Many Americans find themselves providing care for elderly loved ones. It seems never anticipated problems endlessly arise, such as maintaining quality of care and juggling long distance caregiving. On top of that, most people do not know how to evaluate or manage care provided by caregivers or monitor the quality of care received by their loved ones.
With the ever changing landscape that elder care has, how can families easily assess the level of care provided to their elderly loved ones while at the same time protect themselves from charges of abuse and neglect?
A recent pilot study approved by Harvard Medical School has found some initial success in a simple tool that aims to reduce hospital readmissions and neglect among home care patients. The study, which was conducted over 6 months in early 2016, found that caregivers who utilize a short checklist about their patients’ conditions were able to report a number of changes that could result in more costly care interventions or criminal charges if left untreated.
The study is one of the inaugural projects under the newly established Healthcare Markets and Regulation Lab at Harvard Medical School, supported in part by the Laura and John Arnold Foundation.
The program consists of two components: early identification of changes in a patient’s condition and monitoring (or helping to manage) these changes in the home.
Caregivers were required to clock-in and clock-out of a web-based software platform that operates for visit scheduling, integrated point-of-care reporting, two-way caregiver messaging and other managerial functions. The check-in events included a checklist about the patient.
The auditing checklist asked a number of questions, such as, ”Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition or increase in swelling?”
If a caregiver notes any changes in condition, they receive additional questions before receiving a task on the system dashboard. The care manager or primary family caregiver can use that task, along with more information from the caregiver, to determine potential actions for the patient.
“Most interviewees suggested that changes in condition would not have been reported without the in-home checklist,” the study reads. “They also reported relatively few ‘false positives’ in that they felt that most of the tasks warranted attention.”
Dr. Cathleen Carr, Executive Director of CertifiedCare says the answer is for the public to use a Senior Care Auditor (SCA). She says, “Senior care auditing is the new ‘aging in place’ service”.
During the course of the study, caregivers throughout the home care study pilot offices that participated reported condition changes after 2% of all shifts, representing an average 1.9 changes per care recipient. Caregivers noted that the changes likely wouldn’t have been tracked if the checklist weren’t in place.
The study looked at random sample of various offices of an agency with franchises in 45 different locations across the country offering varying levels of care to their clients.
SCAs complete an audit of the residence and senior by evaluating the premises and person(s) condition (not health condition, but mood and appearance). While onsite, the Senior Care Auditor completes the checklist and transmits it to the client via email.
“This service helps ensure the safety of seniors who are home alone or in their institutional environment. This service also ensures that seniors are receiving the proper quality of care they need, and that they are not being abused or neglected”, Carr says.
Senior Care Auditing is a new service expected to grow substantially over the next 30 years as the population of seniors sharply increases. U.S. Department of Commerce Economics and Statistics Administration reports that “In 2050, the number of Americans aged 65 and older is projected to be 88.5 million, more than double its projected population of 40.2 million in 2010.”
Communities across the country need Senior Care Auditors for the growing population who want to stay at home well into their 80s, 90s and 100s.
Fortunately, caregivers reported that the checklist had a largely positive effect and felt “enthusiastic about the intervention,” according to the study. They even noted that the checklist did not add much time to the clock-out process overall, and enjoyed feeling they had a larger role in the overall care of the care recipient.
Elder neglect and hospital readmissions are one of the costliest expenses across the health care system, and senior care auditing can play a big role in reducing avoidable readmissions and criminal charges of neglect.
By Abigail Bazer