A recent FierceHealthcare piece following up on the contention of many hospitals that 30 day readmissions are influenced by social and other factors beyond their purview and control has “found that a “self-care deficit in the elderly post-hospitalization population correlated to bouncing back to the hospital.” Additionally, the research found that ‘patients’ living arrangements, such as whether they lived alone or had a family member as a primary informal caregiver, as well as the frequency of care and the type of care provided, were all related to readmissions.” It is this “self-care deficit” that the “heal in place” paradigm would address.
For patients to “heal in place,” they will need to become experts in self-care and will need a basic and specific skill set. A proactive and creative healthcare community could find ways to bring needed disease information and hands-on clinical know-how to patients, informal caregivers and eventually, to the community at large. Think of it as “Self Care 101.” A long-range option may even be to incorporate this type of training at the middle and high school levels. Students would learn not just about wellness and prevention, but disease management and models of evidence-based self-care; how to fulfill the role of informal caregiver for parents and grandparents; along with instruction regarding living wills, advanced directives, how and when to access the continuum of care along with additional clinical and legal resources.
At the end of the day healthcare reform and healthcare costs will only be affected by knowledgeable and competent self-care and a commitment to personal wellness. The current self-care deficits could be overcome. The investment for the future is not simply one of dollars but rather an investment of knowledge and know-how