The Home Care Agency of the 21st Century (Part 2)

By Mark Shea, MCDM

The Home Care Agency of the 21st Century will be the same as it is now in very many ways and in the most important way. We provide human companionship, human care, human assistance, and most importantly, human touch. Humans will die without these things. We not only crave the companionship, care, and touch of others. We need it. Without it, we fail to thrive and this is particularly true for babies and the elderly. We know this at our core as humans. This is why solitary confinement is considered an extreme punishment. The work of a caregiver is to comfort, to assist, and to love, whatever may come and with any luck, it might be a healing. We are there to help people die too. We help them to die with dignity and as comfortably as we can manage. We soothe families. We laugh with them and cry with them. We cannot be replaced by machines. We are the human element that must remain.

Now comes the machine and the network. The Personal Emergency Response Systems (PERS) Industry has new entrants in the market. I mentioned a couple of these already, BeClose and Grandcare. We have had other PERS products in play in the Home Care business for some time, Phillips Lifeline, for example. The PERS systems that are prevalent today are good for certain people and in certain circumstances. Buttons are usually attached to a pendant worn around the neck, a bracelet, a belt clip, or located on a console in the home. Push the button and an emergency response network is set into motion. Of course there are false alarms but those are a small price to pay for the chance to respond to an actual emergency.

These products are not the right tool for many people however. First, you have to remember that you have such a device. Many seniors and others who need these systems have cognitive impairment, including memory loss. One principle purpose for these is to help someone who may have fallen, is injured and cannot get to the phone. Another problem is that people who fall are sometimes unconscious. Passive monitoring systems, like BeClose and GrandCare, do not require that a button be pushed. The patient does not need to be aware or remember that they have a PERS device. These passive systems can be alert others connected to the system, an alarm can go out, if there has been a lack of motion in the home over a given period. This will not be as fast as the pendant to initiate an emergency response but neither does the person have to lay there with a broken hip until someone finds them. Now, pair a passive monitoring system with a PERS button and you have both systems working for you.

For people who are not in the Health Care business, you may want to know that fall risk is a major area of concern, particularly for eldercare. Each year, one in every three adults age 65 and older falls. Falls can lead to moderate to severe injuries, such as hip fractures and head traumas, and can even increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. For more information about falls and fall prevention, see the CDC article Falls Among Older Adults: An Overview.

Passive monitoring systems can do more than monitor falls. With a skilled analysis, movement and events triggered by switches in the home can predict fall risk. Studying and analyzing these patterns of behavior and system events can give us many clues to what may be happening with this person relative to health and safety. Intel is working on some very interesting devices. One of these is their SHIMMER system. SHIMMER stands for Sensing Health with Intelligence, Modularity, Mobility and Experimental Reusability. These are lightweight, wearable, Bluetooth-enabled monitors. They can track the motion and gait of patients in an effort to better understand and prevent falls. We can know in advance if a person’s fall risk is increasing and act proactively before the fall occurs. A wonderful thing but when wearing my hat as Home Care Agency owner, I wonder what my liability would be if I were partnered with a family in monitoring their loved one and I were to miss these data that predict fall risk and the person falls. Home Care owners will need to think about how expectations are set with the family and make sure there is a service agreement or contract that explains what you can and cannot do.

No matter the data that any surveillance system can capture or any computer can calculate, in our business it takes a human to act upon that information. We can set an alarm in a monitoring system that is triggered when a person doesn’t move in the home between 10AM and 10PM. There are probably many reasons someone would want to track such a thing but let’s say in this case that the family caregiver is worried about falls. The family caregivers want a phone call to remind them to check on Mom if there is no movement in the home for over two hours during non-sleep time. Mom is on vacation, so, there is no motion in the home for two hours and the system sends an alarm. The system worked. It did what it was supposed to. It sent an alarm. It takes a human to interpret what really happened. This alarm will notify someone who will know to turn the alarm off while Mom is gone but this took interpretation on the part of the caregiver. This is one simple example of why caregivers cannot be replaced. Machines are not capable yet of discernment and interpretation. They are definitely not capable of compassion or love.

“So, why did I talk so much about the Internet and disruptive technologies in relation to these devices in the first two articles?” you might ask. I am talking about this because these passive monitoring systems connect to the internet. They are connected to a Web server. A Web server makes it possible for the family and whoever they want to add to their Web dashboard, to view Mom’s activity from wherever they are in the world as long as they have access to the internet. I leave it at that for now but I assure you, many powerful, compelling, and innovative things can be done because of the connection to the Web. Anything possible currently on the Internet, now becomes available to the family on their dashboard. One of the ingenious aspects of this technology is that the business end faces the caregivers and the passive end faces the patient who does not even need to know or remember that it is there to realize it’s benefits. In addition, some systems like The BeClose do not require that the patient have a landline phone or connection to the Internet. Devices can access the Internet through the cellular network. The command unit in the patients home only requires that cellular service be available. This offers the benefits of Information Age technology to people who do not understand or even want to be involved with the Internet. These systems provide a translation point between people who are digitally literate and those who very likely are not digitally literate.

The family now has a way to keep an eye on their loved one, even though they cannot be there all of the time. This will work for many people in many situations. This may very well be all that they need for now or ever for that matter. They can purchase the system, install it, monitor it, and develop their own care plan that they manage within the family from the Web Dashboard. On the other hand, they might need some help. They can create a triangle of care by partnering with others. They can add these other people who could be friends, neighbors…..anyone really. Now imagine if they partner with your Home Care Agency. You become a partner in the triangle of care. You can assist or even drive the care plan.

Triangle of Care

You will have a care plan that is available to you, the Home Care Agency, as long as you are in the circle of care. You will now be able to offer Home Care services ala carte. Let’s say you or someone working for your agency sees the number of trips to the bathroom increasing during the day. You could contact the family to tell them that this is a behavior pattern that experience tells us could be a Urinary Tract Infection, you probably should think about taking Mom to the doctor to check it out. The family can do that and they are happy that they have included you in the Triangle of Care. A situation that could have developed into an acute condition and possibly a health crisis, has been averted. On the other hand, the family may not have anyone in the family available to take Mom to the doctor and ask if you as the Home Care Agency can do that. Why, yes you can. You already have done an assessment; you already have a care plan, now it’s simply a matter of dispatching a caregiver for this one service. Families will now be able to buy from us or do for themselves a large number of Home Care things. We can send a coach for individual family training on a whole host of activities. We can provide classes. We can provide products and services that have nothing to do with Home Care; hairdressers, dog groomers, restaurants, handymen, gardeners….let your imagination run wild.  You as a Home Care owner can now partner with local businesses to provide these services. You become the conduit through which these local businesses can access your community. They are not allowed into the triangle of care, except through you as the representative of the family and patient. You list the most reliable, the best in your area. Because you represent, or could represent, a significant number of families or patients to these merchants and service providers, you have something valuable to sell, to families, patients, and local businesses. Family members who live anywhere in the world, can now buy a product or a service for their loved one because they want to do it and because they happen to have a few bucks left over this month and want to share a little treat with Mom. You offer them a real way to do this. This is one example of the Concierge level in the five levels of the new Home Care Agency that I described in The Home Care Agency of the 21st Century (Part 1). This represents new revenue streams, new services, and new opportunities that were previously unavailable to you. This is the power of the Web. This is the significance of having a device connected to a Web server.

Now you have a few examples of how this Triangle of Care can be leveraged in a network, on the World Wide Web. In the next essay, I’ll discuss the first level of the new Home Care agency, Consumer Electronics point of sale.

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The Home care Agency of the 21st Century (Part 2) by Mark Shea is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
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