Aging In Place Directory

#68 - How Home-Based Healthcare Supports Aging in Place

• Esther C Kane CAPS, C.D.S. • Episode 68

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 In this episode of the Aging in Place Directory Podcast, we explore how home-based healthcare empowers older adults to live independently, safely, and comfortably in their own homes. From skilled nursing visits and in-home therapy sessions to telehealth check-ins and palliative care, discover how medical services brought directly into the home are transforming the way we age. 

You’ll learn about the benefits and challenges of home-based care and get practical tips for families considering this option. Whether you’re a caregiver, senior, or professional in the aging field, this episode sheds light on why home-based healthcare is becoming such a vital part of aging in place. 

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Speaker 1:

Welcome back to the Aging in Place Directory podcast, where we talk about the practical ways older adults and the people who love them can live safely and comfortably at home for as long as possible. I'm your host, robin Schiltz, and today we're diving into a topic that's been changing the way people think about growing older how home-based health care supports aging in place older, how home-based health care supports aging in place. If you're a caregiver, an adult child helping your parent plan for the future, or a senior who just wants to feel more independent, this is a conversation you'll want to stick around for. Before we get into the details, let me start with a story. My neighbor is 82 years old. She is fiercely independent. She also has a tomato garden that she loves. A couple of years ago, she had a fall that resulted in a hip fracture. After surgery, she was faced with a decision Go to a skilled nursing facility for recovery or recover at home with physical therapy and nursing help that came directly to her house. She chose home-based health care and it not only kept her out of an institution, but it also meant she could keep tending that garden and it was an incentive for her to get up and walk around like she needed to do. Granted in the garden, she worked from a tall raised bed and had her walker nearby, but it gave her happiness and it motivated her every day.

Speaker 1:

To me, that is exactly what aging in place is all about. It's keeping people in the homes they love, surrounded by familiar things, while still getting the care they need. So what do we mean when we say home-based health care? Well, it's more than just home care. Home care usually means help with daily activities like bathing and meal prep and light housekeeping or being a companion, but home health care is a clinical service. It's medical care that's brought into someone's home, usually provided by licensed doctors, nurses, physical or occupational therapists and sometimes even specialists. This type of care can include post-surgical recovery support, chronic disease management, like diabetes or heart failure, physical, occupational or speech therapy, medication management and IV treatments, palliative or hospice care and remote monitoring through telehealth. In other words, it's hospital level or clinical level care that happens right in your living room instead of in a facility. And here's something else that's pretty cool Studies show that people tend to recover faster and feel less stress when they're cared for at home. Hospitals can be noisy, disorienting places, but home is familiar, comforting and safer from exposure to infections.

Speaker 1:

The need for home-based health care is only rising. Aarp surveys have found again and again that nearly 80% of adults over age 65 want to stay in their homes as long as possible, but with longer lifespans thanks to advances in medicine, we also have more people managing multiple chronic conditions at once. Add to that the shortage of nursing home staff and the rising cost of long-term facility care, and it's no surprise that families are turning to home-based health care solutions. So let's break down the main ways this kind of care supports aging in place. There's skilled nursing, where a registered nurse can visit regularly to change bandages, check vital signs, manage medications and coordinate care with doctors. This means fewer trips to the emergency room and more consistent monitoring.

Speaker 1:

There's therapy at home. Physical therapists can help someone regain strength after a fall or surgery. Occupational therapists can teach practical skills like how to navigate the kitchen safely or how to use grab bars in the shower. Speech therapists work with stroke survivors or those with conditions like Parkinson's. There are doctor visits at home and, yes, this is actually making a comeback.

Speaker 1:

Some health care systems and concierge doctors now make house calls For older adults with mobility issues. Not having to travel to every appointment can be life-changing. There's also telehealth monitoring. Covid helped to accelerate digital tools for health care. Now, wearable devices and remote monitoring can track blood sugar levels, heart rhythms, oxygen levels and even medication reminders, with health care teams watching from afar. There's also palliative and hospice care.

Speaker 1:

This is a sensitive topic, but it's worth mentioning. End-of-life care at home allows people to spend their last days in peace with family around them. Families often say this is one of the most meaningful aspects of home-based care. So what are the benefits of home-based health care? Well, there are many, but three really stand out. One is independence, because staying at home means keeping routines and caring for pets and hobbies, and you have a sense of control. The second is cost savings.

Speaker 1:

Home-based health care is often a lot less expensive than a nursing facility or extended hospital stay. Medicare and private insurers frequently cover it. Less expensive than a nursing facility or extended hospital stay. Medicare and private insurers frequently cover it. There's also better health outcomes. Studies show fewer re-hospitalizations, faster recovery times and lower rates of depression when people recover at home.

Speaker 1:

Now let's be realistic, though. Not everyone has equal access to home-based health care. Some of the biggest challenges include workforce shortages, because there simply aren't enough nurses and therapists to meet the demand. Also, there are technology gaps. Telehealth assumes someone has internet and can use a smartphone or a tablet, but that's not true for every senior. There are also insurance limitations. While Medicare and Medicaid cover a lot, certain services or longer-term support might not be fully covered and families may have to pay out of pocket.

Speaker 1:

There's also caregiver burnout. Even with home-based healthcare, family caregivers are often doing the coordinating and providing day-to-day support, which can be emotionally and physically exhausting. So while the system is expanding, it isn't yet perfect. Family caregivers are the quiet partners of home-based healthcare. A nurse might visit your home twice a week, but the daughter, the son, the spouse, the neighbor they're usually the ones making sure medications are taken, meals are on the table and the patient feels safe at home. That's why caregiver training is such an important part of this process. Skilled clinicians can actually teach families little things like how to recognize the signs of infection, how to properly support with safe movement transfers or how to handle medical equipment. Empowering family members reduces stress and improves outcomes.

Speaker 1:

So let's talk about where technology meets home-based healthcare. This is one of my favorite parts, because technology is making home-based care more possible than ever. There are smart devices like Alexa that can remind someone to take a medication. There are video doorbells that let seniors see who's at the door without risking a fall to get up and answer it. There's wearables that can alert providers if someone falls or if their heart rate spikes. And there's virtual visits that let doctors drop in. Through a tablet, they can check medications, answer symptom questions excuse me or even adjust recovery plans without requiring a car ride to their office, or even adjust recovery plans without requiring a car ride to their office. In other words, technology is bridging the gap between independence and medical support.

Speaker 1:

Now, when care comes into the home, it's not just a medical thing. There's also a deep emotional impact. Many seniors feel embarrassed or defeated when they have to leave home for a long-term care situation. Home-based services allow them dignity. They get to sleep in their own bed, eat their own food and continue being part of their neighborhood. Social isolation is a risk for many older adults. Social isolation is a risk for many older adults. Home health care professionals often become trusted, regular visitors, offering not just care but also companionship. That sense of connection is sometimes just as healing as the medical treatment itself.

Speaker 1:

If you're thinking about home-based health care for yourself or a loved one. Here are some steps to make it easier. First, talk to the doctor. Ask if home-based services are an option for that specific condition. Next, contact your insurance and find out what's covered. Medicare has detailed criteria, but does cover a wide range of home health services. Then interview agencies. Not all providers are equal. Ask about their staff training, experience in emergency procedures and their communication style. After that, set up the home. Small modifications like adding grab bars, clearing clutter or using medication organizers make care at home safer and use tech tools. Even if your loved one isn't tech savvy, simple devices like medication reminder clocks can be lifesavers.

Speaker 1:

The future of home-based health care is exciting. We're moving toward a model where hospital-at-home becomes mainstream. Some major hospitals are already piloting programs where high-acuity care so things like IV, antibiotics, oxygen therapy or advanced wound care are done entirely at home, with nurses and telehealth check-ins. That means fewer unnecessary hospital stays, lower costs for families and the system, and happier seniors who want nothing more than to stay where they're comfortable. As you see, aging in place is about more than just surviving. It's about thriving. Home-based health care bridges the gap between medical necessity and personal preference. It allows older adults to live safely, independently and with dignity, while families worry less and enjoy more meaningful time together. So the question isn't if home-based health care will shape the future of aging it already is. The real question is how we as families, caregivers and communities will continue to support and expand these services so they are available to everyone who needs them. Thanks for tuning in today. Until the next episode, take care Bye.

Contributor

Esther C. Kane, CAPS, C.D.S.

Host