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What a year it has been. The impact of an unprecedented pandemic has left families scrambling to meet the needs of loved ones and professionals changing their approaches to business. The home care industry is always in flux, but the changes imposed by COVID-19 have required a new and creative response.

The home care industry is in a unique position to meet the health and wellness needs of a booming aging population. We will look at some of the trends this past year as we look towards a new year of opportunity and growth.

Increasing Demand

The demand for home care services has surged during COVID, which is not likely to abate soon. According to Forbes, “ As Covid-19 continues to upend health care delivery as we know it, the preference for home-based care options will continue growing, with consumer sentiment and preferences continuing to shift towards greater acceptance.” Patients are discharged home sooner, the population continues to age, and home care is now on the healthcare industry's radar more than ever. The number of Americans over the age of 65 will double by 2030, so that factor alone will keep the home care industry busy.

Then you have many families who tend to keep their loved ones out of the hospital at all costs. People are delaying or avoiding hospitalization due to concerns about getting sick or contracting COVID. In the same Forbes article, “According to a recent Kaufman Hall survey, 54% of consumers cited fear of contracting Covid-19 as a primary reason to delay care, with 43% citing a fear of going to the hospital as the reason.” As people delay surgeries or even rehab, they continue to need help at home, and that is where home care can help.


The Department of Health and Human Services states, “nearly half (43.5%) of Medicare primary care visits were provided through telehealth compared with less than one percent (0.1%) in February before the PHE (public health emergency.) And, the Centers for Disease Control and Prevention reports that there was a “154% increase in telehealth visits during the last week of March 2020, compared with the same period in 2019 might have been related to pandemic-related telehealth policy changes and public health guidance.”

Telemedicine may be here to stay, and home care can help. Telemedicine allows patients to stay in their homes during routine visits, avoiding travel and potential infection. The challenge is the technology required to use it. Many older adults are not comfortable or can’t access telemedicine. We are already seeing in-home caregivers help coordinate and facilitate these visits with great success.

Isolation and Loneliness

Isolation for seniors was already a growing problem before the pandemic, and now it is a serious health threat. This is especially true for seniors in nursing homes and assisted living communities that prohibit family visits, put a pause on group activities, and require quarantine following any absence from the community. Out of concern for older family members' welfare, many seniors find themselves without family or resident contact for long periods.

Although home care always provides companionship, it is moving in that direction with renewed focus and planning. Social isolation is reported in all sectors of senior housing due to restrictions. Companionship is more important than ever. Reducing loneliness takes a multi-pronged approach that includes helping older adults connect with their families via technology, engaging in preferred activities, and stimulating cognition. Home Care Assistance provides caregivers dedicated to senior living communities' residents and do not provide care outside that setting. This approach reduces exposure and risk to COVID.


As families no longer visit their loved ones, the ability to advocate has taken a big hit. How do families know if someone is adequately cared for? In-home caregivers are in a perfect position to notify families when they notice problems regardless of setting.

Insurance Changes

The Centers for Medicare and Medicaid Services approved non-skilled home care services for recipients of Medicare Advantage plans. The criteria to receive these services are the following:

  • to compensate for physical impairments,
  • diminish the impact of injuries or health conditions
  • reduce avoidable emergency room utilization

It is up to each insurance plan to determine whether they will add this benefit to their insured beneficiaries. Patients must meet the outlined criteria above, and a healthcare provider must recommend the services. It remains to be seen how many insurance companies will add this benefit.

Retention of Staff

Staff retention in the home care industry has been a long-standing problem. The Bureau of Labor Statistics reports that the demand for home health aides will increase to as high as 41 percent by 2026. Turnover has plagued the industry as a whole, and retention is a priority. You can expect to see support for better pay and improved benefits for care providers.

Companies like Home Care Assistance offer 401K benefits and comprehensive training for their caregivers through their proprietary e-learning platform. Home Care Assistance provides expanded training opportunities, higher compensation, longer-hour cases, bonuses, and employee recognition.

Reconsidering Senior Living and Nursing Home Care

There has been a massive change in the senior living industry due to the pandemic. Families are delaying admission to assisted living and nursing homes, and some assisted living communities are not accepting admissions if they have residents with positive cases of COVID. Then you have families pulling their loved ones from senior communities because they are restricted from visiting or are concerned about them getting infected.

These changes put pressure on home care agencies to prove they can provide high quality and safe care to people living at home. They do this by being transparent about their safety protocols and offering families a viable alternative to senior living.

Working with Home Health

The demand for home health medical services is continuing to rise for the same reasons home care is increasing. Complicating the home health picture are projected Medicare cuts to physical therapy services. The Forbes article reports, “81% of physicians responsible for discharge planning now prefer to refer their patients to a home health agency versus a skilled nursing facility, a figure that is up from 54% before the pandemic. “ Home health care is viewed more often as a replacement for rehab, to delay hospitalization, and to keep seniors at home and out of senior living communities.

What this means is that home care has the opportunity to fill in the gaps in care that home health can’t provide. Non-skilled assistance such as personal care, shopping, cooking, and transportation are essential adjuncts to medical home health, which is time-limited. Home care can continue to meet client needs after home health care has ended.

Concluding 2020 with Big Changes for 2021

A summary of expected changes are:

  • Patients are more comfortable with teletherapy and may continue to use it for non-urgent visits.
  • The long-term impact on the assisted living industry is hard to predict. The very amenities that draw people to assisted living are discontinued for now. A decline in admissions has hurt the industry.
  • The tragedy of nursing home deaths has spotlighted the advisability of increasing payment for home care services through Medicaid. Home care services might keep more people from having to turn to nursing homes for their care.
  • Social isolation and loneliness were problems before the pandemic and are worse since. Home care can play a vital role in addressing those problems.

The challenges of this past year have a silver lining. The healthcare industry is adapting and finding creative ways to meet the needs of clients safely and effectively. In this changing environment, successful home care companies will be the ones that meet these challenges head-on.

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About the Author(s)

Carrie Burggraf is a nationally certified geriatric physician’s assistant and has worked in a variety of health care settings including medical offices, hospitals, nursing homes, assisted living communities and rehabilitation centers. She has a BA in Technical Writing, a BS in Medical Science, and an MS in Rural Primary Care.

Carrie currently works as a Home Care Liaison with Home Care Assistance to meet families who are looking to help a loved one stay home but whose cognitive or physical health is making that a challenge. HCA provides caregivers who can perform a variety of household and personal tasks for people with wide-ranging needs.

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