Key Takeaways:
– Homebound seniors, especially those living alone, often face considerable health complications and potential risks.
– With a high prevalence of chronic conditions, mental health issues, and a reliance on others for daily living, this community is often overlooked.
– The demand for home-based care services is escalating, but financial and logistic challenges prevail.
– Amid the growing aging population, the health system needs to prioritize homebound seniors’ healthcare needs.
The Silent Plight of Homebound Seniors Living Alone
Carolyn Dickens, a 76-year-old former lung cancer patient residing in central Harlem, succinctly captures the predicaments of older adults living alone and battling chronic diseases. Being a lung cancer survivor with serious lung disease and recurring fainting spells, her story encapsulates the daily struggle characteristic of the lives of many homebound seniors.
Her solitary existence and frequent health scares highlight a pressing concern often overlooked by healthcare policymakers, legislators, and researchers. Compared to the 1.2 million residents of nursing homes, a substantially larger number of seniors are living homebound lives without formal acknowledgment of their health needs.
The Vulnerabilities of Solitary, Homebound Seniors
A 2020 study published in JAMA Internal Medicine presents some startling figures about this neglected population. Nearly 40% of completely homebound seniors suffer from five or more chronic health conditions. About 30% are suspected to have probable dementia, while 77% struggle with performing at least one daily task, such as bathing or dressing. Further, 40% among them live alone, which exacerbates their vulnerability.
The COVID-19 crisis brought to light and amplified these fragilities. The number of ill or disabled older adults, confined within their homes, doubled as access to help became even more limited.
Prof. Katherine Ornstein, Director of the Center for Equity in Aging at the Johns Hopkins School of Nursing, reiterated that homebound older adults rely heavily on others for basic needs, such as food and healthcare. Those living alone face higher odds of living in unsafe conditions with inadequate food supply and poor access to healthcare services.
The onboard doctor and nurse practitioners from Mount Sinai’s Visiting Doctors Program serve as a lifeline for many such seniors in Manhattan each year. Amid challenging financial constraints, they manage to provide home-based primary care approximately 1,000 patients annually. However, merely 12% of older adults who rarely or never leave their homes can access such services.
Home-Based Primary Care: A Potential Lifeline
For many homebound seniors, visits from healthcare providers offer a crucial line of healthcare support. One such example is Sandra Pettway, a 79-year old Harlem resident with Type 2 diabetes, depression, severe spinal problems, and back pain. Regular check-ins by her doctor help manage her health and ease worries related to impending surgeries and recuperation.
Similarly, for Marianne Gluck Morrison, another senior citizen who copes with multiple health issues areas such as vertigo, wound recovery, diabetes, and others, visits by her doctor function as an essential health check and a crucial source of companionship.
The Way Forward: Expanding Home-based Medical Care
With the rapid aging of the US population, Dr. Bruce Leff, Director of the Center for Transformive Geriatric Research at the Johns Hopkins School of Medicine, predicts an increased demand for home-based care ranging from rehab services to palliative care and hospital-level services. However, this could be a challenge for homebound older adults living alone with no family caregivers to help manage this home-based care.
The stories of Dickens, Pettway, and Morrison underline the vulnerable condition of homebound seniors living alone. The health system needs urgent policies aimed at addressing the overlooked needs of this community, lest their health conditions worsen. Understanding and catering to their healthcare needs should not merely be a matter of convenience but a necessity in a society that aims to value and protect all its citizens, young or old.