Driving better health outcomes through aging in place
By Celestino Garcia | March 30, 2023
Addressing an epidemic of loneliness
While aging in place has been the preferred choice for seniors by a substantial margin, it’s really in recent years that advances in home health services have made it more viable for a greater percentage of the older population. There can be distinct advantages to aging in place, including reduced isolation, which is critical given the epidemic of loneliness among aging adults and the negative impact of loneliness on overall health. In addition to reducing isolation, aging in place can also increase patients’ personal independence while also lowering overall healthcare costs, given most health insurance programs and Medicare do not cover skilled nursing or other long-term care.
Building America’s Healthiest Hometown®
Dr. Jeffrey Lowenkron is the chief medical officer for The Villages Health, which he co-founded in 2012. Built around a model of hospitality, The Villages comprises a collection of charming neighborhoods designed to be communities where older adults can live actively and comfortably with easy access to whatever healthcare services they may need. The concept of the Villages is perhaps best described as “America’s Healthiest Hometown®.”
Per Dr. Lowenkron, one critical element to healthy aging in place at The Villages is social cohesion. Put simply, social cohesion boils down to neighbors simply taking care of one another. The role social cohesion plays is important for a number of reasons, Dr. Lowenkron explained: “One, it prevents isolation, which is one of the biggest drivers of people doing poorly as they age. Second, it means you’ll have help without having to have your family members be the ones that deliver [that help].”
This quality is embedded in all of The Villages communities.
Making aging in place possible for more Americans
In addition to the vital social and emotional benefits, The Villages also ensures access to a full range of healthcare providers to its residents. Dr. Lowenkron describes The Villages as neighborhoods wherein residents are never more than a 15-minute golf cart ride from a healthcare center. Primary care centers within The Villages communities also include behavioral health services, which allows for a tandem care program wherein therapists, primary care doctors, and patients can be in the room at the same time coordinating care. The co-location of primary and behavioral health services also helps mitigate any potential social stigma sometimes associated with seeking behavioral healthcare. The ease of access to a range of care, including some home health options, most often results in greater prevention of serious injury and illness, which results in people being able to stay in their homes longer as they age.
Bringing primary care into patient’s homes
Another home-centric program helping its patients age in place is Village Medical at Home, a full-service, in-home primary healthcare program designed to provide comprehensive care focused on the patient. Dr. Thomas Cornwell, national medical director at Village Medical at Home, has spent his career transforming the delivery of healthcare and advancing home-based primary care nationally. As such, Dr. Cornwell has seen first-hand the remarkable difference in patient outcomes when bringing primary care into the home.
Village Medical at Home provides at-home visits designed to give clients attention tailored to their specific needs in a manner best for both them and their caregivers alike. Their staff of experienced providers assesses and treats clients at home while coordinating care with the rest of the care team, including activities focused on daily living, in-home therapies, and safety checks.
In 2020, Village Medical at Home partnered with Community Aging in Place — Advancing Better Living for Elders (CAPABLE) to provide better healthcare to patients while also significantly reducing costs.
Through this partnership, Village Medical at Home aimed to reduce patients’ reliance on acute care, which is not only expensive but less effective than primary care. “All of a sudden you bring in this high-quality, loving primary care, and patients respond so dramatically,” said Cornwell. “I am used to seeing such amazing differences bringing primary care into the home.”
Transforming lives through in-home care
Even still, the related client survey data surprised Dr. Cornwell. Patients in the CAPABLE program tended to have significantly improved perceived health scores. While only 33% of clients perceived their health to be “good” or “very good” at the start of the program, 76% described their health as “good” or “very good” after program completion. And the survey results of patients that participated in the CAPABLE program were astoundingly positive: A full 100% of patients believed they benefited from CAPABLE; 97.2% felt CAPABLE helped them take care of themselves; and 91.6% believed CAPABLE helped to keep them living at home.
Clients specifically enjoyed the hands-on training CAPABLE offered, and they felt that the staff not only helped them solve their problems but cared about them. Most remarkable perhaps are the client testimonials: “An answer to our prayers. I’m so thrilled. Before life I was at the point where I didn’t know where to turn. [I] feel extremely more relaxed now. [I] can take a bath now. [I] can sleep in the bed now. My whole life seems to have turned around. So many things they did that I never thought I could ever get. … [I] feel so blessed to have had them come into my life.”
Both Dr. Lowenkron and Dr. Cornwell confirm people’s desire to age at home, but the work of The Villages Health and Village Medical at Home and CAPABLE have demonstrated the dramatic and positive impact aging at home can have on health outcomes and lower overall healthcare costs.