Using Home Health Care to Help Senior Housing Residents Age in Place

Alyssa Gerace | February 21, 2012 | Comments (0)

This article is part of a series following “Will the Nation Go Broke Paying for Senior Housing & Long-Term Care?“
The whole aging-in-place movement can be scary for senior housing providers who worry about how their occupancy levels might be affected with seniors increasingly wishing to remain in their own homes, but they can take advantage of the concept for the seniors who are already living in their facilities with the help of home health care services.
The average age and acuity of current residents in both independent and assisted living facilities is going up, and those who are moving in are often older, says Ryan Frederick, principal of Point Forward Solutions, a consulting and financial advisory firm serving the seniors housing and care industry.
Some younger seniors aren’t choosing to enter assisted living because of the higher age and acuity demographics, while those who enter independent living are staying longer before transitioning to a higher level of care.
But despite a longer independent living stay, residents’ overall length of stay is shorter, and many places are experiencing a higher turnover than what they’ve historically had, says Frederick.
“If you’re a CCRC provider, you’re having a harder time bringing younger people in because of aging in place, and you’re gonna be facing a higher turnover,” he says.
It’s a big issue for providers to figure out how to handle this, as high turnovers can be quite costly, and many are beginning to expand their services in order to accommodate changing demographics.
Home Health Care Increasingly a Factor to—and in—Senior Living Communities
As consumers and state governments alike increasingly turn to home health agencies as a more affordable source of senior care, some senior living providers are making sure they’re not left out of the movement by buying agencies or incorporating home care into their communities.
Many signs point toward the declining viability of the next couple generations of seniors being able to afford their long-term care in nursing homes. A generous number of nursing home residents already depend on Medicaid to fund their stays, but as Medicaid eligibility expands and census grows, state governments are looking for ways to deliver care less expensively, and home-based care is one such way to do so.
If senior living providers don’t want to be shut out of the business opportunities presented by the thousands of Baby Boomers, many of whom will be needing some sort of long-term care in the next 15-20 years, they might want to consider integrating home health services.
Providers Adding Health Care Services to Communities
Brookdale Senior Living’s strategy, for example, is adding healthcare services to their communities to help people age in place.
They’re using Care3 Wellness programs through Brookdale’s Innovative Senior Care program, which includes a Medicare-certified home health care service. Care3 Wellness is described as a “comprehensive nursing, therapy, and wellness system” that can help residents retain or improve their independence.
The program’s benefits include the potential for residents to have “better health at any age in any senior living environment,” with residents assessed by senior care professionals on a voluntary basis to determine which segment of the Care3 Wellness Program they would best fit into, according to Brookdale, based on their personal level of health, fitness, or mobility.
Acquiring or Partnering With Home Health Agencies
Some senior care companies, such as The Ensign Group, Inc., (NASDAQ:ENSG) are going a slightly different direction and expanding services by acquiring home health care businesses.
In December, Ensign acquired Homecare Solutions, a Denver, Colo.-based home health agency. This “lateral diversification broaden[ed] Ensign’s reach into that business,” said Christopher Christensen, the company’s president and CEO.
Ensign most recently made headlines for its purchase of Connected Home Health, a Portland home health agency, with Christensen again speaking to the company’s move to grow and develop its home health business.
These two agencies join Ensign’s existing similar operations: Horizon Home Health and Hospice in Idaho; Custom Care Hospice in Texas; Careage Home Care, in Iowa; and Symbil Home Health and Hospice, in Utah. The businesses are operated through affiliates of Cornerstone Healthcare, Inc., Ensign’s home health and hospice-based portfolio subsidiary.
Home Health as a Conduit to Assisted Living Care?
Emeritus Senior Living, based in Seattle, Wash., is considering tapping into the home health care market.
The company currently offers “complimentary home visits” where an Emeritus nurse will do an assessment of a senior in the community and in many cases identify needs that aren’t being met. Then, the senior living provider attempts to connect the individual and their family with resources to help meet those needs, which in some cases could be home health care.
For now, Emeritus is referring these seniors to home health care agencies, but in the future, says the company’s president and CEO Granger Cobb, it’s possible they’ll offer their own home health care services.
“It makes a lot of sense to kind of marry the two,” says Cobb, referring to partnering with home health care. “If we have a licensed home health agency that can fit in nicely with our home visit program, it probably offers even more options in terms of how we can benefit seniors at home.”
However, he also points out that while a home health agency would complement the company’s service offerings, it could also provide a referral conduit into Emeritus communities in the event that it became more cost efficient for someone receiving home health care to enter a facility.
“Generally it’s more affordable to a senior—to a point, when they have someone come in for a few hours a day,” he says. “But when it reaches a point where it’s eight or 10 hours a day, usually assisted living is a more affordable option.”
Rather than seeing the aging in place movement as a foe, senior living providers have the option of incorporating home health care into its existing assisted living and independent communities, whether it’s through a subsidiary operation or a third-party agency. And it’s possible to go still further and expand service offerings to include home care for seniors who haven’t yet joined senior living communities, especially as this could eventually serve as a referral base for potential future residents.
Written by Alyssa Gerace

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2 Votes

(VA) Aid and Attendance Pension rate

Aid and Attendance Rate Increase

Week of February 06, 2012

The United States Senate Committee on Veterans' Affairs approved a rate increase in the Veterans Administration's (VA) Aid and Attendance Pension rate. The VA Aid and Attendance Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also encompasses individuals who are blind or in a nursing home due to mental or physical incapacity and offers eligibility for assisted care in an assisting living facility. For more information, visit VA's Veterans Pension Program webpage.
For complete guides to all veterans benefits, visit the Military.com Benefits Center

CLASS ACT Repeal

“Killing the CLASS program without offering an alternative is irresponsible, ignores a growing problem, and lends credence to the view that too many members of Congress are out of touch with the struggles of middle-class American families,” said Jim Firman, president and CEO of the National Council on Aging (NCOA).
For over two decades, Congress debated how to address long-term care before passing the CLASS Act last year. CLASS would encourage personal responsibility by providing a cash benefit to people needing care at home through voluntary premiums and, according to the Congressional Budget Office (CBO), would save Medicaid dollars.
“Repealing CLASS would likely delay serious efforts to address the need for long-term care reform for another two decades,” added NCOA’s Firman.

How to Succeed at Juggling Caregiving Burdens

 

January 24, 2012 RSS Feed Print

My wife and I recently opened our home for nearly three months to care for a cherished family member and her spouse. What more valuable use of our home, time, and resources could we possibly have, we thought. And we were right. But there were costs—to our family finances, our privacy, and our working lives.
In a very small way, we experienced what millions of Americans live with, many on a constant, long-term basis. More than 65 million of us spend an average of 20 hours a week as unpaid caregivers. Looking only at people being cared for who are at least 50 years old, 90 percent of them are family members.
[See What to do About Retiree Healthcare Costs.]
Family caregiving is now experiencing the inescapable impact of several related trends:
1. The American family has splintered over the past 40 years. Women, the traditional caregivers, are more likely to work, to marry later, if at all, and to have fewer children. Older Americans are increasingly likely to live alone and far away from family members.
2. Older Americans are the nation's fastest-growing population group. Steady increases in life spans are a terrific achievement, but one that raises the odds that elderly family members eventually will become infirm and require care, perhaps for many years.
3. Healthcare costs have risen for years at rates far in excess of overall inflation. They are bankrupting our society. Medicare and Medicaid are running unsustainable deficits. Still, individuals are shouldering their own mountains of healthcare expenses. Studies have found that unanticipated healthcare costs, driven by accidents and chronic illnesses, are the largest cause of personal bankruptcy.
4. The extended recession and weakness in the economy have sapped pocketbooks and reduced people's ability to provide unpaid care to family members.
[See Pat Summitt, at 59, Takes on Alzheimer's.]
Half of family caregiving is provided to a mother (36 percent) or father (14 percent). Grandparents and in-laws each receive 11 percent of all caregiving, and spouses care for one another in 6 percent of the cases. These numbers come from research funded by MetLife in 2009, and sponsored by the National Alliance of Caregiving in collaboration with AARP. An Alliance spokesperson says the findings remain accurate.
More people—caregivers, as well as those being cared for—are older. Among caregivers, 55 percent are older than 50, compared with 47 percent in 2004 and only 38 percent in 1997. Among people receiving care who are at least 50 years old, 31 percent are 85 and up—the so-called "old old"—versus 24 percent in the earlier surveys.
Nearly everyone age 50 and older (96 percent) takes prescription drugs, and half of these people need help from caregivers with their medications. Half of all caregivers also hold full-time jobs, making for a lot of stress. Most caregiving is for long-term physical or mental conditions, and the average caregiving situation lasts 4.6 years.
AARP has been doing a terrific job researching and publicizing the rising societal weight of family caregiving. It also has looked at ways for individuals and institutions to improve a caregiving system that evolved in an earlier time before today's pressures appeared. Late last year, the group highlighted caregiving memoirs and advice of 10 authors. It showcased their work and analyzed the common challenges they faced.
[See 7 Lifestyle Behaviors Linked to Alzheimer's.]
If you are involved in family care—either as the caregiver or recipient—here are 10 common realities of care that AARP identified. By learning to anticipate and cope with these challenges, the quality of care can improve. So can the caregiving stresses borne by family members, most of whom are trying to do what's right.
1. Caregiving is a role (and a relationship).
2. Families benefit from discussing preferences and decision making with each other and with healthcare professionals.
3. Long-term services and supports (LTSS) are expensive.
4. Communication, coordination, and collaboration are fundamental to good care.
5. The most vulnerable and traumatic points in healthcare and LTSS are transitions from one setting to another.
6. Some help and support to care for the caregiver is available if it can be found.
7. Being "proactive" is the key.
8. Public policy solutions are crucial.
9. Advocacy, at both the individual and system levels, is a fundamental part of caregiving in today's world.
10. Culture change is needed.
Here are the 10 authors and caregiving works that AARP highlighted:
1. Howard Gleckman, Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis (New York, NY: St. Martin's Press, 2009).
2. Jane Gross, A Bittersweet Season: Caring for Our Aging Parents—and Ourselves (New York, NY: Knopf, 2011).
3. Robert L. Kane, MD, with Jeannine Ouellette, The Good Caregiver: A One-of-a-Kind Compassionate Resource for Anyone Caring for an Aging Loved One (New York, NY: Penguin Group, 2011).
4. Carol Levine, editor, Always on Call: When Illness Turns Families into Caregivers (Nashville, TN: Vanderbilt University Press, 2004).
5. Suzanne Geffen Mintz, A Family Caregiver Speaks Up: "It Doesn't Have to Be This Hard" (Herndon, VA: Capital Books, Inc., 2007).
6. Walter Mosley, The Last Days of Ptolemy Grey (New York, NY: Penguin Group, 2010).
7. Peter V. Rabins, MD, MPH, with Nancy L. Mace, The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer's Disease, Related Dementias, and Memory Loss, 5th ed. (Baltimore, MD: The Johns Hopkins University Press, 2011).
8. Jonathan Rauch, "Letting Go of My Father," The Atlantic, April 2010.
9. Gail Sheehy, Passages in Caregiving: Turning Chaos Into Confidence (New York, NY: HarperCollins, 2010).
10. Cheryl E. Woodson, MD, To Survive Caregiving: A Daughter's Experience, A Doctor's Advice on Finding Hope, Help and Health (West Conshohocken, PA: Infinity Publishing.Com, 2007).