As we move along our aging path, we encounter events or issues for which
we are not prepared. One of the biggest events is the advent of aging and
subsequent deterioration of our parents.
Society puts great emphasis on the 'downtrodden.' However, issues on aging
know no economic bounds. There are all sorts of help available for low
income seniors through local, state, and federal governmental agencies.
There are multiple not-for-profit organizations involved in delivering
care and comfort for low income seniors. All of these resources are needed
and valuable, but who is looking out for the seniors who don't qualify
for any of these services? Just having financial resources doesn't automatically
mean you have the ability to care for yourself. We must make aging the
issue regardless of our resources.
Many baby boomers will have adequate financial resources available as
they age. Today, the boomers are faced with the aging and care of their
parents. Tomorrow, boomers will face their own issues of aging. What goods
and services will be available for the boomers as they age? How will health
care be delivered in the next twenty years? How will home care be delivered
in the he next twenty years? Currently most people desire aging in place,
remaining in their own homes or retirement living arrangements. As the
boomers reach these needs, what will be available?
The vast majority of seniors today do not want to end their lives in a
nursing home and the boomer will follow this pattern.
The most important health care person to enable seniors to remain in their
homes is a physician. No in-home medical services are performed without
a physician's orders. This should be the beginning of the cycle. Proactive,
preventive health care for seniors would be far less expensive than waiting
for a crisis to occur.
We need to develop a group of physicians who are 'stay at home' advocates
for our seniors.
In the stay-at-home model, simple mobility can be a problem coupled with
transportation. Our stay at home physician groups should develop nurse
practitioners or physician assistants that can 'make house calls.' If seniors
have trouble accessing health care, take health care to them.
Helping seniors make their homes safer would help ease the booming health
care burden. Preventing falls and accidents is easier than treating the
injuries created by falls and accidents.
Transportation of seniors to office visits and required laboratory work
becomes an ever increasing problem. We already have the ability to perform
many testing procedures in the home.
Health Care campuses need to be more senior friendly. We need to develop
centralized, easy to access, safe parking for seniors throughout our community
with regularly scheduled shuttles to the front door of the appropriate
We should ensure proper and appropriate reimbursement rates through Medicare,
Medicaid or private insurance to cover physician related house calls. By
streamlining and delivering proactive, preventive health care, both the
physical and financial burden would be improved.
Physicians or those prescribing in-home services should not have financial
ties to in-home service providers. We need to develop competitively priced
goods and services required to help seniors stay home. The vast majority
of services required to help seniors remain in their homes is assistance
with daily living activities. The amount of time required for in-home medically
necessary services is minimal. Even in today's rest home model, the vast
majority of services are non-medical assistance with daily living activities.
We need to separate in-home medical services from in-home non-medical
services. The medical model does not have the ability to deliver personal
care goods and services on a competitive basis. The medical model is highly
bureaucratic, over regulated, and its hierarchy is difficult to change.
The ability and skill to understand and manage the delivery of non medical
goods and services is different than those for the delivery of health care.
You wouldn't ask your doctor to tune up your car nor would you ask a registered
nurse to wash your clothes.
Locally our largest providers of in-home services are nurse owned or hospital
owned home health agencies. Medical institutions have figured out how to
justify charging over $5.00 for an aspirin. We can buy a bottle containing
well over 100 aspirin at Wal-Mart for less than $5.00. Why do we think
medical institutions are going to provide personal care economically?
In the future, Home Care needs to be delivered by separate providers
from Health Care. Today, Health Care is trying to be all things to all
people. Health Care should concentrate on the delivery of health care.
Forward as recited from “Think Ahead
of Disaster” by Eric Naegler