The New York Times wrote an article on ‘Too Little Too Late’ about a growing epidemic among older Americans: bankruptcy. What does that have to do with healthcare and discharge planning? A lot, actually. The article shared the story of a senior with Parkinson’s disease whose wife was battling cancer and how, when he lost his medical coverage after his union changed their eligibility requirements, they were left to credit cards to pay for medical expenses. Until of course, those ran dry.
For ‘about three in five (seniors)’ escalating bankruptcy rates were due to ‘unmanageable medical expenses.’ A sad story and one you may be all too familiar with. As we transition clients’ home after hospital stays, how do we ask the right questions that address all social determinants of health, not just medical issues, to ensure success once they are home?
Gaps in our current system, especially for those with chronic health and social issues that so often lead to the roller coaster of crises for seniors, as mentioned in the NY Times article, have to be closed. That’s where you come in.
We all have a responsibility to help people make informed decisions about their post-acute care but also to provide the data that supports the choices offered. But despite all these efforts, it all comes down to a person-centered approach – seniors and their family caregivers want advice, want human direction, want guidance in moments when they are overwhelmed, stressed, and concerned about paying for senior care. Instead of sharing an alphabetized list of home care providers, educate them on how to make the most out of their choices by choosing providers that address these cost-saving measures:
- Social isolation – In a KTSP segment on ‘Inside Your Health’ Archelle Georgiou points to social isolation as a growing problem in Minnesota for seniors and the risk it poses on their health. For example, consider those clients who are going home after surgery to repair a broken hip, how will they get out of their home to do the things that make them feel whole: grocery shopping, card playing, beauty salon, etc.? These things matter.
- Reducing the need for care – Once home, how will the home care provider they choose work to reduce their need for care long-term? What outcomes do they have to demonstrate how they have helped clients save money? Help them identify providers who work to build their independence (and protect it – see next bullet) because the more they can reduce or even eliminate their need for care, the more seniors save.
- Prevent hospitalizations and ER visits – These visits are where medical expenses can soar and most can be prevented. The easy-button for seniors facing an issue at home is all too often a 911-call. Help them identify home care providers who use a proactive approach to prevent health care crises from occurring in the first place. Every ER or hospital visit prevented saves your clients money and quality of life long-term.
- Invest a little to save a lot – Often health and senior care professionals are so worried about protecting seniors’ money that they don’t even mention private-pay options to clients. This can actually have a detrimental impact on their long-term health costs. Often the gaps left by insurance-covered options are where seniors can quickly decline into another major health care crisis. Investing in ongoing support and guidance through a private-pay option that works to prevent health crisis can help seniors maintain their independence at home longer. Vern Gillespie was told he’d never go home again, and he was spending upwards of $7,000 a month for long-term care, all he wanted to do was to go home to ride his John Deere tractor again. By choosing a proactive model for home care, he was able to not only go home but also reduce his need for care to just $300 per month – a $90,000 a year savings.
- Sparked living – One way to combat social isolation is to focus on how seniors can live with purpose and meaning every day. Increasingly, as Dr. Georgiou noted, this not only improves quality of life, but protects people’s health. And protecting people’s health saves them money. Teach the seniors you discharge to ask potential providers questions about client engagement and how the provider addresses life goals, not just health goals. When the care plan reflects the client’s goals, not just the provider’s, seniors are more likely to be actively engaged in the plan. Client engagement is a critical component in medication adherence, following through on discharge plans, and overall wellbeing. Studies show that goals and plans that focus on the individual’s purpose and passion can improve outcomes long-term and keep seniors thriving.
The right post-acute experience can positively impact people’s health costs long-term. It also plays a critical role in preventing hospitalization and unnecessary ER visits and improving outcomes once they are discharged home. Educating our clients on how to make wise post-acute care decisions is one way we can help lessen the medical cost burden that is leading to the rise of bankruptcy in seniors.
We are curious to hear your experience, are your surprised by the bankruptcy rise among seniors? How are your discharge plans addressing long-term costs? Share On!