Home care strengthens assisted living.

A few years ago, my company helped a delightful, "80-something" woman who was healthy, alert and self-sufficient except for needing a little extra assistance because of her deteriorating eyesight. Essentially, our aide would arrive at the woman's home every day, check in with the woman's caregivers, and help the resident enjoy her meals without getting food all over her lap. An everyday occurrence in home health care - except, in this case, the woman's home was an assisted living residence.

There's been a lot of discussion throughout the long-term care industry about the importance of thinking and doing business "outside the box." Skilled nursing homes are venturing into subacute care, retirement communities are offering nursing care, and just about everyone, it seems, is exploring assisted living. So where does home care fit in?

One answer to this question can be found in the case I've just cited. Obviously, the assisted living staff was perfectly capable of handling the woman's extra mealtime needs - and certainly did so before we came along. But at some point, the intensive care that was needed by one resident had started to detract from the amount of attention that staff could give to the remaining residents. What was fair for one resident became unfair to the others.

Our homemaker companion was able to supplement the level of care already provided, by giving the resident as much extra assistance as she needed, and only when she needed it. At the very least, this resolved an expensive staffing dilemma for the provider. More importantly, the strategic involvement of home care helped the resident to stay in assisted living, rather than transfer into a more intensive level of care when her need for such costly care was limited.

In these times of containing health care costs and helping elders to "age in place" as long as possible, home care is in a strong position to help both seniors and long-term care companies. The benefit to seniors is clear - they can stay in their homes longer than otherwise possible, whether in a private home or in senior housing. The benefit to senior housing providers should also be clear; rather than seeing homemaker companion care as a straight competitor for their business, the most proactive providers understand the advantages of forming strategic alliances, with such advantages:

Resident retention. This applies not only to assistance with activities of daily living, but to cases of post-acute care, when homemakers and personal care attendants can help residents recover in a low-intensity care setting, rather than moving them into a more intensive facility. Assisted living providers know that if someone goes into a convalescent home from a hospital, it will be a challenge to get them back.

Keeping costs down. As a home care provider, our services to residents help to free the senior housing staff for other residents. Also, since the resident is our client, the senior housing facility does not have to pay our way.

Broadening the referral base. Home care providers work with clients who eventually will need round-the-clock assistance or health care. Our case managers work closely with hospital discharge planners, and personal care attendants work directly in the community. We're in people's homes, and we are in a position to recommend senior housing to clients who need it.

Transitioning a new resident. Most often, by the time someone realizes that they need to move into an assisted living residence, they need to do so right away. Home care can be brought on to help with the transition, to have a plan to care for the person at home until the preliminary processing is complete and the new apartment is ready.

Home health care comes in different forms. At Homecare USA, we provide homemaker companion care, personal care attendants, and certified nursing aides. The level of assistance can range from helping someone with bathing, dressing, transportation and other non-medical needs, to medication monitoring and nursing care. By joining the Assisted Living Federation of America (ALFA), our company has begun to forge new relationships that will ultimately help us all to provide the best care possible.

Because long-term care providers have been driven by stiffer competition to think and act "outside the box," consumers have started to reap the rewards. When home care providers and senior housing providers work together, they ultimately are giving consumers what consumers want most: autonomy and aging in place, easier transition periods and a flexible health care model that is responsive to their changing needs. And there is no way to price out the enormous "savings" in terms of the peace of mind that residents and their families get, when the resident can stay at one place as long as possible.

Jean Kauth is Chairman of the Board for Homecare USA in San Diego, CA. She recently served on a panel titled "The Missing Links: Home Health, Therapy and Medical" at ALFA's spring conference.