The transformation of healthcare from a hospital-based system to a more decentralized model happening in patients’ homes will be one of the biggest labor shifts in the U.S. economy over the next 10-plus years. It’s being driven by an aging population and their families seeking alternative ways to care for older relatives, and an upswell of Americans living with multiple chronic illnesses.
The hospital-at-home model is no longer experimental
The change that emerged out of necessity because of COVID is now becoming a permanent part of healthcare. The Hospital-at-Home model is shifting more care for patients into their residence, and this model is becoming part of the value-based care shift with the reimbursement model.
For example, if a patient has a condition with a long recovery time that doesn’t necessarily need a hospital bed – such as pneumonia, they might spend their entire recovery period at home. This would of course be done with a rotating team of carers that come in to check on them and do any necessary testing to ensure they’re getting on okay. This helps to free up beds for patients in more severe conditions whilst ensuring that a patient has their needs met. By doing this in their home, they can remain comfortable, which often helps to improve their recovery rate and helps prevent hospital readmission.
Geographic demand is creating real localized opportunity
Basic knowledge of the demographical makeup of the United States tells you that over the next decade, more and more people will be reaching retirement and the aged population will be larger, hence the need for more carers.
The best yardsticks for gauging where home care is needed most are the communities that are rapidly aging. That means populations where individuals over 65 are growing faster than the U.S. average, as baby boomers retire – or cities that are already older overall, having long been popular destinations for retirees. Either way, the signal is the same: a swelling demand for care that outpaces the available workforce. Philadelphia hits both marks. Its aging population is growing steadily while a large existing senior community is already in place, which is exactly why opportunities for those seeking home care jobs Philadelphia PA are expanding faster than in most U.S. cities.
The caregiver role has expanded well beyond ADLs
There is a misconception that home care work involves only helping someone bathe, and get dressed, and the classic activities of daily living. That’s not today’s game.
Today’s direct care worker is expected to log in to an electronic health record, hopping on a telehealth video chat with a patient’s daughter present, and then operating a remote patient monitoring device to track that same patient’s vital signs and sending them every morning to the nurse at the office. All of this, they do in a standard morning’s work. They are the implementer of a care plan someone with an MD in a consulting room or a case manager at a keyboard has devised, but cannot execute.
Having a good standard of literacy when it comes to technology is a non negotiable in the modern day workplace. Employers have long valued the ability for an employee to be able to utilise caregiving technology to elevate standards and reduce costs, but it is now an expectation. If you’re able to take on new technology and become proficient with it, then you’re going to become and remain employable. On the other hand, if you’re unable to pick up and learn new things required to provide care, then there’s likely not a place in the industry for you anymore.
The other big one is the rise in specialized training for, say, dementia support or palliative care. Followers of this blog will note the extent the last few years has seen as an ever-increasing drumbeat of these qualifications coming through. They make direct care work more complex, more guided by evidence-based protocols, easier to defend from a legal perspective, and easier to bill health insurance payers. This isn’t just training your friends how to deal with a person with Alzheimer’s. This is building a professional pipeline.
Autonomy and patient relationships set this work apart
Home care values what you learn on the job as a provider, based on a human relationship you won’t find in a paper chart. It supports small acts of professional rebellion in the maintenance of dignity or comfort or autonomy every day.
Where healthcare goes from here
The continuum of care, meaning patients have a single, coordinated care experience across a variety of healthcare providers and specialties, has been a consistent ambition for policymakers, health systems, and payers. Yet the truth is, computer systems are largely just catching up to the idea. And change, until very recently, has been hard to come by on the ground.
The pandemic has made too much of what was abstract, urgent and too much of what was needed more obvious. Antiquated referral patterns, repetitive testing, and poorly tracked outcomes expose patient lives to avoidable risk. Part of the charge to bounce back better included a mandate to make more substantial changes, take risks, and be less patient.
