Family Caregiver Considerations for the Future of Hospital at Home Programs
The declaration of the COVID-19 public health emergency accelerated an already burgeoning movement of health care into the home. The Hospital at Home (HaH) model shifts care into the home setting and delivers acute hospital-level care to eligible patients where they live instead of in a hospital. Although moving hospital care into the home may be associated with positive health outcomes and patient satisfaction, it raises concerns about support for and inclusion of family in these care models. Family caregivers are critical to HaH success, yet many current HaH programs do not explicitly account for the needs of family caregivers, there is an overall lack of information regarding the expectations of family caregivers, and few studies have assessed the impact of HaH on family caregivers. Given the potential for increased dependence on caregivers, HaH programs should ensure that family caregivers are both included and supported.
The AARP Public Policy Institute engaged ATI Advisory to assist with research on the impact of HaH programs on family caregivers. This research included a landscape analysis of leading HaH programs across the country, review of existing published research on the impact and effectiveness of HaH models, multiple interviews with HaH program operators, stakeholders, and caregiver advocates to gain a more comprehensive perspective of this model and specific HaH programs, and a roundtable event to gather input from experts on HaH and family caregiving. Findings from our conducted research as well as feedback and ideas gathered during our interviews and the roundtable event shaped the creation of the Family Caregiver Considerations presented in this policy brief.
More inclusive and supportive policies for caregivers will allow HaH programs to truly meet the needs of both family caregivers and patients. In order to best support these two groups, the following four Family Caregiver Considerations must be incorporated into HaH policy and program design by federal policy makers and HaH program operators:
- Ensure choice, access, and equity
- Be clear and understandable to the patient and family caregiver
- Recognize and support the family caregiver
- Allow for appropriate levels of research and learning
For HaH programs to succeed and fully benefit all parties involved, policy makers and HaH operators must acknowledge the crucial role that family caregivers have played—and will continue to play—in this care model.