caregivers

Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — Who are the forgotten soldiers of health care? — is reprinted below. To see all of his blog posts, click here.

If I were to ask you about the forgotten soldiers of health care, you might think about hard-working nurses and clinicians, or the ER staff that works diligently through the night. While these professions are absolutely critical to our nation’s health care system, my thoughts go closer to home, to family.

Think about how difficult it is to care for someone who is over 65 and needs assistance at home. Whether it’s managing multiple medications or monitoring blood-sugar levels, in-home care for an older person living with chronic conditions takes a team approach.

Primary care physicians can quarterback care and coordinate among specialists, and nurses can make sure care is efficient and consistent.

But beyond the traditional doctor/patient relationship, there is a forgotten soldier. This person is not a doctor or a nurse or a licensed care professional. Many times the person does not work in the health care industry. But they have the most unbreakable bond with the patient: They are family. That person is the caregiver.

And this was reinforced for me during a recent visit to Houston.

Meet “George”

While I was in Houston, I was fortunate enough to participate in an in-home visit with one of our members, “George.” I also met his wife, “Mary,” their daughter, “Beth,” and several members of George’s clinical team.

George is 71 years old and is in a Medicare Advantage PPO plan. He lives with multiple chronic conditions, including coronary artery disease and hypertension, and he has undergone a coronary artery bypass.

Living with these multiple chronic conditions is not easy for George, and it also takes a toll on Mary and Beth. Treating these conditions requires a holistic approach.

For example, Humana and our partners — physicians, nurses and clinical care experts — help care for George in a number of ways. He receives occupational therapy to strengthen his upper extremities and fine motor muscles, and physical therapy, primarily for his lower extremities and gross motor muscles. Under the direction of a care professional, George also receives support for personal care and activities of daily living, like feeding, showering, dressing, etc.

The Sit Down

Both George’s nurse and his therapist led the visit. His wife and daughter were there, too.

From the start, it was evident that the nurse and therapist had a strong, personal bond with George, Mary and Beth. The nurse and therapist, both of whom I could see were an unofficial extension of the family, understood the critical care and emotional support that Mary and Beth provided to George.

At the end of the 30-minute visit, I asked George what was most important about the care he received. He said he appreciated help from people with a positive attitude; he liked the quality of the interaction and not being “rushed;” and he noted the dependability of the team members, who always show up and follow through.

The care team benefitted too, enhancing their already deep, holistic understanding of George and reinforcing the bond of trust. It was clear to me that this care team – family and clinical – had been making a difference in George’s life, and that he was thankful.

The Importance of Caregivers

November is National Family Caregivers Month, a time to recognize the critical care provided by approximately 43.5 million caregivers. Their work had an estimated economic value of $470 billion in unpaid services in 2013. And with the senior population growing, many of us are going to find ourselves in the shoes of Mary and Beth – as caregivers.

These forgotten soldiers of health care will help determine how well America copes with the rising tide of chronic conditions. I’m encouraged, having seen firsthand how Humana’s Caregivers Network Resource Group is providing resources for our employees caring for family members and other loved ones.

While George has a very strong clinical team and family support network, there are many members who are not as fortunate. They are socially isolated and don’t have family to turn to for care. Their children may live in different cities. They might not have close relatives or friends.

This is the challenge, and we must be prepared.

It’s only going to become more common

In the caregiving world, relationships matter. Technology can help, maybe by building caregiver networks to identify people who have the time to help. But it’s not going to change health.

Technology is not a substitute for trust between two people. Basic human interactions can’t be replaced with a robot, an app or some other form of technology. It’s the low-tech and human efforts that are most impactful.

Our front-line associates know they can have an impact on the health, well-being and experience of our members. They are in this together, and they know it takes a team built on trust, empathy and emotion to make life better.

Mary and Beth are the unsung heroes, the forgotten soldiers of health care. They have an amazing impact on the people they care for, and on our health care system. You may also get the call – as a wife, daughter, husband or son – to be a caregiver. We need to ensure that we’re all prepared to receive this call, and to act on it.

 

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Humana’s Nate Kvamme, Vice President of Wellness Solutions, has written about 5 Wellness Trends to Help Support Happier and Healthier Employees in U.S. News & World Report.

“The newly released 2017 Humana Wellness Trends Report uncovers the five trends that currently have the most impact on employees – both inside and outside the workplace,” he wrote. “Specifically, workers are getting older, more fatigued and increasingly worried about their finances while they rely on mindfulness and emerging technology to help them achieve their desired health.”

Nate wrote about how workplace wellness programs have evolved to help improve employee well-being, productivity and morale.

Read his article here.

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Bruce BroussardIn a series of LinkedIn Influencer blog posts, Humana President and CEO Bruce Broussard shares insights and ideas about the future of health care and discusses the importance of working together to improve the health-care system as well as our own health and well-being. His latest — The Human Problem With Health Technology — is reprinted below. To see all of his blog posts, click here.

One of my favorite activities is taking a bike ride. It’s a wonderful way to experience nature and challenge myself. How many miles did I ride? How long did it take? Did I do better than my last time?

Cycling is traditionally an individual sport, so I use a Garmin device to answer those questions. My Garmin device provides me with details, but it’s limited when it comes to seeing how I relate to others who also love cycling. For that, I use the app Strava.

Strava is a way for me and others to see how we measure up to one another. Strava is not a device, but it’s designed to create a community by connecting fellow cyclists. You can follow anyone on it.

Despite the individuality of cycling, there is a need to connect with other people who share this experience. There’s a social aspect to the sport, and it reflects the challenge we face with technology in health care today: Technology must be easy to use and deliver the human connection to improve a person’s health.

And nowhere is this more critical than in America’s rapidly growing senior population—a large number of whom are grappling with multiple chronic conditions.

Addressing Loneliness and Isolation

America’s seniors could benefit greatly from more human-centered technology. Three out of four Americans aged 65 or older live with multiple chronic conditions, and 71 percent of the money spent on health care in the U.S. is associated with chronic conditions. And the baby-boom generation is steaming into retirement, with 10,000 people a day aging into Medicare.

But health isn’t just about the physical aspects. Research has found that 17 percent of adults age 65 or older are isolated, and 26 percent are at increased risk of death due to subjective feelings of loneliness. If a person is living alone, and dealing with multiple chronic conditions, he or she might become depressed. People also won’t eat right or be active if they’re depressed.

Our species needs to connect with other people. Yet millions of seniors are lonely; they don’t have adequate social connections. That innate need to connect, to be social, and to be loved and to love other people is not being met in a large part of the population.

Things like remote monitoring technology can help, but only if it incorporates a person’s lifestyle and the physician/patient relationship. Technology has to go beyond monitoring basic physical activity. Devices have to achieve true connections and address real chronic health problems, like the nearly five million Americans in the U.S. who have congestive heart failure (CHF).

An Example of Connected Health

In order to help our members with chronic conditions spend more time living their lives by staying out of the hospital, we launched a CHF remote monitoring pilot program to help them keep track of their condition.

When a person has CHF, his or her heart doesn’t pump strongly enough to move blood around the body. As a result, the person retains water – in places such as the lungs, legs or chest cavity – and can suffer from shortness of breath. If the person experiences a significant change in weight from the previous day, this could signal a complication, which might lead to a trip to the hospital.

At Humana, we’re all too familiar with CHF. Approximately 300,000 of our 3.2 million Humana Medicare Advantage (MA) members live with CHF, and they account for more than 40 percent of MA admissions. Here’s how the pilot program works, with a member we’ll call “Brenda.”

After being selected, Brenda met with her primary care physician and a nurse. She was shown how to use a smart scale that would send her weight to Humana every day. When Brenda weighed herself the next morning, the scale sent her weight to her nurse, who called Brenda to congratulate her on her first weigh in.

If Brenda’s weight were outside an established range, her physician and nurse would be immediately notified. The nurse could then contact Brenda to see if she needed a new prescription or a consultation with the physician, enabling Brenda to have her weight fluctuation addressed immediately without having to go to the hospital.

Ease of Use and Human Connection

Members who participated in the CHF pilot program weighed in 88 percent of the time during the first 100 days. So why has this program been successful? There are two core elements: ease of use and human connection.

The table stakes for remote monitoring is ease of use. Brenda’s scale has no plug, no buttons, and requires almost no instructions. She doesn’t need Wi-Fi or Bluetooth to use the scale, and she doesn’t need to register it anywhere. Her scale simply works right out of the box. To be certain Brenda knows exactly what to do with her scale, she used it in front of her nurse as soon as she received it.

But to keep weighing in every day, this new activity has to be bonded to something Brenda values: human connection. Because Brenda knows her nurse is on the other side of the scale, and is looking out for her health and well-being, she is more likely to weigh in each day. Additionally, we have found that group enrollment sessions help people like Brenda because they see other people with CHF taking action to monitor their condition.

The program only works if people like Brenda take a small action each day. Technology can make it easier for Brenda to take that action, but in the end she will do it because of deeper, more human motivations like connecting to others.

There are other elements that help enhance the effectiveness of health-related technology, in addition to ease of use and the human connection, such as the motivation that comes as a result of a person seeing his or her specific progress (personalized, real-time, relevant information, aka the “so what”). This can be a powerful hook for encouraging ongoing engagement and helping people become more knowledgeable, and confident, in managing their condition. For example, the CHF pilot also includes sending “certificates of accomplishment,” recognizing those who’ve reached various milestones and that receiving recognition for their effort seemed to be an effective way of keeping people engaged.

The Way Forward

Health-related technology such as remote monitoring and scales can help our aging population improve their health. But it won’t do so unless the technology brings together the lifestyle and clinical aspects of a person’s health in a way that makes it easy to get people more engaged in managing their health.

The integration of physicians and clinicians, as we’ve seen with our CHF program, is important; their recommendations carry influence, and they can ensure that the data is used to highlight moments of influence. The key is not just the utilization of the technology; it’s the design and integration of the program. There is a real need for deep clinical engagement, both in getting people engaged in their health and in helping physicians and other health care providers move beyond prevention and wellness and toward managing chronic conditions.

At Humana, taking care of seniors living with multiple chronic conditions is what we do best. The role of technology is only going to become more important. But let’s never forget that technology must make things easier and more human to make a difference in health.

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Humana associate Dana Drzayich Antol, MS, a research consultant with Comprehensive Health Insights, recently won first place in the Psychosocial Support category for her team’s poster presentation at the Academy of Oncology Nurse & Patient Navigators’ (AONN+) Seventh Annual Navigation & Survivorship Conference in Las Vegas.

The team’s presentation — which was a combined effort between employees of Humana and Genentech Inc. — showed social support to be a moderator in the relationship between comorbidity medication adherence and health-related quality of life (HRQOL) for patients with metastatic cancer. Co-authors of this presentation included: Adrianne W. Casebeer, PhD, MPP, MS; Sari Hopson, PhD, MSPH; Raya Khoury, MPH; Aparna Parikh, MD; Alisha Stein, RN-NC, MSN, OCN; Todd Michael, PharmD, RPH; Stephen Stemkowski, PhD, MHA; and Mikele Bunce, PhD, MPH.

The study assessed HRQOL by having participants complete the Centers for Disease Control and Prevention’s Healthy Days survey. On its own, low comorbidity medication adherence adversely impacted the patients’ number of healthy days. The association between comorbidity medication adherence and the reduction in the number of healthy days was further amplified in the presence of patient-perceived fair or poor social support. These findings have important implications for improving or preserving the quality of life for patients with cancer.

The Academy of Oncology Nurse & Patient Navigators (AONN+) is the largest national specialty organization dedicated to improving patient care and quality of life by defining, enhancing, and promoting the role of oncology nurse and patient navigators. The organization, which has more than 5,000 members, was founded in 2009 to provide a network for all professionals involved and interested in patient navigation and survivorship care services in order to better manage the complexities of the cancer treatment process.

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Sometimes you need a little help when it comes to taking charge of your own health, making healthy choices and simply getting things done.

Humana offers a service called Humana At Home that is provided by Care Managers, nurses, nurse practitioners, home health aides, and other professionals to help people live safely at home, even when faced with medical, functional and behavioral health challenges.

The Humana At Home service includes in-home visits, telephonic advice, clinical care and in-home technologies that offer remote monitoring and other solutions. There’s even an Online Points of Care portal that helps members learn about and manage their health conditions, share updates with family caregivers and professionals, and access a national directory of vetted community resources for elder care and caregiving. Humana At Home professionals specialize in caring for older adults with multiple chronic conditions and functional, behavioral and/or cognitive limitations.

People who receive Humana At Home services live longer and go to the hospital less.

Eighty-nine percent of Americans over 65 want to live out their lives in their own homes. But a majority of members cite health problems as the No. 1 threat to their independence.

Many people are vulnerable not just because they are sick, but because they struggle with their daily activities. They might have trouble reaching for things in the pantry or bending to pick up a newspaper. The might have trouble preparing a meal, shopping or doing housework. Many suffer from short-term memory loss and have difficulty managing money or their medications. They might have trouble standing, walking or bathing.

These are real risks that make people more vulnerable to falls, accidents and hospitalizations. These seniors are more prone to malnutrition, infection and abuse. There’s a high degree of stress and anxiety about how to navigate the healthcare system.

In a fragmented health system, Humana care professionals offer a unique, holistic approach to wellness. Humana nurses and care managers can offer:

Medication management
Nutritional counseling
Home safety and falls prevention
Mental health support
Care coordination

A Care Manger might, for example, identify a community resource to help someone pay unpaid utility bills that otherwise could lead to a nonfunctioning refrigerator, spoiling insulin and limiting the person’s access to fresh food.

Field care managers visit Humana’s most vulnerable members to understand and address any factors that impact their ability to remain independent at home and avoid unnecessary hospital visits.

Our services are tailored to meet individual needs and circumstances:

Short-term after a hospital stay (Transitions)
Ongoing care (Telephonic and/or face-to-face)
Technology-enabled (Remote monitoring)
Preventive (Stay Healthy)
Community outreach (finding people who do not have phones)
Skilled care (Home health and nurse practitioner home visits)
Non-Humana members (Private pay)

It’s all designed to help us provide the right intervention, at the right time, in the right way, in the right place.

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