When Jennifer Hale thinks of age-friendly care in hospice, her mind goes first to what might seem an unusual place: man’s best friend.

As the VP of Clinical Quality and Standards of hospice provider Compassus, Hale views age-friendly care as an approach to care that is “focused specifically on the needs of people as they age in their home setting,” she says.

That means hospice providers listen to what their patients need and want to make them comfortable and give them dignity at the end of life. Compassus uses its clinical assessment not just to capture a patient’s health information but also to inform their goals, hopes and fears.

“In one patient’s case, her greatest concern was making sure that her dog was cared for after she died,” Hale says. “People say that: ‘After I’ve gone, who’s going to take care of my dog?’ That is the thing that gives them the most anxiety and grief.”

In these cases, Compassus explores all options for pet support to solve that issue. It may seem like a small item for a patient near the end of life, but for that patient, getting it right is essential to their peace of mind in hospice care.

“From a hospice perspective, age-friendly care for people who are living with terminal illnesses is about focusing on those things which support the elder person to sustain their psychosocial, spiritual, mental and physical mobility and help them stay safely in their home setting for as long as possible,” Hale says. “We recognize that each individual has specific personal needs, wants and desires, and things that are important to them. We start by asking what those things are, and we proceed from there.”

How hospice providers are building age-friendly care

Brentwood, Tennessee-based Compassus delivers hospice care — along with home health, palliative and home infusion — to patients nationwide: nearly 270 locations in 30 states in every part of the country, taking a personalized approach with each patient. They lean on HCHB’s Person-Centered Care Plans, (PCCP) to document their age-friendly care in hospice.

“First and foremost, age-friendly care in hospice means you’re focusing on what matters most to the patient,” says Lynn Carroll, Vice President of Product Management – EHR at Homecare Homebase.

Carroll breaks down the execution of age-friendly care into four areas:

• Understand each patient’s goals. Carroll notes these could be as simple as wanting to be able to change their cat’s litter on time.
• Educate the patient and family on their medication. Providers should ensure that patients and their family members and caregivers understand the medications they are taking, the side effects they can have and the risk versus reward of taking them at the end of life.
• Understand mentation. Clinicians can use this knowledge to lower the risk of changes in memory or mood.
• Maximize mobility. Providers must ensure that the patient has as much mobility and independence as possible, which could mean the strength and balance to safely move around their house, or to reach what they need if bed-bound.

“Age-friendly care certification was another way for us to validate our care model,” Hale says. “We worked with Homecare Homebase to implement their person-centered care plan which actually further validated the approach to care that we were already taking.”

Inside ROI of age-friendly care

Because age-friendly care using PCCP is tailored to each individual, determining ROI is personalized too.

“I think there are two ways to measure ROI with PCCP.” says Donnette Threats, Director of Product Management at Homecare Homebase. “Start with your staff survey. In most organizations, you’re going to survey your staff to see how they feel about what they’re doing and if they love their job. Research has shown that staff feel a whole lot better about their job when they feel competent.”

In other words, because PCCP designs care around the patient, staff members feel that they are maximizing their time with patients.

“If I’m a staff member, I’m going to walk out of each house feeling really good that I provided great care, regardless of everything else that I can’t control,” Threats says. “That improves my sense of accomplishment — my sense of how I feel about my job.”

The second one is CAHPS outcomes. Compassus has seen improvements there as well.

“So far we have seen a reduction in regulatory citations as we were able to achieve that first aim of aligning the EMR with what surveyors are looking for,” Hale says. “We’re able to see an improvement in our overall CAHPS survey outcomes. We’ve also seen improvements in our visits in the last days of life.”

That’s a return on investment that is priceless.

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