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Integrating social care and elder care has many benefits

This piece by ACCESS Health Chair and President William A. Haseltine originally appeared in McKnight’s Senior Living.

The social needs of older adults are multifaceted, diverse and, more often than not, unmet. This is especially true for older adults living with disabilities, low incomes or multiple chronic conditions. For many, day-to-day mobility is restricted to the community or the home, limiting their access to elder care services outside the scope of either.

Fortunately, emergent solutions such as person-centered long-term care are helping caregivers accommodate the full complexity of the people they serve. There is no escaping the fact, however, that it will take systems-level change for a solution so individualized to reach the entirety of an aging population. A new report published by the National Academies of Sciences, Engineering, and Medicine proposes a paradigm shift that might just fit the bill — the integration of social care and medical care.

The report urges public health leaders and healthcare providers to acknowledge the relevance of social needs to medical needs and adjust their service delivery systems accordingly. Because social care and person-centered long-term care are both designed to give residents and patients the fullest continuum of supports and services possible, elder care providers would have much to gain from social care integration. The areas of overlap outlined below are just a few reasons why.

Home- and community-based care

According to the National Academies report, enveloping social care organizations into the fold of the traditional healthcare systems would rebalance services between clinical and community settings, on the one hand, and make them more responsive to the social conditions of patients on the other. Older adults who have easy access to social and medical services as they age stand a better chance of managing certain health risks and behaviors early on, as well as remaining an active participant in community life.

Home- and community-based services also make it possible for older adults to spend as much of their lives as they can in the comfort of their own homes (including senior living, if that’s where they live). Caregivers who provide home-based care, a branch of healthcare that generally falls under social care, are trained to identify and honor the natural rhythms and preferences of individuals. This example of person-centered care functions as a much-needed corrective to the current reality for many older adults, in which they shuffle from provider to provider and never come away fully satisfied.

Interdisciplinary care teams

Family caregivers, home health aides and gerontologists are just a few of the types of professionals who make up the social care workforce. Their unique perspective on the social needs of those in their care, especially in the case of older adults, should prove valuable to any healthcare provider accustomed to approaching and conceiving of health through a strictly medical lens.

With social care integration comes the opportunity to form interdisciplinary care teams that can coordinate, for any given resident or patient, the distribution of responsibilities between social and traditional healthcare workers. In addition to being incredibly convenient for older adults, who would alternatively spend unnecessary amounts of time and energy navigating fragmented social and medical service delivery systems, interdisciplinary care teams are more capable of maintaining stable relationships between caregivers and with patients.

Interdisciplinary care, in addition to bridging gaps between services, also alleviates providers of the burdens produced by redundancy, miscommunication and other inefficiencies caused by poor coordination. In Uppsala, Sweden, for example, a central care coordination group formed by doctors, occupational therapists, nurses and municipal support agents does this for the town’s primary care physicians by conducting care-planning meetings for their patients. The delegation of that task alone not only frees up overburdened physicians but also opens up a healthy channel of ongoing communication between providers.

Shared care philosophy

Social care integration, like person-centered elder care, can equip healthcare providers and systems around the world with the tools, knowledge and capabilities needed to treat older adults with the comfort, respect and dignity they deserve. It also is cost-effective, as demonstrated by initiatives such as the CAPABLE (Community Aging in Place—Advancing Better Living for Elders) program, which yielded cost savings six times the amount spent on implementation.

A care philosophy that emphasizes the whole of a person, rather than reducing an individual to his or her health problems and limitations, is precisely what older adults deserve. Although it will require substantial policy support and organizational buy-in, countries that integrate social and medical care are building health systems that can live up to that philosophy — for the aging populations of today and for future generations.