Homecare’s Role in Care Coordination

Homecare, also known as companion care, personal care or private duty care, is primarily positioned as care that supports aging in place by assisting with activities of daily living. As our industry has evolved, our impact has gone well beyond that. Increasingly, the health care ecosystem has taken note of our impact and is relying on home care to reduce hospital readmissions, improve outcomes in value-based care models and address social determinants of health. 

That’s because homecare providers have identified the opportunity to play a greater role in the overall health and well-being of older adults by integrating fall prevention programs, structured mobility routines, cognitive engagement activities and social connection plans. 

This shifts non-medical care from “helping” to actively preserving function and independence.

It’s time we elevated our elevator pitch to reflect that. We need to lead with how integral homecare is to overall health and well-being. This strategic re-positioning would move us from helping with bathing and housekeeping to being on the frontline of functional health preservation and social stability infrastructure. Reframing our impact elevates our perceived clinical and economic value. 

And the data is there to support this shift. Pew Research issued a report that found that 93% of those 65-and-older are living in their own homes. And 60% of those without a current caregiver want to continue aging in place if, and when, they can no longer live independently. Out of this group, 37% believed it was extremely or very likely that they would have someone to care for them at home. Additionally, 43% said it was somewhat likely.

Clearly, the need for homecare will only increase in the coming years, and we must proactively position our industry and our services to meet this growing demand.

Promote Programs & Services

Homecare providers and their non-clinical, highly skilled caregivers can play a significant role in promoting an individual’s health, safety and recovery from illness or injury. While many health care providers come into the home for various medical interventions, they tend to be there for much shorter durations in comparison to a homecare provider. Not only does having a non-clinical caregiver in a home for extended periods of time provide critical assistance with activities of daily living (ADLs), but the caregiver can also observe changes in a patient that warrant alerting members of the care team.

As hospitals contend with the pressure to provide great care in a tight window of time while ensuring there is little to no re-admission, the value of homecare in the continuation and coordination of care following a hospital discharge has elevated our profile.

In 2023, SYNERGY HomeCare launched ConciergeCare, a new high-touch homecare offering designed to ease the process of returning home post-discharge from a hospital, rehabilitation facility, skilled nursing facility or specialty outpatient surgery center. The program is designed to make the client’s home the most comfortable environment for recovery, while anticipating the myriad of personal needs clients may have as they progress through their healing journey.

This is a critical juncture in the client’s path to recovery, one that can support compliance with prescribed medications and interventions to reduce the likelihood of readmission to the hospital. Specially trained caregivers can become critical eyes and ears in the home to report changes that may warrant medical interventions such as:

• Changes in appetite and food consumption
• Increased isolation or withdrawal
• Erratic behavior or physical complaints, perhaps associated with medication side effects
• Changes of frequency or patterns of toileting or sudden incontinence
• Changes in pain levels or increased weakness or disorientation
• Changes in the patient’s mental health

By adopting this role as a key component of care coordination, caregivers can enhance clients’ quality of life during healing and recovery and ultimately ensure the best possible outcome for the long term.

While it is true that homecare is non-medical in nature, it can’t be overstated that the profound and positive impact that home care has on an individual’s health, well-being and safety. As leaders in the home care space, we can’t be shy in shouting our value from the rooftops. The well-being of our nation depends on it.