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22nd May 2025
Does Home Care Help Chronic Disease Management in Elders?
Does Home Care Help Chronic Disease Management in Elders?
Yes. An elderly patient with a chronic disease can be effectively looked after at home. There are definite plus points in not hospitalizing such patients, with lower costs being one significant advantage.
It is important to make sure that the type of care-giving at home includes basic emotional support as well as medical and nursing services. Allowing the patient to stay at home, in an environment where he or she is comfortable creates a personal touch. This makes the medical treatment more effective and also improves the patient’s mood and quality of life. The familiar surrounding remove stress and fear, which helps the healing or disease management process, both in the short or long-term.
How does Home-Based Care Help?
Referenced from an article by the NIH, Government of Canada
https://pmc.ncbi.nlm.nih.gov/articles/PMC3804052/
“It is assumed that patients with chronic disease will benefit if they are living at home and being looked after at home or in the community. In addition, there may be cost savings to the health care system when care is provided in the community or in the home instead of in hospitals and other health care settings.
This evidence-based analysis examined whether in-home care given by different health care professionals improved patient and health system outcomes.
Patients included those with heart failure, atrial fibrillation, coronary artery disease, stroke, chronic obstructive pulmonary disease, diabetes, chronic wounds, and with more than one chronic disease. The results show that in-home care delivered by nurses has a beneficial effect on patients’ health outcomes. Patient mortality and/or patient hospitalization were reduced.
In-home care also improved patients’ activities of daily living when delivered by occupational therapists and physical therapists. In addition, the results showed that in-home care delivered by nurses has a beneficial effect on health system outcomes, reducing the number of unplanned hospitalizations and emergency department visits”.
What is meant by the term “Chronic Disease?”
Referenced from Center for Managing Chronic Disease, University of Michigan https://cmcd.sph.umich.edu/about/about-chronic-disease/
“Chronic diseases are long-lasting conditions that usually can be controlled but not cured. People living with chronic illnesses often must manage daily symptoms that affect their quality of life, and experience acute health problems and complications that can shorten their life expectancy. According to the Centers for Disease Control, chronic disease is the leading cause of death and disability in the United States, accounting for 70% of all deaths. Moreover, chronic conditions such as back pain and depression are often the main drivers of decreased productivity and increased healthcare costs. Data from the World Health Organization show that chronic disease is the major cause of premature death around the world, even in places where infectious disease are rampant. The good news is that through effective behavior change efforts, appropriate medical management, and systematic monitoring to identifying new problems, chronic diseases and their consequences can often be prevented or managed effectively.
CMCD aims to help people prevent and control the effects of their chronic illness by putting them at the center of disease control solutions. When designs for patient education, service delivery, and payment systems all focus on building the capacity of individuals and families to manage disease effectively, disease control improves, health care costs go down, and family well-being gets better”.
The Older Person’s Preferences for Home-based or Hospital Care
Referenced from Research Paper from the Journal of the American Medical Association (JAMA).
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485327
Background: Although the home is expanding as a potential site for acute illness treatment, little is known about patients’ preferences for home vs the hospital.
Objective: To determine older persons’ preferences for home or hospital as a treatment site for acute illness and factors associated with preference.
Methods: Two hundred forty-six community-dwelling persons aged 65 years or older hospitalized with congestive heart failure, chronic obstructive pulmonary disease, or pneumonia were identified in 2 urban teaching hospitals and received telephone interviews 2 months after hospitalization.
They were asked their preference for home or hospital treatment, given the availability of equivalent therapies and outcomes at the 2 sites and a nursing visit and several hours of home health aide assistance daily in the home. They were also asked about changes in preference with changes in the description of the outcome or the availability of services.
Results: If home and hospital offered equivalent outcomes, 46% of the sample preferred treatment at home. Preferences were heavily dependent on the outcome of the illness, physician opinion about the best site of care, and the provision of house calls. Higher education, white race, living with a spouse, being deeply religious, and having 2 or more dependencies in activities of daily living were associated with a preference for home treatment.
Conclusions: Under conditions of equivalent outcome, preferences for treatment site are almost equally divided between home and hospital. Explicit elucidation of preferences is necessary if patients’ preferences are to play a meaningful role in decision making about site of care”.
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