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The Future Of Home Health

Home Health

I would like to let you know what I heard and how the future of home health will look.  About eight years ago a physician out of John Hopkins did a demonstration study called Hospital at Home.  Though the number in the study was low the outcomes and the savings to Medicare were significant.

So far I have seen very little movement toward implementing this as a standard for home health until the 2017 CAHSAH conference.  In one of the networking meetings, I met a gentleman who said that he wanted to start up a Hospital at Home. Finally!!  My vision for the future of the home health industry is that all home health agencies will have three divisions; the Acute team, the sub-acute team, and the chronic team.

Acute Team

The Acute team will be made up of acute care nurses, specially trained aides, emergency level physicians, pharmacists, and therapists. Infusion and respiratory services will be available if needed patients will be referred from the emergency room to the team who will meet the patient back at home after the ER has done the stabilization of the patient.  The nurse and the MD will do a joint assessment that establishes the plan of care.  The first two to three days will have around the clock nurses, gradually passed off to hourly aides a week or less.

Sub-Acute team [currently the home health team]

If the patient is stable and reasonably self- sufficient, they will be pass to the sub-acute team which will see daily X two and every other day for 4 days.   If not a chronic condition dc if patient is managing and acute issue is resolved.  If the patient has a chronic disease that has resulted in repeat ER or hospital stays, the patient is referred to the chronic team whose job is to prevent any further emergent care issues.

Chronic Team

The Chronic care team has a Geriatric Care Manager, a physician and aides.  All aides are assigned based on their preparation and the needs of the patient.  Some patients will need ongoing aide support and others will need only the skilled nurses and physician oversight.  Services will be dependent upon need and may vary over time.

 

Ginny

Electronics And Apps For The Universal Home

Electronics and Apps

Last week we talked about the design elements that are being incorporated into home designs and remodels that make a home livable for all ages and needs.  Today we are going to discuss the emerging electronics and apps that will be incorporated as part of the new Universal Home.

Currently there are what I call general use apps that are applicable regardless of age or disability.  These already exist and are in current use.  In the future, these apps will be incorporated as part of the home and will be either voice directed or motion directed.

Most of this technology already exists, but with the rapid advance of technology there will be many more added in the future.

“We’re no longer in the realm of future tech — today you can control and automate your home right from your smartphone without spending a fortune and without a centralized home automation system” Grant Brunner

In the future, these “apps’ will be part of the home construction.  The Universal Home will be “wired” with what we currently can only get through a smartphone app.

Current Apps Available:

Phillip Hue:  This is a lighting system that has the ability to dim, brighten, and change the color of its bulbs on command

Nest Thermostat:  Once you have it installed in your home, you just treat it like a normal thermostat. You turn it up when you’re home, down when you leave, and up again when you wake up. Soon it will learn what your pattern is and you’ll always come home to a house that is the perfect temperature. This kind of learning system is a huge step forward in the smart home.

Wemo:  This is a combination of a switch, a motion sensor, and an iOS app. Once this devices installed in your house, you can control any device you have plugged in right from your iPhone. Did you leave the light on downstairs? Do you want the TV to be on for you when you come home from work? Put it on a timer. With the motion sensor, you can even have everything turn on when you enter a room, and turn off when you leave.

Video Intercom or Smart Door Bell:  A video intercom is great for your house because you can see who’s at your front door before you open it.

Smart Alarm:  The installation of a smart home alarm system will provide security levels at home alerting to potential emergency situations in the home.

Smart Leak Detection:  Detects water leaks from a number of sources ranging from leaking pipes to refrigerators.

Smart Energy Control:  The IL 2.0 paradigm supports a number of energy saving devices ranging from motion sensors and wireless light switches to smart thermostats and energy monitoring units.

Smart Cameras:  cameras allow you to view live video images on your smartphone. Additionally, they can be configured to record live video when an alarm is detected.

 Current apps specifically for seniors that in the future will be a standard part of the Universal Home:

  • Smart stove alarms alert older adults to potentially dangerous situations in the kitchen. More than just smoke detectors, which only sound when smoke is actually present, new stove alarms sound alerts before toxic gases are produced, helping older adults prevent potential fire hazards.
  • Smart medication pillboxes offer audible or visual cues for older adults to prompt them to take their meds. at the proper time.
  • motion-activated lights that can be installed in the homes of those wishing to live independently. Motion-activated reminders can be installed and customized to the routines of older adults.  For instance, a motion-sensitive device by an entrance way can be set to trigger a reminder for an older person to lock the door or check the identity of the person knocking before opening the door

motion-sensitive device by an entrance way can be set to trigger a reminder for an older person to lock the door or check the identity of the person knocking before opening the door

  • Smart thermostats that can be activated by remote control or even by voice command, thereby eliminating the need to get up to adjust temperature settings. Such devices can also be monitored remotely by caregivers to ensure that temperatures in the homes of older ones remain comfortable and safe.
  • large, high-visibility displays that are both easy to see and manipulate with stiff fingers; key-less entry locks for those with arthritic hands, and curtains or blinds that can be operated with remote control devices.
  • Safety and security features that allow an individual to activate an emergency call to emergency systems
  • ADL Systems: An ADL system will help you age in place by continuously providing key information to your loved ones and caregiver.
  • Health monitoring Wearable: Monitors health status and can report to an emergency provider of family member if there is an identified issue

Our world is changing rapidly. The home of the near future will allow all of us regardless of age or degree of disability to continue to live in our own homes.  Truly aging in place

Ginny Kenyon

The New Private Duty Home Care Economy And The Rules

Private Duty

Private Duty Home Care Economy

It’s no secret that our economy has changed in crucial, fundamental ways that are redefining what it means to be successful in private duty home care. Competition has increased in some markets as people displaced from other industries see private duty home care as an attractive business opportunity. Consumers are less likely to purchase high-hour services, and nervously seek cheaper, untrained, unsupervised alternatives to what professional private duty home care companies provide. Marketing has emerged as a full-time role for Private Duty home care companies that wish to become known as preferred providers with a recognizable brand. Overhead has increased in the form of regulation and oversight, increased expectations of consumer families, due diligence in hiring and orientation, and the requirements for maximum efficiency. Growing your Private Duty home care business, demands that you take several steps to adapt to the new tough economy. Read more…

The Homes Of The Now And The Future; The Universal Home

Universal Homes

The Universal Homes Of The Future

I am hearing more and more about Universal homes these days and it is beginning to appear in home health related news. “Universal design, also called barrier-free design, focuses on making the house safe and accessible for everyone, regardless of age, physical ability, or stature. True aging in place!

When thinking of home design for disabilities, most of us think immediately of ramps and grab bars when we think of accessible housing, but universal design goes far beyond that while remaining largely invisible to the casual observer. In fact, applying universal design concepts such as wider doors and hallways makes a house feel more spacious.”

As Fred Astaire said, “Old age is like everything else,”. “To make a success of it, you’ve got to start young.” These same principles apply to home design: Plan for all stages of life when remodeling or building, even if you are in perfect health now. You never know what life may throw your way, be it be a minor mishap (breaking your leg) or something more serious (being confined to a wheelchair)”

The most important aspect of Universal Design is flexibility. Remember that technologies are always evolving and your lifestyle is similarly inclined to change at a moment’s notice. Universal Design allows your home to transition with you as life happens rather than forcing you to work around frustrating barriers.

So, what will the home of the future look like?  The following is just a beginning of what I am seeing architects begin to incorporate into home designs:

  • There will be limited use of stairs,
  • lighting systems will be automatic, coming on when someone enters a space and turn off when they leave [motion sensors]
  • large windows, French doors, placed throughout the house to maximize natural lighting. Additionally, the use of skylights and solar tubes to bring in natural light
  • Curbless showers, grab bars designed to look like part of the feature not like an addition, towel and robe hooks next to the shower, recessed storage in the shower for soap, shampoo and conditioner
  • Faucets throughout the house that works with touch or movement
  • Levered handles on doors
  • Soft slide cabinet and drawers that require little effort to open and close
  • Slip resistant floors
  • Cabinets that sit on the counter space for easy access
  • Increased space between areas especially in the kitchen that accommodate a wheelchair or a walker

These are a few of the elements that we will be seeing in all home designs and remodels.  Next week we will cover the expanded use of apps that are being incorporated into the universal home.

Excited To Start Up Your New Home Care Agency?

Home Care Agency

Achieving the Ultimate Success

When we start a new home health, home care or hospice business and are experiencing the excitement and exhilaration of the new venture, we seldom remember that we are building beyond the near future. We are also building for the time we retire and/or sell our agency or have a succession plan to pass it to our children. The best time to think about what your home health, home care or hospice agency will be worth is at the very beginning.

When starting up any business, the business fundamentals — matters that must be tended to before you do anything else – need to be hammered out first. What do you want the ultimate outcome for your successful home health, home care or hospice agency start-up to be? Is this going to be your retirement or a legacy for your children? For instance, if it is for retirement and you feel that you will need several million in your retirement account when you sell the agency, you will want to build an agency that is structurally sound, operationally efficient, with cash flow and incomes to meet that goal. So how do you do that? Read more…

The Future of Transportation and Home Health

Transportation

Self-Driving Cars?

One of the big costs and barriers for home health agencies is transportation.  How many times have we all lost money on unfilled shifts or visits because of car problems?  At the CAHSAH conference last month we heard that some agencies are solving the problem by using Uber.  While it does cost the agency a bit more, it is more than made up by not having the entire shift lost because the aide or nurse had car problems.

With the projection that in the very near future most of us will have self-driven cars, this will be less of a problem especially if as projected. An article I read that posted on theguardian website provides some insight into this impending innovative approach to transportation. We will not own the cars. Instead, there will be a monthly bill to pay for the use of a car that will be summoned by cell phone to pick us up and drop us off.  No more missed shifts or visits and for those of you with teenagers, no more speeding tickets or totaled cars, as the cars all have sensors that prevent crashes as well as maintain the speed limits and are not driven by the younger drivers.

Are Your Home Care Policies and Procedures Up-To-Date?

Home Care Policies and Procedures

Not long ago, we had the privilege of doing an organizational assessment in a small rural home care agency. When we asked about the policy and procedure manuals, we were told they were at least 15 years old, and had not been updated.

In the home care business, especially with smaller agencies, it’s easy to overlook the need for well-documented policies and procedures. However, home care policy and procedure manuals are very important for your agency. They provide a framework for your operations, and help ensure you remain compliant with state requirements and industry regulations. A home care manual also makes your values and expectations clear to employees, defines training procedures, and sets administrative policies.

Ginny Kenyon, RN, MN, Principal

Kenyon HomeCare Consulting

The Future Universal Home

Universal Home

 

Continuing on with last week’s blog on technologies, let me present you with the universal home of the future that in the next ten to twenty years will be our reality.

How Will Technology Change Health Care Services In The Home?

The Universal home will have motion sensors, cameras inside and out, with facial recognition.  The house will be wired with a “Siri” type of artificial intelligence (AI) that is much more advanced than it is today.  The roof will have roof tiles that function like solar panels and will be wired into the house electrical grid to provide electricity to the home. [These already exist through Elon Musk’s {Tesla} company and are expected to hit the market this year or next].  Windows will be non-glare that allow for day and night time and will adjust with the outside light to maintain a constant light in the house.  The AI will be trainable to your specific wants and needs. [ again, both already available]

Imagine walking up to your home and have the AI greet you with welcome home, open the door and ask if you need anything or let you know that what you have programed is ready.  Some will want a drink poured and waiting at the wet-bar others may want a snack, or just a recap of all the phone messages that were left for the day.  The AI can be programed to whatever you want.  The house temperature is maintained at whatever you set it and adjusted by the AI as you request.  All orders to the AI will be voice driven and of course voice recognition so only approved voices can direct same as the camera.

Televisions, radios, etc. will be activated by your direction and to the stations you prefer.   Meals will be prepared for you with your preferences and for the number of individuals that will be present.  The fridge will give you a list of what is in the fridge and the AI will place an order with the grocery delivery company for delivery on a specified day.  The house will have a preprogramed sweeper that keeps the floors clean and further in the future you will have a house robot that can load and unload the dishwasher, clean the furniture, do the laundry, fold and put away the clothes, make the bed and any other tasks you need done.

Think how this will change your health care services in the home.  If you think this is fiction, know that in Japan where the caregiver shortage is more severe than ours, they already have developed robots called care-bots to care for their elderly.  It is coming faster than we can even imagine.

Ginny Kenyon, RN, MN, Principal

Kenyon HomeCare Consulting

Importance Of Chronic Disease Education To The Homecare World

Chronic Disease Education

Why Is Chronic Disease Education Important?

Managers and business owners have discovered that basic training doesn’t always prepare students for work in the real world. Is that to say required training isn’t important? Not at all. It simply means that caregivers need continued chronic disease education to stay abreast of constant changes, new medical discoveries and proven outcomes. Then these caregivers will truly impact the world of homecare!

Fortunately, chronic disease education exists to meet this pressing need. The right disease education program enhances every aspect of homecare – your clients, caregivers, and organization.

The Future is NOW!!

technologyLast week I attended the California Association for Health Services at Home (CAHSAH) annual conference. It was an exceptional conference with a lot of great presentations.  I walked away with a couple of themes; technology is moving faster than we ever anticipated, so fast that it is going to be hard to keep up.  Rules and regulations will continue to evolve and Home Health and Hospice as we know it now, will not look or be the same.  I will discuss the different aspect of these topics in future blogs. Today’s focus will be technology.

One of the presentations was facilitated by Craig Falk, who owns Craig Cares, a Home Care agency in California. He has recognized that for clients and families to be able to afford care he needed to implement technology into his care services.  As a result, he has developed a program called “Sensor Safe“, which uses current technologies available such as motion sensors, and sensor pads to help monitor individuals that need monitoring, but not necessarily around the clock attendance.  The program is designed such that if the motion or pad sensors indicate that  the client has moved, say from the bed at night to the bathroom, those movements will be noted.  It there is no additional movement in 20 minutes the system sends an alert that the client may need help. The lack of motion triggers a phone call to the home.  If it is not answered, an Aide is dispatched to check on the client.

This program is in its initial stage and there is more to come from the trials already done.  The limited use so far has documented that one client did in fact need 24/7 care, another client saw that they could reduce their monthly expenditure in half and as a result, a new client was gained for the agency.  Total gain from 5 patients including new ones gained as a result has shown a $300,000 gain for the year for only 5 clients.  More to come when the program is really up and running in its completed state.

 

Ginny Kenyon