Behind The Emerging Trend Of Self-Directed Home-Based Care In The US

Home Health Care News / By Patrick Filbin

More home-based care agencies are turning to family members and loved ones to fill staffing needs. This is the case with both seniors and children being cared for in the home. Even the White House has recently been supportive of the paid family caregiver model.

A recent study from Northwestern University could also bolster support. It found that children who received care from family members trained as CNAs were not more likely to be hospitalized compared to children cared for by traditional CNAs.

The study also found children cared for by family members experienced greater care continuity because turnover was not as much of an issue.

“We’ve known for a long time that children with disabilities and chronic conditions at home have had trouble accessing in-home care,” Carolyn Foster, a pediatric researcher at the Ann and Robert H. Lurie Children’s Hospital in Chicago, told Home Health Care News. “There was already an underlying problem of having trouble getting people to work in the home health care industry. Now there’s research that shows parents of children who have medical needs will have to essentially drop out of the workforce to provide their child services because they have trouble getting an in-home provider.”

The same can be said for the senior and special needs populations…

…The flexibility to pay family members through Medicaid for home-based care services varies by state. Some states won’t allow a family member to be paid for those services at all.

Others, like Colorado, have gone above and beyond to make it easier for family members to become paid caregivers.

Colorado’s Medicaid program – which was at the center of the Northwestern study – will assist family members to become licensed CNAs, which allows home health agencies to hire those family members.

“We were interested in seeing whether those kids were more likely to get hospitalized, if they got sick more often and what the costs looked like,” Foster said. “We ultimately found that, at least for the number of hospitalizations, it was the same. We also found – which was kind of profound but not really surprising – that there was this incredible continuity in care. A huge problem for these kids is that even if they do get a home health care provider, there’s huge turnover and the people who take care of them don’t get to know them very well and then leave their job.”

The same issues exist in home-based senior care…

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