Essays

Essays November 2018
Keynote Address at Home Care and the Future of Aging

The Heart of the Matter: People, Health & Home

Shirlee Sharkey

Shirlee Sharkey 

They say the kitchen is the heart of the home. It’s a place of congregation and conversation; where meals are created, coffee is brewed, and stories are shared.

After embarking on a renovation project this summer, I’ve come to discover there are many common threads between kitchens and home care, particularly when it comes to design and the need for innovation. In both cases, the goal is to create something that works for your needs and fits with your lifestyle, preferences and patterns. With that in mind, here are my top three tips and some practical insight for updating your kitchen – or better yet, modernizing home care in Ontario.

#1. EXPAND IT

Let’s be honest, no one wants a tiny kitchen! Open-concept layouts have been all the rage for years. With few walls or barriers separating rooms, this design feature allows for clear sight-lines and a sense of flow throughout your home.

Applying this to healthcare, how can we design and build an ‘open-concept’ system? For starters, we’d need to bust out the sledge hammer and break down the silos of care. On renovation shows, this is usually the fun part, but in healthcare we struggle with it.

An open-concept health system would foster more direct links between home care, long-term care, primary care and hospitals, and patients would receive care in the most appropriate, least expensive setting.  

ALC, for example, is not just a hospital issue but a more systemic challenge that requires transformation across the entire system of care. Despite a concerted effort, the number of ALC patients in Ontario is growing. Looking at this issue from a home and community care lens – before someone even opens the door to an emergency department, hospital or long-term care home – can yield a new perspective.

recent report by CIHI found that up to 30 percent of ALC patients entering long-term care could be successfully cared for at home. This has been corroborated through our own work and research at SE Health, which confirms there are multiple points in the patient journey where we can change the hospitalization trajectory. The health system is hungry for new models of care and to get it right, we need to leverage the wisdom of people, families and providers. It doesn’t need to be perfect; this is all about progress.

#2. STREAMLINE IT

Updating your kitchen is a great opportunity to de-clutter and focus on the things you really use.

There’s a growing trend towards multi-function tools; last year, the ‘Instapot’ became an overnight sensation – it’s a pressure cooker, slow cooker, rice cooker, yogurt marker, sauté pan, steamer and food warmer, all-in-one. And for about $200, it’s a deal. Imagine if you had to buy each of those appliances separately? Yet that is exactly what we’ve done in home care, where each service – whether it’s nursing, personal support services, therapy or care coordination – is segmented and purchased separately, often from different providers.

Streamlining home care means fewer layers, less complexity and duplication. The lengthy multiple assessment process is something we hear about constantly from people and families. From a systems’ perspective, it doesn’t make sense to ration or delay access to home care, which is – by far – the least expensive option.

Just like you wouldn’t store the pot you use to cook with every day, way up on the highest shelf behind the popcorn maker, we need to make home care readily available, timely and convenient to access. This not only applies to the personal support workers, nurses and therapists providing care in the home, but also to opportunities with voice, text, virtual visits and new modalities such as AI and VR.

Artificial intelligence, which is being called the ‘electricity of healthcare’, can liberate a lot of time that health professionals currently spend on cognitive tasks, which a machine can do faster and better. By giving front-line providers more freedom and time with clients, this will increase, not decrease, compassion in healthcare.

3. PERSONALIZE IT

Patients are diverse and have different needs, even when they are dealing with the same health condition.  As a visiting nurse – I used to always say, “When you know one patient – that’s what you know – one.”

There are endless possibilities to customize care in the home according to an individual’s strengths, needs and choices.

Some countries internationally have really disrupted their funding models and taken a quantum leap towards personalization with mechanisms such as personal care budgets and home care packages. Australia’s shift to consumer-directed care is one example, which yields many strengths but has its limitations as well.

The pace of change and level of disruption we collectively can handle are important strategic factors. When renovating a kitchen, families still need to find ways to eat and carry on with their lives. Likewise in healthcare, we must continue to care and support people through times of change and transformation.

There are many things we can do to allow for greater personalization, flexibility and innovation in home care. Things like redesigning our work processes; freeing up the access points; becoming more knowledgeable with data; and incorporating new tools and technologies.

Interestingly, we are already seeing a level of convergence between kitchens and healthcare. Smart fridges can help monitor whether a senior has been eating enough and what foods they are running low in, while stovetop monitors can reduce the risk of fires for seniors who want to – and still can – cook for themselves, but are becoming more forgetful.

Supporting people to live and age at home is a broader ecosystem that requires a broader conversation, within and beyond healthcare. Investing in home care means investing in people, their health and their networks.  If we expand, streamline and personalize our approach, health and care will congregate, not in hospital hallways, but the places and spaces that are core to our everyday lives.

About the Author

Shirlee Sharkey is President and CEO of SE Health, Markham, ON

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