I love nothing more than seeing new ideas and innovative concepts brought to the elder care space. There is so much to consider and do when taking care of your elderly family members, and this blog series is intended to highlight some of the innovations and newer tools that contribute to an overall better experience for our loved ones.

This week we are highlighting Senior Helpers , an in home care provider, and an innovative screening tool they are using to keep seniors safer at home and avoid the constant cycle of falling–> hospital –>rehab–>repeat. Amy Walter of Senior Helpers provided some insight into the screening tool and how critical it is for safety.

What are some trends you are seeing with seniors who choose to continue to live at home especially during a pandemic?  

Oftentimes we see a lot of seniors who go from rehab, back to their home, suffer from another fall and then have to be hospitalized all over again. Events that lead to re-hospitalizations among seniors is rising at an alarming rate. With the population aging, the increase in hospitalizations is of great concern to seniors, their families, healthcare systems, government payors and insurance companies. Keeping seniors safe at home, particularly now, during a pandemic, is of the utmost importance to everyone involved.  

What are some ways rehospitalization can be prevented? 

The sad reality is that 20% who leave the hospital will be readmitted within 30 days and more than half will be readmitted within one year.  However, the good news is 76% of readmissions are preventable. In order to provide the best recommendations for avoiding readmission, it takes an individualized approach because each person has a unique set of circumstances when they get home. These are called social determinants of health (SDOH). 

Researchers have found that Social Determinants of Health (SDOH), the patient’s environmental and social factors, have a greater influence on health outcomes than genetics or clinical care. 1 More than 90% of hospital readmissions can be traced to non-clinical factors such as having insufficient support for day-to-day functional needs after a patient is discharged to home. 2 If we are going to keep seniors home safe then we need to understand what we are sending seniors home to and how they will manage!  For example- understanding how a discharging patient will pick up their medications and who will help him/her reconcile what medications are at home and which ones should or shouldn’t be taken. 

What’s an example of someone who is high risk for readmission? 

Imagine the discharging patient is 85 years old, has limited mobility, no longer drives, lives with her 90-year-old husband who she cares for because he has dementia and she has mild cognitive impairment herself! As a social worker with 16 years of experience, I can tell you this is a common scenario!

What innovation is Senior Helpers bringing to this issue?

Until recently, there was not an objective way of identifying health risks associated with social determinants of health. Thankfully, there is a scoring tool that now helps us identify, measure and address all relevant social, behavioral, functional and environmental influencers that put a senior at risk of harm, called the LIFE profile. Based on 20 years of research, following 75,000 seniors as they discharged home from the hospital, the LIFE profile tool scores patients in the five key areas that determine success or failure at home. 

  1. Medical Condition Management
    • Ability to monitor medical conditions and follow medication regimen
  2. Safety
    • Identify hidden safety risks and areas of concern around the home
  3. Independence
    • Ability to safely perform daily activities in the home
  4. Caregiver Burden
    • Availability of resources and care from family, caregivers, and the community
  5. Quality of life
    • Access to enjoyable leisure activities and social interaction

Senior Helpers can stop the revolving door of hospitalizations by using this proprietary tool to assess our clients in these five key areas and work together with families to address the identified risks, create a long-term solution and put the right level of caregiving in place to keep seniors home safe. 

To learn more about the LIFE Profile TM, call Amy Walter at Senior Helpers 615-613-6796. To schedule a LIFE Profile – click on the link: Calendly – Steve Chapek 

  1. University of Wisconsin Population Health Institute, “Different Perspective for Assigning Weights to Determinants of Health” – February, 2010.
  2. Andrew Auebach, et. al. “Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients” – Journal of American Medical Association, April 2016. 

Thanks to Amy and Senior Helpers for sharing this awesome tool!