As I watched family members age, each went through a very different process of managing their health in their final years. Some spent time in an assisted living facility, some in a nursing home, and one spent her remaining time at home with the support of home health services.
Each struggled with dementia and other conditions and required the support of professional health care workers. The way they received that support depended largely on their resources, insurance coverage, and savings they’d built up over the years—savings meant to last for the remainder of their lives.
Right now, older Americans make up 12 percent of the population, and in 20 years, that number will reach 20 percent. As America’s population ages, there will be a greater need for skilled home health care services for our nation’s older citizens. Most older people (89%) say they want to age in place — i.e., live independently and remain in their home.
In watching how members of my family aged, I can tell you this would be my preference, too.
When my aunt, who suffered from dementia, lost her husband and full-time caregiver, my family feared she’d experience a steep decline in her health. Before he passed away, my uncle had handled all of her care—from feeding and bathing her, to cleaning and assisting her around the home. My aunt was a private person who lived in the same home for more than 50 years. Placing her in assisted living would’ve been detrimental to her mental well-being. Thanks to her financial resources and some amazing family and home health support, she was able to live comfortably in her home for two more years until she passed away peacefully in her bed.
Aging In Place vs. Skilled Nursing Facilities
In a nursing home or assisted living facility, there are staff that attend to meals, housekeeping, and in many cases, medical needs. Finding a home health care service that can provide the wide range of services someone might need to remain comfortable at home can be challenging and often expensive.
Yet home health care services still have the potential to reduce health care costs. The average cost of care in a skilled nursing facility is $449 per day or $26,940 for a 60-day stay, compared to $2,674 for a 60-day home health episode.
Home-Delivered Meals Support Independent Living
In talking with home health agencies and care workers, I’ve learned that food and meal preparation is one of the top needs in this patient population. According to Dr. Tracy Lippard, Clinical Lead for Complex Needs at Kaiser Permanente, “Our providers visit our members at their homes to check on medical issues like how their heart condition is doing — but sometimes they find the most important problem is an empty fridge.” Unfortunately, meal prep or meal delivery is not always reimbursed or considered as part of the home health model.
These patients also tend to be among the more chronically ill and are managing, on average, 4.2 medical diagnoses per patient. The most common include hypertension, heart disease, diabetes mellitus, and chronic obstructive pulmonary disease. ALL of these diagnoses require diet modifications in order to manage the illness.
Food is an important part of not only managing illness, but also keeping our aging population living at home, as most prefer. Even though someone may be able to live independently, it still may be difficult for them to shop and prepare their own meals, especially meals tailored for multiple chronic health issues.
In Project Angel Heart’s Meals for Care Transitions program, 83 percent of patients reported that receiving medically tailored meals allowed them to remain independent at home. Because these patients had a recent stay in a hospital, skilled nursing facility, or nursing home, they’re part of the population who are most vulnerable during their first few weeks at home. Stabilizing them can mean large health care cost savings.
Medically-Tailored Meals Lead to Reduced Health Care Costs
In addition, providing meals for older Americans with chronic conditions has the potential to reduce health care costs. In our recently released research study in partnership with the Center for Improving Value in Health Care (CIVHC), people on Medicare (age 65 or older) had 14 percent lower monthly medical costs while receiving Project Angel Heart’s medically tailored meals.
Insurance companies are becoming more open to providing meals as part of their members’ health plan benefits. In Colorado, Denver Health Medical Plan recently added meals as a benefit for Medicare Choice members, members eligible for both Medicare and Medicaid. These members receive 10 days of meals after a hospitalization to help them get back on their feet and receive the nourishment needed for recovery.
As more of our population shifts to age 65-plus, creating solutions that help older neighbors, especially those dealing with chronic illness, age in their homes will be vital to helping them maintain good health and live a quality life.
 A Data Book: Healthcare Spending and the Medicare Program. Medicare Payment Advisory Commission. June 2015
Leslie Scotland-Stewart is the director of Project Angel Heart’s Meals for Care Transitions program. She worked in sales and marketing for a variety of Fortune 500 companies before deciding to focus her career on health and wellness. After helping build a startup company that helps executives become healthier leaders, she joined Project Angel Heart in a business development role. She has a passion for all things health, including nutrition, exercise, and mindfulness. Leslie has her MBA from the University of Denver and teaches fitness classes on the side. She loves spending time with her family, going to the zoo, hiking, or doing anything that will keep the family active. She also loves to travel and is always in pursuit of the most delicious coffee and dark chocolate!