If you or someone in your life encounters this need, you may be faced with many decisions that must be made fairly quickly. One of those decisions will be whether to receive care in the hospital or the home. According to the CDC, each year, 4.5 million U.S. citizens require long-term, end-of-life care.
What is Hospital-At-Home Care?
Hospital-at-home care is exactly what it sounds like. Modern technology and systems now allow for hospital-level care within the home environment. Patients that would normally be looking at long stays in the hospital due to chronic health conditions, may now have the option of bringing and have access to hospital-grade equipment and professionals right at their bedside.
Types of Hospital at Home Care
There are varying levels of healthcare that may be required within the home. The two primary types of hospital-at-home-care are medical and non-medical.
1 Medical
Medical care is prescribed by a doctor and it must be provided by a medical professional like a physician, a physical therapist, or a nurse.
Hospital-at-home medical care can be required for:
- Wound care
- Injections
- Physical therapy
- Speech therapy
- Nutrition therapy
Medical care can also be necessary for a short amount of time to allow the medical professional to educate the patient’s caregiver.
2 Non-Medical
Non-medical care is provided by a home health care aide and will involve assistance with day-to-day life.
Non-medical care may include the following:
- Bathing
- Dressing
- Meal preparations
- Errands
- Shopping
- Housekeeping
Non-medical care will require coordination between the care provider, the aide, and a medical professional.
How is Hospital-At Home Care Different From Hospitalization?
Hospital-at-home care and hospitalization can each be suited to different patient’s needs and there are benefits to each. This can depend on the patient’s desire for autonomy and mobility and the amount of time or severity that the patient is affected.
1 Hospital-At-Home Care
Hospital-at-home care can be best for patients with long-term needs and chronic health conditions. If the patient is at an age in life where it is difficult to complete day-to-day tasks but would still like to stay in their home, then hospital-at-home care may be beneficial.
The following struggles may indicate that the patient could benefit from at-home care:
- Keeping food stocked at home and regularly feeding themselves
- Hearing and answering the phone when it rings
- Cleaning up after themselves or maintaining personal hygiene
- Maintaining a healthy and fulfilling social life
Home health care can provide the patient with a strong sense of autonomy while still ensuring that their needs are being met. It can alleviate stress on family members or caregivers. It can improve the quality of life and lead to fewer hospital readmissions.
2 Hospitalization
Hospitalization for a senior or chronically ill patient can mean a long-term stay while being carefully monitored and cared for by a medical team. Hospitalization could be preferred even for chronically ill patients if they are averse to welcoming a stranger into their homes. A patient’s home may be a sacred and private space for them, and they may prefer to keep medical care limited to within the walls of the hospital.
Benefits of Hospital-At-Home Care
There are several benefits when choosing hospital-at-home care.
1 Care and companionship
A professional at home can solely focus on the patient. They have more awareness of the patient’s day-to-day needs, and they are usually able to build a bond that betters the quality of the patient’s life. This is especially important for seniors or chronically ill patients who live alone.
2 Comfort
It’s highly unlikely (but not unheard of) for a hospital room to be more comfortable than a patient’s home. The patient’s recovery or care will most likely be better facilitated when done in a place that they feel comfortable.
3 Time spent with loved ones
It’s difficult in the long term for a family to continuously gather at the hospital. Especially later in life, it’s important to families that they can maximize their time with the patient. This is easier to do when hospital-level care is brought into the home environment.
Who Benefits from Hospital-At-Home Care?
1 Patient
The patient can live in their own space that is comfortable to them.
2 Caregiver
Having a professional at home who can assist in daily living activities can take the stress off of family members or caregivers who are often already overwhelmed with duties.
3 Medical Team
Having a professional at home allows for the entire medical team involved in the patient’s health to have eyes and ears on the ground floor of the patient’s life. This leads to a better understanding of the patient’s needs.
Home Care versus In-Patient Hospital Costs
Costs vary based on the provider and the severity of the patient’s needs. Research has shown that supporting an in-home patient can cost 52% less than hospitalization.
These results can be due to:
- Reduced ER visits with more consistent care
- Reduced exposure to other illnesses at the hospital
- Shorter treatment times and more acute care
Johns Hopkins Model of Hospital-at-Home Care
The Johns Hopkins Model was developed for elderly patients who refused to be admitted to the hospital or would be put at risk from hospital-acquired infections.
The Johns Hopkins Model involves a step by step process for Hospital-at-Home Care:
- Identify a patient in need of hospital-at-home care.
- Assess if the patient’s home is suitable for hospital-at-home care integration.
- Assign a physician to be responsible for the patient’s care management.
- Explain the program to the patient and supply them with the necessary equipment.
- A caregiver and physician collaborate on the treatment protocol.
- The patient is monitored daily.
- If the patient is doing better, they are put into the custody of a primary care physician.
The Johns Hopkins Model has led to lower hospital readmission rates, higher satisfaction among patients and family members, and require shorter treatment times.
How Technology Bridges the Gap Between Home and Hospital?
Hospital-at-home care is easier than ever with the use of telemedicine, remote patient monitoring, better care coordination by involving interdisciplinary care teams for patients’ post-discharge care. While the patient is being monitored carefully, this may not require a physician traveling to that specific home, but they may be able to meet virtually via various video and audio conferencing platforms. Hospital-at-home care requires immense collaboration across a team of those invested in a patient’s well-being.
Rainbow Health assists in making collaboration easy by keeping everyone in the loop. The caregiver can see when appointments are scheduled, the physician can communicate what needs are not being met with others involved, and a patient may even be able to access more autonomy in their life by scheduling rides to appointments in the future or having food delivered to their home.
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