In Home Caregivers: Staying Out of the Hospital

Health care providers

By Pamela D. Wilson, CSA, MS, BS/BA, CG

In a study recently published in the Journal of the American Geriatrics Society*1, older adults receiving assistance with activities of daily living had lower rates of acute hospitalizations versus those not receiving assistance.  The article states that nearly 30% of adults age 75 and older have one or more disabilities in performing basic activities of daily living.  These activities include: bathing, dressing, toileting, transferring/mobility and eating.

Individuals who have difficulty performing activities of daily living use a greater amount of health care dollars for physician visits and hospitalizations.  Additionally, hospital stays tend to be longer than normal and overall recovery rates lower.

Older woman with caregiversSurprised?  We shouldn’t be.  It’s logical that an individual receiving assistance with activities to maintain personal hygiene, nutrition and mobility will fare better than individuals not receiving assistance.  Skin problems, weight loss and falls are common problems among older adults.  Left unchecked or unmonitored, these issues result in frequent emergency room admissions.

Many older adults find themselves frequently in and out of the hospital and wonder why?  Many of these older adults fail to monitor their health and have no friends or family available to provide support.  Some older adults  are too stubborn to accept help.  Others fail to complete recommended follow ups like physician visits or taking prescribed medications.  With our health, the devil is in the details of making sure that we are doing everything possible to avoid health declines or unexpected events.

This issue of higher utilization of physician visits and frequent hospitalizations is the “why” for in  home care that many older adults resist or see as unnecessary because insurance does not reimburse for what is typically called “custodial care”.  When one examined the benefits for supporting an older adult to remain independent and in their home as long as possible, in home care should be considered

It is the responsibility of older adults to educate themselves about options to avoid repeat hospitalizations or eventual placement in a nursing home at significant expense.  At the point chronic illness creates health emergencies and hospitalization some type of care must be considered whether the care be in home care or moving to a care community.

It’s important not to wait too long if your desire is to remain at home because there is a point where in home care due to either the practicality of care needs or expense may no longer be  an option.  Making an early decision allows the choice to decide where and how you wish to live and to receive care.  If you need assistance in identifying and considering options schedule a consultation with me and I’ll help.


1  Sands, and others.  Rates of Acute Care Admissions for Frail Older People Living with Met Versus Unmet Activity of Daily Living Needs.  JAGS 54:339-344,  Vol 54, No. 2.

© 2012, 2013 Pamela D. Wilson, All Rights Reserved

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