Benefits of Moving Care Home

Moving care to the home is not an unhappy development. Ninety percent of US healthcare dollars go to pay for management of chronic disease.^[5] For much of that, care in the home is perfectly adequate; as technology improves, the quality of home care will improve along with it. Already, we can provide dialysis, x-rays and intravenous therapy at home. AI-powered chatbots now act as first points of contact for patients, gathering information and offering basic guidance before a virtual visit with a professional. Specialists of all descriptions can see patients virtually. The hospital-at-home concept permits management of even very sick patients in their own homes, and diminishes the patient’s exposure to the microbial milieu of the hospital and its risks of infection. Smart homes permit health monitoring, safety features such as automatic stove shut-offs, medication reminders, and connectivity to family and emergency services. The future will bring exponential expansion of these trends.

Stimulated by the pandemic, distance care continues to grow more capable, accessible, and accepted. Remote monitoring, which can be done as readily from home as in a hospital, can provide a cost-effective way to track the progression of chronic illness and to identify decompensation early, before it requires admission. Such prevalent and consequential conditions as diabetes, COPD, hypertension, some dysrhythmias, and heart failure can be readily monitored with relatively inexpensive, off-the-shelf devices already on the market. Traditional videoconferencing telemedicine can address many acute problems; that capability will only increase with time.

Care at home will also help rectify the isolation problem so common among seniors. Loneliness and isolation have serious effects, and remaining at home with loved ones, close to neighbors and friends, is an antidote.^[6] The home will grow not only more attractive as a site of care, but, increasingly, a superior one. To be surrounded by one’s loved ones and friends is a bulwark against isolation.

Falls are a serious problem, often in seniors a cause of not only serious morbidity but even mortality.^[7] Falls can occur at home. The probability of a fall is higher in unfamiliar environments such as hospital or SNF rooms, however. In the home, we will see risk assessments personalized for both the patients themselves and their environment, exercise programs to improve balance and health, and tailored safety features. Falls will remain a problem, but will become less prevalent.

Communities will increasingly be designed to make it easier for patients to gain access to the outdoors and engage in safe, healthful activities such as walking or bike-riding.^[8] The benefits of exercise are well-established, and neighborhoods of the future will be constructed to encourage residents to enjoy and thrive from more interaction with nature.