Around the world incidence of COVID-19 deaths has been highest at senior living communities – e.g. at care homes and “old age” homes. Many facilities have seen uncontrolled outbreaks with devastating consequences for both elderly residents and care workers. On World Elderly Day, which is marked on October 1, Prateep Sen and Tamojit Dutta, co-CEOs, TriBeCa Care, review the impact of COVID-19 on the elderly and envisage the changes required in senior care services in the country
India, with a population of 110 million senior citizens, has traditionally looked after its elderly through an informal joint-family network. There was limited need to step outside the immediate family and seek professional help. Affordability of such services was not a major concern nor was the need for managing depression among the elderly. Care needs were close looped and met entirely by the family.
But even before COVID-19, care for the elderly was becoming more difficult to manage without some external help. With an increasingly young, mobile workforce – many of whom had left home in search of jobs and advancement – the Indian senior citizen often struggled to cope with everyday life on her own.
COVID-19 of course has taken the elder care crisis to an entirely new level globally. The disease has affected senior citizens disproportionately and made a bad situation much worse. It is time that we as a country, look at the future and truly understand the enormous scale of challenges in geriatric care. How the lack of a well-funded or well-structured senior care industry is taking its toll on families and healthcare systems.
COVID-19 has also highlighted some of the major challenges for the elderly:
- Lack of socialisation during lockdown
- Impact on mental health and sense of self-worth
- Dearth of specialist online platforms that work well for the aged
- Feeling of helplessness in times of a major crisis
Home based senior care will become more critical to healthcare systems
Geriatric care is massively undervalued by the wider healthcare industry. Clinicians tend to focus only on the “narrow” medical needs of the elderly. The cardiac surgeon focusses on the heart. The endocrinologist on diabetes management. The orthopaedic doctor on the knee replacement surgery. But there is limited focus on the holistic wellbeing of the elderly. Who, for example, is evaluating the wider non-medical or mental health needs of the aged?
Even families, struggling with care of their elderly loved ones, are sometimes reluctant to seek outside expertise. They feel guilty to accept help from others and are almost duty bound by social norms to do everything themselves. This is not always going to be possible.
Globally, home care companies provide a range of non-medical and emergency support services that help the elderly remain healthy and independent in their own homes. Not only are these services critical for families, they also reduce pressure on limited hospital resources. Less pressure on hospitals will allow clinicians to focus on critical cases that truly deserve their attention.
Around the world incidence of COVID-19 deaths has been highest at senior living communities – e.g. at care homes and “old age” homes. Many facilities have seen uncontrolled outbreaks with devastating consequences for both elderly residents and care workers.
This has highlighted, yet again, how important home-based care is for vulnerable senior citizens. The elderly who have remained in their own homes, often under the supervision of professional care companies, have largely been safe and healthy through the pandemic. In fact, home care demand has grown exponentially through the COVID-19 crisis at the expense of hospital-based care.
COVID-19 has proven that home care companies can reduce unnecessary hospitalisations, prevent fall accidents, and provide immediate emergency response, if needed. A trained home care worker can identify potential depression among the elderly and trigger protocol-based mechanisms with psychologists and family members.
Over the next 20 years, many more wrap-around services will be available for families dealing with ageing at home.
Home based senior care will be covered by health insurance
In India, a major challenge for the wider acceptance of home-based care is not just social, but also financial. Senior care is not covered by health insurance or public spending, unlike in many western countries. Historically there have been many reasons for this, including:
- Lack of professional care companies who provide consistent services
- Scepticism among doctors about the efficacy of healthcare at home
- Difficulty in monitoring nursing care quality at multiple home locations
- The perception that only limited health conditions can be managed at home
Yet, COVID-19 has shown that many chronic health conditions can be managed effectively away from hospitals. That this can be done without exposing vulnerable elders to pandemic risks at clinics is an added benefit. With the advent of tele-health, IoT devices including sensors at home and professional home care companies, hospital-level services at home will soon become a reality.
We hope that as insurance companies take cognisance of excellent home care options and discover the huge cost savings versus hospitalisation, they will offer these services more widely to their members. Many more seniors can then get the care and attention they need without having to be admitted in hospitals.
Already, insurance companies like ICICI Lombard have tied up with senior care companies like Tribeca Care to provide remote monitoring of COVID-19 patients.
Senior care services will be more regulated and tech-driven in the future
Today’s increasingly affordable, smart technology platforms allow professional home care companies to offer comprehensive remote services that go much beyond an occasional tele-health consultation.
And as governments start taking senior safety seriously, this industry will be regulated more closely. Gone will be the unlicensed, ill-organised local care agency with poor delivery capabilities. They will be replaced by well-funded, tech-enabled professional companies that provide trained care workers for a range of geriatric services.
Breath-taking tech innovations will ensure better monitoring of home care. For example, sensors – stuck to doors, bed, chairs, and fridges – will provide deep insights about an elderly’s everyday life. GPS technology will easily track dementia patients at-risk of “going missing”. Talking robots will probably reduce loneliness and depression among the elderly.
While COVID-19 has been devastating to the world’s economy, it has taught us some valuable lessons about caring for our seniors. Many of today’s hospital-based care models will be replaced by cheaper, better, tech-supported home-based care platforms over time. That surely is the best outcome for families, governments, and the elderly themselves.