In 3 Technologies That Are Advancing Hospice Care, we discussed how telemedicine, predictive analytics, and virtual reality (VR) benefited patients in hospice. This time, we’re covering three additional technologies: electronic medical records (EMR), mHealth (example: wearables), and smart homes. 

Aging World

The above article primarily covered the benefits to hospice residents during the COVID-19 pandemic. But that’s just a noteworthy bump in a growing trend for hospice care. 

The pace of population aging is much faster than in the past. According to the United Nations, the population worldwide will age significantly in the first half of this century. Consider the following:

  • Between 2015 and 2050, the proportion of the world’s population over 60 years old will nearly double from 12 percent to 22 percent.
  • Back in 2019, approximately 9 percent of the Western Hemisphere’s population was over the age of 65. That’s a jump from 6.8 percent just 10 years ago. In 2020, the number of people 60 years and up outnumbered children younger than 5 years.
  • In 2020, the global population age 60 years and over was approximately 1.4 billion. By 2030, over 17 percent will be aged 60 years or over. 
  • By 2050, the world’s population of people aged 60 years and older will double to 2.1 billion. The number of persons aged 80 years or older is expected to triple between 2020 and 2050 to reach 426 million. Note 80 percent of this older population will be living in low- and middle-income countries.

How Will Hospice Be Affected

The numbers for the US are equally ﹘ if not more ﹘ eye-catching. Much of it is driven by the aging of the Baby Boomers, or those born between 1946 and 1964.

  • The first ones turned 65 years old back in 2011.
  • From then until 2030, approximately 10,000 Baby Boomers will turn 65 a day. The last ones will celebrate their 65th year in 2029. 
  • In 2030, when all boomers will be older than 65, older Americans will make up 21 percent of the population. That is up from 15 percent today. The US Census Bureau projects that by 2035, there will be 77 million Americans over the age of 65, which will outnumber children under the age of 18 (76.5 million).
  • By 2060, nearly one in four Americans will be 65 years and older, the number of those age 85+ will triple, and the country will add a half million centenarians to its census rolls.
  • Baby boomers have higher life expectancies than previous generations. Average life expectancy back in 1900 was just over 48 years old. This has climbed to over 78 in 2020.

These swelling numbers will see greater demands for healthcare, in-home caregiving, assisted living facilities, and hospice. Seniors aged 65 have a nearly 70 percent chance of requiring long-term care services in the future. At the same time, there will be less federal aid in the form of Social Security. In 2020, it’s calculated to take three-and-a-half working age adults for every older person eligible for Social Security. By 2060, that number is expected to fall to two-and-a-half for each eligible one.

“The mismatch between old and young will have implications across the coming years,” points out Dr. Grace Whiting, president and CEO of the National Alliance of Caregivers.

“We aren’t having enough children to take care of us in our old age. Look at my family: my in-law was one of six children, my husband and I were one of two, and we don’t have kids. Extrapolate that out, and that’s what’s happening nationwide.”

EMR to Treat Hospice Caregiver Burnout

Hospices provide medical care, pain management, as well as emotional and spiritual support to their end-of-life patients (called “residents”). It’s exhausting work at the best of times to the staff from hospice clinicians, RNs, CNAs, to caregivers. Then in 2014, the number of hospice providers fell from 5,800 to 4,092. Thankfully that number has since climbed to 4,840 in 2019. In 2020, 1.61 million residents were taken care of through hospice services in the United States.

With less places to care for them, it’s unsurprising that burnout among staff is high. Sixty-two percent say they are suffering from it. Symptoms range from emotional exhaustion; “depersonalization” or tendency to treat people as objects and cynically; and low personal accomplishment or feelings of dissatisfaction with work.  

“Burnout is essentially a flight or fight response to an external threat. That’s why staff withdraw or act out,” said Arif Kamal, MD, associate professor of Medicine and Business Administration at Duke University and co-author of a study on burnout. “I would liken it to trying to do your taxes while a tiger is chasing you. There is evidence across the nursing and medical literature that burnout is associated with more mistakes, specifically in paying attention to detail. ”One of the ways the healthcare industry is treating this burnout is through the use of electronic medical records (EMR). This is similar to Burnout In Nurses: Its Symptoms, Causes, and Treatments and 3 Ways to Make Doctors Hate EHR a Little Less. Thirty-five percent of hospice staff say they spend 2-5 hours in preparation for interdisciplinary group or team (IDG/IDT) meetings with 15 percent spending even longer. EMR can cut back on that time, automatically pre-populating all required patient charts, notes, forms and other hospice documentation in medical tablets and PCs. Staff can then spend time with residents and their families; hospice clinicians may be even able to get their personal time back.

mHealth Expands Hospice Care with Wearables

Mobile health, or mHealth, is described by the World Health Organization as the “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices.” The healthcare industry is turning to such devices for research, expanded health care delivery by clinicians, and better patient outcomes. For hospice, smartphones used for video chat or text messaging could complement existing home visits between residents and loved ones. Hospice providers can monitor residents’ symptoms 24/7 through mHealth devices called “wearables” which in turn could lead to earlier interventions if there’s a problem. 

mPERS (Mobile Personal Emergency Response) devices are one of the most well-known forms of mHealth. They usually consist of a push-button item which the resident presses to connect to an operator if they have fallen or are in distress. More advanced versions monitor the resident and automatically alert caregivers or nurses on their medical panel PC if there’s a problem. 

Other forms of mHealth appropriate for hospice include: 

A more advanced form of the earlier mPERS, this device allows the operator to track the resident via GPS. It can give reminder notifications of when it is time to take medication and check on medical tests. It can even connect to a doctor for a health consultation. At higher tiers, an Electronic Caregiver can be equipped with wireless devices that monitor a resident’s weight, temperature, glucose levels, blood pressure, heart rate, and oxygen levels. 

This wearable is placed inside of the resident’s briefs to detect bacteria in the urine. This may be a sign of a urinary tract infection (UTI) which can be dangerous to the elderly. Such detection is even more vital for those suffering from Alzheimer’s or other forms of dementia which makes it near impossible for them to communicate their distress.

The Aira is an electronic aid for residents suffering visual impairment like blindness. Available as either a smartphone app or wearable “Smart glasses,” this mHealth device sees for them either through the phone or the glasses. A connected operator then either tells the user what they’re looking at whether it be a street corner or hospice staff. They’ll even read for them. The operator can also send text messages. 

“We are witnessing wearables becoming better in functionality across the board; most are becoming friendlier to seniors and their caregivers,” says Simona Valanciute, CEO and president of San Diego Oasis, an educational program for adults 50 and older. “I strongly believe that wearable technologies will become more integrated into healthcare and home care settings.” 

Smart Home: Living in an mHealth Device

Since residents spend the vast majority, if not all, of their time in the hospice home, why not extend mHealth to the dwelling itself? That’s probably the thinking behind the smart home,” a building equipped with technology from monitoring residents for safety to making the place as comfortable as possible. 

Some of the technologies found in smart homes include:

  • A home security camera system to keep an eye on residents 24/7. Family members to caregivers can view the home from their smartphones or medical tablets. Many such cameras often include two-way communication. This allows residents to call out to those watching and vice versa. 
  • Besides monitoring via camera, windows and door sensors can alert family and hospice staff if opened by a resident by accident or intentionally. Caregivers can then respond promptly. 
  • A smart thermostat allows caregivers and even the residents themselves the ability to create a more pleasant home environment. Besides controlling the temperature, more advanced models turn on the lights at night or draw the blinds when it gets dark. Hospice staff now have one less thing to worry about and can focus on the residents.   
  • Finally, a smart home can be equipped with sensors to recognize fire, gas, or water leaks. Many can be set up to automatically shut off the gas or water supply while alerting caregivers or emergency services. 

The Aware Home at the Georgia Institute of Technology, the Smart Medical Home based at the Center for Future Health at the University of Rochester, New York, and The TigerPlace project in Missouri showcase some of the world’s most advanced smart home technology. 

Closing Thoughts 

The world’s population is getting older and in ever increasing numbers. To deal with their elderly, many countries are turning to technologies like EMR to help caregivers to smart homes. 

Contact an expert at Cybernet if you’re interested in finding out how technologies can help in hospice care. Also follow Cybernet on Facebook, Twitter, and Linkedin to stay up to date on this and other relevant topics.