Background
Think that occupational therapy is not recognized? Sure, many people do not know what occupational therapy is or what occupational therapists do. We are also seeing a more popular trend of aging in place, but as mentioned in one of our previous posts on aging in place, occupational therapists are not doing a good enough job in raising recognition for the value of the profession.
An older adult stays at home during the pandemic.The Appeal of Aging in Place
Why is aging in place such a big deal? Many factors may contribute to an older adult wanting to continue living in the homes as they age. The coronavirus and COVID-19 pandemic have resulted in many serious outbreaks across the country. It’s no surprise that patients in hospitals want to avoid going to a skilled nursing facility. Unfortunately, there aren’t that many alternatives besides a discharge back home. A second factor is cost. Staying a skilled nursing facility can be expensive without long term insurance. Add to this the aging babyboomer population, many Americans being uninsured, lack of available beds and staffing (a common barrier I face in discharge planning when collaborating with the case manager) – makes aging in place more appealing.
Falls can lead to Death
Falls can have serious consequences for an older adult. Falls can lead to death in the home, en route to the hospital, or further down the road due to other complications. Falls also incur high costs to the individual, family, and overall healthcare system.
What Joe Biden Highlighted
Joe Biden gave a speech on July 21 outlining his $775 billion plan to support working parents and caregivers.
Think of expanded vital services like rides to appointments, meals, day programs for seniors, making their home safer for them. It builds on an innovative and created provision under the Affordable Care Act. The very program the president ceaselessly is trying to gut. For example, there was a pilot program now in 27 cities, in 16 states where a nurse, an occupational therapist and a handyman come to the home that’s caring for an aging family member. They might not be able to cure a mom’s Alzheimer’s, but they can make sure she doesn’t break her hip. So they walk through the house. This is what’s going on now. And they install handrails in the right spots in the house, in the bathroom, or they fix the door or that’s stuck so she doesn’t trip while she tries to open it. It initially found that about $3,000 in program costs yield more than $20,000 in saving to the government from hospitalization for other reasons. Simple steps to save lives, save money, and provide critical peace of mind.
Home health OT can make safety recommendations such as installation of grab bars in strategic locations.Key Points
In summary, Joe Biden highlights the value of:
- Older adults can continue to live in their homes
- Collaborative interdisciplinary home health
- The value of home health occupational therapy
- Fall and injury prevention
- The decreased burden on the healthcare system from prevention
- Cost-benefit of reduced hospitalizations
- Occupational therapy saves lives
A real-world example
I recently discharged an older adult with dementia who still had the capacity to make medical decisions back home. He had repeated falls, including the most recent which resulted in his hospitalization. This patient had been refusing other living arrangements including assisted living. Despite us recommending they have 24/7 supervision, the family was unable to provide such accommodation due to (you guessed it – financial barriers and caregiver availability). The best that they could do was arrange for check-ins from friends and neighbors. We stressed the importance of home health with all the disciplines of occupational therapy, physical therapy, speech therapy, social work, and home health aide. Often times, as occupational therapists in today’s healthcare system, we can only do our best in making our recommendations, but aging in place may be the only option.
Next Steps
We as occupational therapists still have a long road ahead of us. Aging in place will likely more an issue in American society. There may be many outcomes from this next election and the pandemic. No matter which outcome, occupational therapists can still be proactive in advocating for the value of occupational therapy with the public, politicians, and our friends and families. The story that Joe Biden highlights may be the best we can do in some cases as some conditions have no cure, but these arrangements can very well allow an older adult to age in place in their home while lowering costs and saving their life.
