Some months ago, 86-yearold Y.K. Srinivasan of Bengaluru needed skin grafting, a standard procedure, but at his age it put the octogenarian’s mobility under check.

Not willing to stay in the hospital for long after the procedure, he opted to recover in the comfort of his home instead of continuing his stay in the hospital. "I needed assistance with daily routine activities such as grooming, using the toilet, bathing and administering medicines, and engaged a healthcare attendant," he recounts. It cost him Rs 30,000 a month to hire a full-time attendant at his house.

Srinivasan’s is not a unique case. Many older Indians are living alone, which is a stark reality of nuclear homes and increasing longevity. There is also the case of addressing the hospital capacity problem, especially when it comes to recovery, wherein the home-recovery solution is preferred by the elderly and many others who find hospital stays intimidating and even depressing.

Allowing patients to receive treatment at home is gaining huge popularity and several studies point to improved outcomes. The mushrooming healthcare support system industry is adding to the increase in traction for such services.

Convenient care

One of the biggest flaws with hospitalisation is that it expects patients to fit around services, rather than have services fit around patients. To tap into this shortcoming, several businesses have come up which are pushing the growth of healthcare at home. At-home healthcare is nothing but an active treatment by healthcare professionals in the patient’s own home for a condition that would otherwise require hospital care. This requires putting the patient at the centre of a network of preventative and proactive care, and providing the level of professional support necessary for the patients to become and remain independent in their own home.

"Treatment at home helped me to regain my confidence and mobility," says Srinivasan. The impact was such that he was fine with a nightonly attendant within a month. 

Clinically safe and effective home healthcare has become possible for an increasing range of conditions and treatments from the earlier only-attendant type needs. Recalls 37-year-old Monika Sachdeva from New Delhi: "I had a severe back pain, which was not healing despite taking painkillers prescribed by the orthopaedic consultant. I then engaged a physiotherapist who treated me at home and I was cured in three days."

At-home healthcare now extends to caring for people with long-term conditions like specialised cancer services where a nurse-led multidisciplinary team provides treatment while patients remain under the overall care of the referring hospital or doctor. "Instead of sitting at a hospital reception, I wanted to spend time with my mother who had her knee replaced and needed emotional support," recounts Deepti Patwardhan, who spent three weeks with her mother in Pune before leaving her to the care of house helps and physiotherapists. The trend for care at home has also to do with individual and undivided attention that one receives.

Not just medical

At-home care is not just for recovering patients, it is also for those who need assistance in old age or otherwise. "My father is not fit to travel and join us in the UK, and it is extremely difficult for us to make frequent trips and be with him in Mumbai," says Karen D’Souza, whose father is 88 and lives all by himself in his flat in Santacruz. He has a nurse coming in every day to help him with his bath, meals and medicines, besides a monthly schedule to see the doctor for a general check-up. He is not keen to move to an old-age home, after he was left unattended there once three years ago.

Times are changing with the availability of qualified caregivers as well as companions who spend time with the elderly just to give them company. "I was spending time with my grandmother who had no ailments but was lonely and found that it was helping her. So, I have started spending time not only with her but other elderly people nearby as well," says Deepti Bansal, a Gurgaon-based, 20-year-old college student. There are organised companion providers such as Epoch Elder Care, First Seniors, MayaCare, and others offering services of social and intellectual companionship.

In the backdrop of rising crime against the elderly, there are also services that are not focused just on healthcare-related issues but also somewhat manage to check on their safety. Considering the old have restricted movements and health issues, there is very little to do beyond watching TV or reading. "I was getting depressed with nobody to spend time with after my husband’s demise. My children no more stay in the city and I do not wish to stay with them," says 70-year-old Sumitra Rao of Gurgaon.

"The personal attention and understanding extended to us from the very first day is something that I cannot forget. They made sure that the attendant was used to being with the elderly, was co-operative and a perfect match for our home environment," attests Srinivasan. Srinivasan and his wife have retained the services only for the nights now owing to high costs, an option readily available.

With a rising elderly population, sophisticated at-home caregiving can help revitalise people’s sunset years and also bring in more players to offer solutions, which are on the lines of long-term care and hospice. The support of family, friends and now caregivers is what people in old age, as well as when they are unwell, need. Rao is now contemplating on taking a holiday in the hills along with her caregiving attendant whom she feels will be a good companion. The elderly have a reason to remain optimistic now and recover faster in familiar surroundings.

Selecting a care giver

Convenience comes at a cost and at-home care givers need to be selected after due deliberation. While there are agencies and companies providing these services, the person actually coming to help has to fit into your home and suit your needs.

Screening

Meet the person who is likely to be assigned to you and find out about their past experience and if they meet your specific needs, only then should you proceed further.

List your needs

Do you need general assistance or medical assistance, because each calls for different type of expertise and the costs vary accordingly.

Check references

Speak to people who have used such services in the past or people who have used the same caregiver and their experiences.

Share information

The more care providers know about you, the better care they can give as they will understand individual habits. In case of the elderly, it will be good if the caregiver is aware of family members as they may speak about them to the caregiver, who can in turn have a constructive conversation and not be lost.

Prepare questions

It’s a good idea to have a third person present when you are screening so that you can have someone trusted to pose questions you may not be comfortable asking. It will also provide a second opinion.

shipra@outlookindia.com