Howard Girard received hospital-at-home care for his conditions of covid, COPD, and congestive heart failure. His daughter, Lori Girard, believes that this care likely extended his life and allowed him to enjoy himself. Although he has since passed away, the Girard family speaks highly of the hospital-at-home program. In a similar vein, Chad Semling and his wife, Clare, have also had positive experiences with hospital-at-home care for Chad’s chronic illnesses. While some family caregivers may have concerns about taking on this responsibility, the hospital-at-home programs often provide support from visiting clinicians. However, the impact on family caregivers is an important consideration. It is crucial to assess whether unpaid and untrained family caregivers are prepared for the responsibility of overseeing a critically ill individual at home, even with assistance from professionals. As hospital-at-home programs become more widespread in response to the COVID-19 pandemic, there is a need to evaluate the effects on family caregivers. Ultimately, caregivers must understand the challenges and obligations associated with hospital-at-home care. Although the programs do not expect caregivers to handle medical tasks, they may need to assist with tasks such as helping the patient move or providing basic care. While home health aides can sometimes be arranged for additional help, it may be limited. It is crucial to address the impact on caregivers, as research is limited in this area. The AARP advises policymakers to ensure that family members are fully informed about the program and in agreement with the decision to pursue hospital-at-home care. Currently, this is not a federal requirement, but many hospital-at-home programs involve family caregivers in decision-making. The Centers for Medicare & Medicaid is considering adding rules to clarify the responsibilities of caregivers and emphasize the importance of their focus on the patient’s emotional well-being. Obtaining more data on caregivers’ experiences and evaluating the financial implications for families would help inform future developments in hospital-at-home programs. Ultimately, the well-being of both patients and caregivers should be a priority when considering hospital-at-home care.
The Burden of Responsibility in the Growing Trend of ‘Hospital-at-Home’: Family Caregivers in the Spotlight
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