By Val J. Halamandaris
Many have speculated about the greatest legacy of the 20th century. In my view, it is the gift of longevity. Augustus Caesar, credited for the first studies of life expectancy, found the average Roman lived to be 33 years of age. By 1900, 19 centuries later, life expectancy had only been extended 12 years. In the 20th century, it increased by 33 years, with genetic engineering offering the promise of more sharp gains in the future.
While medical science has set back mortality, individuals who live longer lives will increasingly need assistance to cope with their disabilities.
In 1995 for the first time, more people died of chronic disease than of acute disease. What this suggests is that the future will be about the management of chronic disease and not acute illness. The number of people going into hospitals will be fewer and they will spend less time there. What will increase but geometric progressions is the number of people cared for at home.
The press of demographics and increased life expectancy are the primary reasons why the demand for home care services will increase. Here are some other reasons:
- Home care is delivered at home. Our home is our castle, our refuge from the storm. When we are happy we go home to celebrate. When we are not feeling well we seek the sanctity of our home and the comfort of being with loved ones.
- Home care keeps families together. There is no more important social value. It is particularly important in time of illness.
- Home care helps the elderly maintain their independence. None of us wants to be totally dependent and helpless. With some assistance, seniors can continue to function as viable members of society.
- Home care prevents or postpones institutionalization. No one wants to be placed in a nursing home unless this is the only place where we can obtain the total 24-hour care that we need.
- Home care promotes healing. There is much scientific evidence that patients heal more quickly at home.
- Home care represents the best tradition in American health care. Most healthcare has always been given in the home. A visit to the hospital is the exception rather than the rule.
- Home care is sager. For all of its lifesaving potential, some 20% of the people who enter a hospital develop a complication such as an infection. The incidence of such risks at home is near zero.
- Home care allows a maximum amount of freedom for the individual. A hospital of necessity, is a regimented, regulated environment. The same is true of a nursing home.
- Home care is personalized care. Home care is tailored to the needs of each individual. It is delivered one-on-one.
- Home care, by definition, involves the individual and the gamily in the care that is delivered. The patient and his family are taught to participate in their health care.
- Home care reduces stress. Unlike most forms of health care, which can increase anxiety and stress, home care has the opposite effect.
- Home care is the most effective form of health care. There is a very high consumer satisfaction associated with care delivered in the home.
- Home care is given by special people. By and Large, Home care nurses and aides look at what they do as a calling not as a job. They are motivated by the psychic income they receive helping people get better rather than by wages that tend to be comparatively low.
- Home care is the only way to reach some people. In many of the rural parts of America or dense urban areas, home care is the only form of health care available. Nurses and aides visit patients in remote areas on horseback or by jeep. In urban areas they may be accompanied by armed guards to bring the healing mission into high-crime areas.
- Home care extends life. Studies by schools of nursing and by government agencies established beyond a doubt that home care extends longevity. The visits by home care personnel help people not only medically but spiritually.
- Home care improves the quality of life. Home care not only helps add years to life, but also life to years. Studies in the US and abroad show that those receiving home care have higher rates of satisfaction with life.
- Home care is the most efficient form of health care. This is because it is personalized, it uses the patient’s own home, instructs the patient, enlists the patient’s family as caregivers t cuts down on expensive travel to hospitals, and minimizes expensive hospital stays. Historically there has been comparatively little fraud and abuse associated with federal payments for home care.
- Home care is less expensive than other forms of care. The evidence from studies around the world(Including massive new studies in Canada), demonstrate that home care is always far less expensive than hospitalization and almost always less costly that comparable placement in the nursing home.
- Technology increasingly makes home care the preferred mode of health care delivery. Telemedicine, a spin-off of the space program, is making tremendous inroads. The Internet will increasingly make it possible to diagnose, monitor and treat illness at a distance-in patient’s homes.
- Home care is the preferred form of health care for the infirm and disabled. Home care is preferred by a margin of 90% over comparable institutional care by individuals who are infirm. Individuals who are facing terminal illness are increasingly electing that form of home care called hospice.
In short, home care is the oldest form of health care. Health care has been traditionally given at home throughout the centuries. It is also the newest. Modern technology has developed to the point where virtually anything that is available in a hospital can be provided at home. There is significant evidence that it is less costly than other forms of care available to the American public. Little wonder that the public is demanding that it be made more available. It is an idea whose time has come.