How will you deliver the care that consumers want as they age?

New EY research shows healthcare consumers want a tech-enabled aging experience that helps them stay independent and at home.

In brief

• In an age where people are focused on longevity and wellness, our care models for the aging are failing and unsustainable.
• Huge opportunity exists for health organizations to help people age healthier, reducing cost and burden.
• Caregivers are stretched too thin and a critical unpaid factor in the system, with one in five telling EY they spend 31 plus hours caring for their loved ones.

Healthspan vs. lifespan

With evidence pointing to the importance of mobility, nutrition, socialization and intellectual challenges to aging well, experts in the space see the need for more of a wellness model rather than a treatment model. At Shannex in Canada, a company that supports people as they age, residents or members will be able to receive regular functional health assessments that will present data on their current and projected health state, given their lifestyles. They can use the results to enroll in specific programming that will help them achieve their health goals. “We do believe there's going to be very high demand from those seeking lifestyle and care interventions to live better, longer” said Jason Shannon, Shannex President.

The EY survey highlighted some opportunities for health organizations to improve the levers that impact healthy aging. Respondents shared their current levels of healthy habits for aging:

• Only 26% of respondents are following a personalized nutrition program
• Only 25% are participating in social clubs or activities
• 43% are following a fitness plan
• 50% are undertaking intellectual challenges

As roughly 30% of older adults are living with some form of cognitive impairment, some experts are pushing for regular, standardized cognitive screening in primary care — as routine as a mammogram or colonoscopy — to get to the bottom of it. “Historically, the majority of primary care providers don't screen proactively. It's only been when symptoms become really noticeable, or families demand it, that providers pull out a cognitive assessment," said Elli Kaplan, CEO of Neurotrack, a US company that has developed a digital tool to make the screening process easier for clinicians and patients. Recent research suggests it can take more than 3 years for patients to get a diagnosis, and more than 60% of people with dementia go undiagnosed, an unfortunate reality that can close the window of opportunity for disease-modifying treatments and robs patients of having a voice in their own care. Regular screening could fix this and help normalize important conversations around cognitive health, she said.

The ever-important role of caregiving

The current system also relies heavily on the unpaid labor of caregivers. The EY survey showed that 48% of caregiver respondents rate the system as extremely or very difficult to navigate, with women caregivers more likely to rate it as difficult (50% vs 38% of men).

In some cases, the amount of time spent caregiving is staggering: One in five caregiver respondents spend more than 31 hours a week taking care of a loved one, with the majority (80%) of caregivers spending at least 5 hours a week on their duties. These figures suggest an opportunity for health organizations to employ technology to lessen the burden for caretakers who are often balancing work, families and caregiving. Intuitive digital tools can help ease the process of care coordination, so stressed caregivers are not wasting their time making multiple phone calls for every appointment or struggling to find medical advice for their loved ones’ issues.

When asked what supports would help improve their caregiving experience:

• 58% of respondents want more education on their roles and/or responsibilities and on the caregiving tasks to keep someone safe at home
• 60% said provision of financial support for carers/caregivers will better support them

Cara Abbott, founder of Betterleave in the US, saw the barriers firsthand when caring for her mother with a terminal illness and said health systems need to re-center care models on patient- and family-centered care. "I was overwhelmed by how fragmented and impersonal the transitions of care felt. And there was little guidance or communication from palliative to hospice and through bereavement — and not enough done to make sure I was supported along the way." Abbott said. "When families are engaged and included in care plans, it not only improves the patient’s experience but leads to better outcomes for providers like reduced hospital readmissions and increased ratings and stronger care continuity.”

How health organizations can help consumers age better

Five areas of focus can help organizations in the health, consumer and government space move toward healthcare that keeps people healthier longer as they age:

1. Empower consumers to manage their own health destiny. One of the biggest hurdles to improving population health is successfully convincing consumers to abandon unhealthy lifestyle choices in favor of behaviors that will help them avoid chronic conditions or health crises as they age. With the data that exists across the health ecosystem, analytics can be used to create health forecasts for consumers based on their care record. The forecasts can be paired up with personalized plans of interventions that might help them course correct to avoid chronic disease, frailty or acute illness. Consumers already are collecting their own health data via wearables and tracking apps. Health organizations can embrace that trend, supporting consumers to drive toward a longer “healthspan” with education, training and other supports.
2. Transform care models to improve community-based support and navigation so people can remain at home longer and aren’t forced into traumatic acute care situations because they could not access real-time support. Place-based changes, such as walking paths that remove any tripping hazards, can help people stay in their communities longer. Community interventions delivered through home visits, organization of social groups, fitness classes and caregiver support also can make a big impact on patient and family lives.
   
3. Take advantage of consumer openness to digital technologies to deliver care where they want it. With a plethora of sensors that can alert consumers to everything from a medicine cabinet that has not been opened to a stove that has been left on too long can help support safety for people to age at home. Health organizations can further support mobility and health through virtual physical therapists and nutrition coaches. However, there must be recognition that not all people will be able to afford or access these technologies, but that a preventative approach can lower overall health costs for health systems.
4. Build awareness of the benefits of community care to involve stakeholders in shifting investment from acute to preventative care. It is less expensive to deliver and what consumers want. “The challenge always is trying to innovate within the confines of a funding model or current policy environment that, at times, kind of limits and inhibits innovation,” said David Larmour, CEO of Dale Cottages in Australia.
5. Support caregivers to alleviate burden and create a more transparent, accessible system of care and support. “If that family caregiver burns out and just can't cope and can't manage, then they bring grandma or grandpa to the emergency department, and they just say, I can't manage anymore,” said Dr. Richard Lewanczuk, of Alberta Health Services in Canada. “The minute we admit them to the hospital, there's a deterioration in physical functioning, mental functioning, and quite often people then need to be institutionalized. So, anything that we can do to support family caregivers, and keep people healthy and well in their communities, that will then help people not get to the emergency department.” When a family needs help, an infusion of community interventions can pay off in multiple ways.

Sector findings

By centering care in the home and the community, health organizations can deliver better outcomes and experience for consumers, their families, their budgets and society.

Summary

Aging care must move away from institutional models toward approaches that reflect consumer expectations, support caregivers and prioritize prevention. Community-based and technology-enabled solutions are key to building a sustainable health ecosystem.