Can reducing healthcare costs
for our elderly be as simple
as providing them with a little household help each day?
Purdue University researchers think this may be the case.
They say older people who do not have help for daily tasks
such as dressing and bathing are much more likely to be
hospitalized for acute illness than those who receive the
help they need. The result is a piling on to already steep
healthcare costs for our aging loved ones.
As a possible antidote, a research team says it has found
evidence that older adults who qualify for nursing-home care
because of their disabilities can continue to live in their
homes provided they receive assistance with fundamental
needs such as bathing, dressing and preparing food.
Elders who lived alone without such needed assistance were
more likely to require hospitalization. After a few weeks of
help with daily tasks, however, the need for healthcare
dropped off, implying that a little help with the basics
goes a long way, said Purdue nursing professor Laura P.
Sands.
"While such essential care would not include the cost of
visits to the doctor, our data suggest that people who
receive additional assistance would be less likely to be
hospitalized, and that could conceivably allow us to keep
our health care-costs down while still providing for our
frail elders," said Sands. "As our population ages, there
will be more need to find economical ways to care for this
group, and adequate home-based care could be both less
expensive and more effective for some than full-time
nursing-home care."
To examine what effect living with unmet needs had on the
use of medical services, Sands' team studied 2,943 frail
older people enrolled at 13 sites nationwide in the Program
of All-inclusive Care for the Elderly. The program provides
medical and social services that also meets the daily living
needs of those eligible for nursing homes.
"Nearly 30% of adults aged 75 and older have one or more
disabilities in performing basic activities of daily
living," Sands said. "Additionally, of the more than 2.3
million older adults with severe disability, 84% receive
some form of public health insurance. We wanted to find out
what might be done to help this group more effectively."
According to the group’s report published in the Journal of
the American Geriatrics Society, those who lived with unmet
daily living needs before enrollment in the program were
more likely to live alone and to have been admitted to a
hospital or nursing home in the previous six months.
"People who have difficulty with bathing, dressing and
walking across a room require our healthcare system to a
greater extent," Sands said. "Those who have trouble
performing such activities have higher rates of
hospitalizations, longer hospital stays, and more physician
visits than those with no disabilities."
But after six weeks of receiving the program's services, the
number of hospital admissions for those who had been living
with unmet needs significantly declined, becoming similar to
the admission rates of those who had their needs met before
enrollment.
"What this suggests is that if a homemaker or personal
assistant helps these frail elders for a few hours a day,
they would be less likely to experience medical conditions
such as hunger, dehydration, falls and skin problems that
occur when disabled older adults do not receive needed help
with daily tasks." Sands said. "As our government is under
increasing pressure to develop fiscally feasible solutions
for caring for disabled older people, we feel providing
disabled elders with adequate home-based care should receive
further attention."
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