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Tech-enabled home care is betwixt and between

Caught in nowheresville -- neither nursing home, ALF or safe home care.  Today we are in a no-man's land of legislative initiatives to keep (or move) seniors at home and out of a shrinking number of nursing homes -- between the CLASS Act, CMS program experiments, PACE program here and Medicaid payment (see Leading Age/CAST report about which states reimburse PERS et al.) -- the only really clarity is that government agencies believe that the costs of care are lower at home.  On the other hand, we are at an amazingly under-deployed stage of the use of technology in delivering home care services (if you have any statistics that prove otherwise, please come forth!) So on the one hand, we chip away at the viability of nursing homes (1000 have closed within the past 10 years), we don't chip away at the cost of assisted living, however, which is financially out of reach when there is no pricey home to sell. Yet 24x7 home care is priced by MetLife at a US-wide average of $183K/year (in comparison to a US-wide average of $40K/year for Assisted Living).  So what are families to do?

'Telecaregiving' is an answer -- maybe for the poor or officially disabled. So perhaps you saw the article about seniors and telecaregiving from ResCare. Kentucky-based ResCare notes that its 50,000 employees help 1 million individuals across the US; its history is in serving the cognitively or physically disabled with the majority of its care recipients on Medicaid.  The Telecaregiving service uses a few cameras (in the kitchen) and motion sensors monitored by a remotely located caregiver who checks in on a frail individual or couple during the evening hours, chatting with them and observing whether they're okay. Do you find it ironic that the majority of ResCare clients (per their own website) are on Medicaid? Which means they have qualified for disability payments or spent down their assets to a low enough level to qualify as poor. So this 'telecaregiving' is not a service for those too middle class to qualify for Medicaid and are not rich enough to fund a long life expectancy in Assisted Living.  The Coughlin comment from the article about innovations in technology: "Frankly, we're already 20 years behind" -- is so true, but not just in the way he meant. If ResCare can provide a Medicaid-qualified, camera and sensor-based system integrated with caregiver oversight, where is the consumer-purchasable equivalent of this tech-plus-care package?  Not obvious from the leading home care company, HomeInstead (services of a franchise, of course, 'vary by location'). Not with RightAtHome (also franchised, so ditto on variability).

Blend care and tech-enabled services -- the blueprint of choice.  As a sales tactic for remote monitoring technology of all types, vendors love to say that compared to the cost of assisted living or a nursing home, tech XYZ's price and monthly charges are no-brainers. Well, of course, there is no comparing a tech tool that connects to a call center with three meals per day plus housekeeping plus social activities plus making sure that Mrs. Smith makes it to breakfast.  In our 20-year Coughlin catchup period, let's see camera-sensor packaging as simple as this baby monitoring system you can find on Best Buy offered by Home Instead franchises as basic services that supplement the in-home care time with off-hours centralized monitoring.  Clearly there are call centers out there (that respond to PERS pendant activations) with the people who could be contracted to check-in after dinner or on weekends. 

Examples wanted: Senior housing companies have the infrastructure to lead tech-enabling home caregiving.  Some senior housing/living organizations partner with home and companion care services to help residents in their independent living units. Perhaps they reach out with information and seminars for non-residents in the area -- and some organizations like Good Samaritans deploy telehealth and remote monitoring services.  I would like to learn about more examples where the IT infrastructure of a senior housing community was deployed as a means for those home care agencies to remotely monitor residents in independent living units after hours. And if that is feasible, it is a short leap to use those 'telecaregiving' services to support residents in the surrounding area who may not be ready or financially able to move into a senior housing community.

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