Thanks, Warren!

Posted on | March 14, 2008 | Comments Off on Thanks, Warren!

Notes on caregiving from a colleague in Louisiana

Warren Hebert, a home-health executive in Louisiana who is also a registered nurse, attended the American Society of Association Executives (ASAE) meeting last year when I spoke there. He contacted me recently by email to let me know that he was distributing a summary of my speech to some of his fellow home-health executives.

I asked Warren if he would allow me to post his email here for our Health Commentary audience. I do so partly because he has captured the presentation very well; but also because he has expanded on it with his own description of an encounter he had with a caregiver who experienced all the challenges our system could dish out. Please read Warren’s article, below, and you’ll hear the tale. Meantime, my thanks to Warren for his kind words and for the work he and others are doing to address our nation’s caregiving issues:

“Dear State Association Colleagues,

A handful of us were in Chicagoland for the ASAE Annual Conference. While there were a number of solid presentations one of the most intriguing was from Mike Magee, M.D., entitled “Health Politics: Where is our Health System Headed?” The session captured Dr. Magee’s view of the mega-trends that will drive change in healthcare, and certainly deserves our attention. His You-Tube like website, which debuts next month, asks for video stories of consumer’s health care experiences, and will definitely get the attention of the press. While you can get most of the information he shared at his other website, http://www.healthpolitics.org, here are a few thoughts from my notes.

The five mega-trends Dr. Magee says will change healthcare include: the aging of America; the health consumer movement (or uprising); changing relationships between professional and family caregivers (a new partnership VS old paternalism); the internet and the emergence of NGOs – non-governmental organizations. The simultaneous occurrence of these trends coincides with three business sectors, not from healthcare, that all three recognize the opportunity in the domain previously reserved for doctors, hospitals, and more conventional providers of health care. Dr. Magee indicates the financial institutions, technology sector, and the entertainment industry are making major investments in healthcare. Health savings accounts and reverse mortgages are two examples of finance folks tapping into large financial transactions having to do with health and illness. He indicates the technology folks, with smart houses, killer applications related to ‘lifespan management’, and more, will be major players as manifested by the work of CAST, Center for Aging Service Technologies- www.agingtech.org. Lastly he indicates the entertainment folks will get into health education and managing personal health and wellness, all available with a click of the remote control from your living room couch. Dr. Magee indicates that the fact that these sectors are already in the homes of America make it obvious that this is where people want and should receive their care. Thus the title of his book, Home Centered Health Care.

He feels that there are those who benefit from a ‘dis-integrated’ system, who will resist change at all cost. Dr. Magee states that hospitals, physicians, nurses, and others that benefit from the current more paternalistic system are also likely to fight change in favor of the status quo. He cites the tipping points that make change inevitable, including connectivity in the form of broad band and Wi-Max, which will allow free phone and internet access over a 50-mile radius. He also sees a tipping point in the changing role and recognition of the more educated and informed family caregiver, partnering with the MD and other providers, to better orchestrate their family member’s care. He calls this person a ‘home-health manager’, who he feels should be given credit in the form of reduced health premiums for the family when they help keep costs down. This is not to be confused with a home health manager, that we have as members of our association. He feels the family caregiver, becoming a manager of the home’s health, should be rewarded if he/she keeps a healthy family with reduced health care premiums.

There are other tipping points but the last one I’ll mention is equity & justice. He indicates having one sixth of our population without access to healthcare is discriminatory and prejudiced. I spent eight hours in the Houston airport after a flight was cancelled due to a tropical storm. I met a gentleman in his mid-fifties who overheard part of my cell phone call with an Alzheimer’s executive director. The gentleman introduced himself, and then freely shared his experience of leaving his job as an engineer, for over nine years, to care for his wife who had progressive M.S. Their children were grown and away, and with property and a savings account they did not qualify for assistance of any kind. He wouldn’t institutionalize her, citing their wonderful 30 plus year marriage, and the wife wouldn’t accept care from another person. After two failed attempts at hiring a caregiver he stayed at home, going through their savings, his retirement, and eventually selling his property to allow him to be at home with his wife, who died in May of ’06. (He was in the airport returning home from a 12-day Alaskan Cruise, a well deserved break I’d say.) Stories like his make it clear that at times our health system can be unfair. We’ve certainly got work to do.

So what should we be doing? First, I encourage you to obtain and read Dr. Magee’s book is entitled “Home-Centered Health Care, The Populist Transformation of the American Health Care System” and to visit his website. Second, be aware of Dr. Magee’s work as a Commissioner with the National Commission for Quality Long Term Care and as a Fellow with the Center for Aging Services Technology. CAST is sponsored by the American Association for Homes and Services for the Aging, and is only part of a much larger effort to advance care for the aged, at home and via institutional care. Third, as state associations, responsible for making our membership aware of the horizon for care in the home, we should become familiar with the work of these groups and be aware that their work will impact our home health members. CAST’s website can be found at html www.agingtech.org. Dr. Magee’s website again is http://www.healthpolitics.org. When you visit Dr. Magee’s website you’ll find he has a video of the potential home care of the future, at http://www.healthpolitics.org/aging_videos1.asp. This seven minute video, while intended to be futuristic, isn’t far from reality today. Make the time to view it.

The prologue of Dr. Magee’s book is written by Larry Minnix, CEO of AAHSA and the Epilogue by Eric Dishman of Intel and the Chair of the Center for Aging Services Technologies. We’ve known for some time that organizations and industries providing institutional and assisted living types of long term care were going to move toward home and community based care. These websites, Dr. Magee’s book, and the results already achieved by CAST, the National Commission for Quality Long Term Care tell me that they have arrived and will challenge us to be better at the work our state associations do for our membership.”

Warren Hebert, RN, CAE
RWJ Executive Nurse Fellow
Chair, Council for State Home Care Associations