Aging in the Third Millenium: Part 4

Finding the right caregiver can be a challenge, especially when today’s feisty elders may not want or feel they need any help — even in their 90s. If only something as amorphous as matching your grandparent’s personality and lifestyle to the appropriate home assistant were more quantifiable.

HomeHero to the rescue. As its name implies, HomeHero connects seniors with home care mathematically, so there’s less room for error. And it works: HomeHero has gown to become the largest independent home care provider in California, where it launched in 2013.

The Match Game

The 15-point matching algorithm takes the guesswork out of finding the right match. It’s a little like friend dating — in fact, 28-year-old co-founder Kyle Hill says HomeHero is “more like Match.com than like Uber” — and affords seniors and their families the option of completing the questionnaire on their own online, or in collaboration with HomeHero via a phone call. (Though these entrepreneurs are young, they understand generational preferences — which are rapidly dissolving as today’s elders embrace technology).

According to a company profile in Forbes, HomeHero’s algorithm takes just twelve minutes to suggest suitable care providers. It’s not a new concept, or even disruptive, but it may be the best tech solution yet for seniors who themselves are on the leading edge technologically. As a next step, HomeHero is forming the HomeHero Collaborative, a care management platform for hospitals and health plans that connects and extends the health system into the home.

Born Free

Some seniors are going to refuse a home attendant no matter what. And they could be right: such a step might be unnecessary, with the advent of next generation PERS (personal emergency response systems). Freeus provides Belle, a mobile emergency alert pendant that connects users to an emergency care center 24/7, where Belle wearers can speak with specialists via built-in two-way voice technology. The specialists, in turn, will send loved ones or emergency services to seniors if such action is warranted.

A companion product, eResponder, features a rechargeable battery, and enables caregivers to receive low battery and power off notifications by text message and email. Caregivers can also be contacted if the eResponder user needs non-emergency assistance.

Reimagining Medicare

Then again, perhaps the best course of action is to start at the source, and reinvent Medicare. At Washington’s Center for Medicare & Medicaid Innovation, that’s precisely what a visionary alliance of doctors, lawyers, health policy experts, and career Medicare employees are attempting to do.

Created under the aegis of the Affordable Care Act, the Center has already tried 60 experiments that alter payment and accounting practices, to see what might be most effective.

Excessive Care?

The key to overhauling home care — or health care in general — lies in listening to the seniors themselves, as Atul Gawande makes clear in his breakthrough book, Being Mortal: Medicine and What Matters in the End. Our culture has a propensity for prolonging life at all costs, even to the detriment of the patient, which I experienced when my mother was dying. Though she had a DNR (do not resuscitate) on record, this did not take into account incidents that occurred while she was conscious, in the days and weeks following an unsuccessful heart valve replacement. The doctors recommended seemingly endless procedures that my Dad, wanting to do all he could for her, kept authorizing.

“Patients often want to be kept comfortable rather than undergo medical interventions, but physicians are trained to do everything possible to prevent death,” says Dr. Diane Meier, director of the Center to Advance Palliative Care and professor of geriatrics at Mount Sinai’s Icahn School of Medicine in New York. Yet, shockingly, doctors themselves do not choose these same medical procedures when they are terminally ill, preferring to spend their remaining time with loved ones rather than attempting to prolong their lives.

The 4 Cs of Proactive Care

What does “proactive” health care for seniors look like? It’s akin to what builds ongoing reverse mortgage relationships:

1. Customer-centric
2. Connected
3. Continuous
4. Coordinated

With digital technology and a person-centered focus, the shift towards connected, continuous, coordinated care that emphasizes the older adult in question is poised to become a welcome new model of proactive care.