Not just tech: 'Hospital at home' has to take caregivers into account, experts say

As hospital-at-home programs have expanded, so have responsibilities for family caregivers, NPR reported.

Healthcare experts told the news outlet that health systems need to take into account the strain on loved ones when patients are diverted to the home for acute care rather than the hospital. An estimated 10 to 62 percent of patients turn down the programs, which are now offered by 290 hospitals nationwide.

"The family caregivers are completely invisible," Susan Reinhard, director of AARP's Public Policy Institute, told NPR. "They're not turning to wife, daughter, or husband, and saying: Can you handle this? That's the discussion we think needs to happen."

CMS said the agency "makes it very clear that during the hospital-at-home stay, hospitals are not to use family members, support persons, or caregivers to provide care that would otherwise fall to nurses or other hospital staff during an inpatient admission," CMS chief medical officer Lee Fleisher, MD, said in a statement to the news outlet.

But caregivers might do things like bring their loved ones water at night, help turn them over in bed, change their clothes, or walk them to the bathroom, according to the July 18 story.

"A huge part of the process is making sure that both patients and their caregivers have a really good idea of what they're getting into," Margaret Paulson, DO, director of the hospital-at-home program for Mayo Clinic in Eau Claire, Wis., told NPR. "If you're the caregiver, is it going to drive you crazy if people are going in and out of your home, or are you OK with that?"

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