90% of seniors planned to continue living in their current homes for the next five to 10 years. While 85% of those were confident in their ability to do without making major home modifications, nearly two in 10 Americans age 70 and older said they either could not accomplish or found it hard to complete daily tasks without assistance. Fifteen percent weren’t confident their finances would sustain them through retirement.
That’s where home health care services come in. Less expensive than daily visits from registered nurses, caregivers like the 150 or so employed by the Right at Home franchise offer options to seniors whose families may live out of state or need help juggling responsibilities.
“We do everything from running personal errands, light housekeeping, any cooking that needs to be done, bathing, dressing … We’ll never leave someone unattended,” Brown said. “We’ve had to get up and do cases at three o’clock in the morning.”
Right at Home also works with independent and assisted living facilities and partners with Lexington Medical Center’s hospital-to-home program, which assigns eligible patients 20 home health care hours after being discharged to help prevent readmission.
Numbers from the Lexington Medical Center Foundation, which administers the program, show its value. The initiative began in 2016, and in October of that year, six patients were referred into it. Four had had emergency department or inpatient hospital stays 90 days prior to their admission. Two were readmitted within 30 days after release.
The program, which focuses on patients with chronic diseases such as heart failure and chronic obstructive pulmonary disease or who have had procedures such as joint replacement, steadily took on more referrals. In July 2017, 28 patients were referred, 13 with previous hospital stays. Four were readmitted within 30 days. Last September, three of 25 referred patients – eight of whom had been previously hospitalized – were readmitted.
“The goal is to get people out of the hospital,” said Thomas Tafel, foundation community outreach manager. “With these co-morbid and chronic diseases, you see a lot of the same people, and so the goal is to get them well and get them well enough to be on their own.”
Hospitals also benefit from reducing readmissions. Centers for Medicaid and Medicare Services data indicate 20% of Medicare beneficiaries will be readmitted to an acute care facility within 30 days, which translates into 2 million admissions with an annual cost of $15 billion.
Tafel said patients sometimes call an ambulance to get assistance with non-emergency tasks, resulting in another admission.
“If they can get some help just doing daily things, we can get them out of the hospital,” he said.
Right at Home caregivers, who do not perform medical services, spend the night if needed but are not live-in aides. The agency provides care for a minimum of three hours a week up to 24 hours a day at $22 an hour and accepts long-term care insurance, private pay and respite vouchers through a state-funded relief program for qualified families.
“We see a lot of people that are really grateful that we’re there, especially if they’re far-away family members,” Brown said. “It allows them to know their parents are OK.”
An interactive family portal allows loved ones to log in and see pictures of caregivers and their daily schedules and tasks. Caregivers are required to have at least one year of hands-on experience in a hospital or similar facility, be licensed by the state and pass background and random drug tests, Brown said.
“We try as best we can to get the best out there as far as our employees are concerned,” Brown said. “It weeds out a lot of people. It also prevents us being able to hire as many people as we’d like, but for us, it’s worth it. (Clients) need to be able to trust that whoever is in there is going to do a good job.”
Receiving validation for the work is one of the best parts of an often-challenging job, said Brown, who recalled meeting the daughter of a client Right at Home helped for four years before the client’s death two months ago.
“Her daughter came into town and came into our office. It was our first time meeting her in person,” Brown said. “She was extremely grateful because she just had peace of mind knowing that we were there. … Our caregivers kind of become part of their clients’ family. They depend on that person, physically but also emotionally. They’re a support for them, and companionship.”