By Florence Cino
Home healthcare with a Home Health Aide, or Nursing Home care? It’s an agonizing question that many families are faced with, and with baby boomers aging into their seventies and eighties, more families than ever will be mulling over this complicated decision. While some people view nursing home care as the more convenient option, particularly when the time comes that aging parents can no longer live alone, there is an avalanche of information to support that in-home healthcare provides a safer, more comfortable, more dignified and healthier environment; and is more cost-effective than nursing home care.
According to Oxford Academic, after one year of long-term care, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries. While this may not sound like a lot, it breaks down to more than a million lives, and every life holds value. Then there are the costs to consider. According to an October 24, 2018 article published on AARP.org, “Nursing home costs tip the scales at $100,000 per year per patient, as opposed to in-home long-term care which comes in at just over $50,000 a year, per patient.”
Intangibles like quality of life, compassion and dignity also gain higher marks with home health care. Everyday tasks that most of us take for granted like transfers, walking, dressing, using the restroom, feeding and linen changes are attended to more swiftly with in-home care. A Home Health Aide is at the patient’s disposal to assist immediately, whereas nursing home clients must wait for often overburdened staff members to become available for assistance.
Home healthcare recipients also have what we would call “home-court advantage.” Navigating the familiar terrain of home creates a safer environment, and in many cases, means less travel distance from room to room when the client’s energy may be at a premium. SeniorLiving.org asserts that “many seniors report having a greater quality of life and happiness with in-home care, and statistics show that these beneficiaries actually have up to 50% fewer doctor’s visits annually.”
Institutions tend to be noisier and the patient cannot control their environment like they would at home. A home setting is generally more tranquil and quieter, lending itself to better sleep and less accidents and falls, as a result. Home settings are especially beneficial for clients who tend to wander. A Home Health Aide is there to prevent patients from wandering out of the home unsupervised and can effectively guide the client when leaving the home for outings.
There is also an intimacy and trust that develops between the patient and a Home Health Aide that cannot be replicated with nursing home staff, making the patient more reluctant to share valuable information with nursing home staff that may be needed for the benefit of the client’s health and safety.
Another advantage is the ability for a trusted family member or friend to be compensated for caring for a loved one in the home. MedicaidPlanningAssistance.org explains “Through many of the state [Medicaid] plans, personal care services are available, and many of the states allow program participants to self-direct their own care.”
This means the program participants can elect for a trusted family member or friend to act as their Home Health Aide and companion. The MedicaidPlanningAssistance.org article goes on to explain, “With self-direction, program participants are able to hire, train, manage, and even fire, the caregiver of their choosing. This means that relatives and friends who serve as informal caregivers can become paid caregivers through Medicaid’s state plan.”
Another important issue to consider is the spread of disease-causing germs to patients whose immune systems may already be compromised due to advanced age or illness. When patients are cared for in their home, they are not exposed to certain elements and germs that can make them susceptible to secondary illnesses.
In a study conducted by the National Institute on Aging, the findings where consistent to show that people want to stay at home and don’t want to be in facilities. “Most people do not want to wind up in a facility setting. They would ideally prefer to stay in a community setting at home for mental, physical and emotional health, and morale.”
HCAOA.org corroborates this finding, stating that “9 out of 10 seniors aged 65 and over want to remain at home for as long as possible, and 80 percent think their current home is where they will always live.”
Florence Cino is Director of Patient Services for Edison Home Healthcare, a full-service, Joint Commission-accredited home care services agency, headquartered in New York.