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Automation Hits Home Health Care

Home health care is an expanding field. It was named as one of the top five most profitable franchises by the Franchise Business Review in 2012, which reported that the median investment to start up a home health care franchise was about $66,000. Sheila McMackin, president of the National Private Duty Association, told USA Today that new home health care companies average first-year revenue of $248,000. Industry leaders earned about $1 million in 2012, with margins of 30-40 percent, while for typical firms, the average net profit was 12-15 percent.

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Many older Americans would prefer to have their health care needs handled in their own homes, as opposed to being a patient in a hospital, reported the Sarasota Herald-Tribune. The Health and Human Services Secretary, Kathleen Sebelius, said that "All Americans -- including people with disabilities and seniors -- should be able to live at home with the supports they need, participating in communities that value their contributions -- rather than in nursing homes or other institutions."

About 28 percent of Americans over the age of 65 lived on their own in 2012 (not counting those living in facilities), according to the Administration on Aging. Of the 4 million direct care workers in the country, 54 percent are in home care or other elder care facilities, and the Sarasota Herald-Tribune estimates this number could tick up to 66 percent by 2018. These numbers point to the need for qualified home health care professionals. Right now a lot of the care is handled by family members, neighbors and other altruistic individuals. An estimated 66 million unpaid caregivers operate in this country, compensated only with the satisfaction of helping people in need or the gratitude of those they serve.

The state of Florida is hoping to find a bit of help in alleviating the pressure on family members providing home care by having health maintenance organizations (HMOs) enter the fray. Some medical professionals, like Larry Polivka, are worried about that move. Polivka, the executive director of the Claude Pepper Center at Florida State University, wants to makes sure that we find out what works before making a massive switch in home we provide elder care.

"I'm not saying for-profit HMOs can't do the job," Polivka said. "But we need to have in place more comparative models so we can contrast and compare and decide what's best. Instead we're just rushing pell-mell in one direction or another, depending on which way the wind blows -- ignoring the fact that this is going to be one of the hugest issues over the next three decades."

One problem with the current system of home care is that soon the number of patients may dwarf the number of aides available to look after them. According to the Department of Health and Human Services by the year 2030 an estimated 72 million Americans will be age 65 and over. Growth for home care aides may not be able to match that. The Bureau of Labor Statistics predicts that employment for home health and personal care aides could grow much faster than average to keep up with nationwide demand, climbing by 70 percent between 2010 and 2020. Requirements for these professionals vary by state, and some states require formal education in this field as well as on-the-job training (bls.gov.ooh, 2012).

What can interested individuals expect from these careers? Bls.gov provides separate salary figures for home health aides and personal care aides in the U.S. While both occupations offer personal care, such as help with daily living activities, home health aides also provide routine health care such as applying dressings. Aides are employed in a range of different settings, and in general, health care facilities or retirement communities paid more than in-home services in 2012. Within the industry segment of home health care services, personal care aides earned a mean annual wage of $19,080, compared to $21,750 for home health care aides (bls.gov/oes, 2013).

Other long-term care providers include occupations like certified nursing assistants, licensed practical or licensed vocational nurses, and registered nurses, which all need specialized training. Of the 718,800 LPN/LVNs employed nationwide in 2012, about 77,990 worked in the home health care services industry, earning a mean annual wage of $43,920 (bls.gov/oes, 2013). Salaries can vary according to location, experience and other factors.

Jim Osborn, the executive director of the Robotics Institute's Quality of Life Technology Center at Carnegie Mellon University, described the growing demand in senior care to The New York Times: "There are two trends that are going in opposite directions. One is the increasing number of elderly people, and the other is the decline in the number of people to take care of them." Osborn has a possible solution -- "Part of the view we've already espoused is that robots will start to fill in those gaps."

Different prototypes of home care robots have been produced and are being tested. Cody is the brainchild of researchers at the Georgia Institute of Technology, while Carnegie Mellon has the Home Exploring Robot Butler (HERB). Another robot, being developed in the UK by the University of Reading, is named Hector.

Detractors concerned with the idea of using robots to provide home health care include Sherry Turkle, a professor at MIT. She was present for a series of interactions between Paro, a robot shaped like a baby seal, and some older patients. After witnessing how the patients, particularly one woman, treated the robot as if it were real, Turkle told The New York Times, "I felt like this isn't amazing; this is sad."

In contrast, Wendy Rogers, professor at Georgia Tech, noted that older Americans could develop relationships with robots just like we do with other objects in our lives. "We are social beings, and we do develop social types of relationships with lots of things. Think about the GPS in your car, you talk to it and it talks to you. This isn't a bad thing, it's just what we do."

This is an important discussion, especially with the gap foreseen between the number of patients who need and desire home health care and the amount of qualified workers in the field. If robots could provide some of the care that an older population needs, this is an idea we could see more of in the future.

About the Author:

Jamar Ramos has been writing poetry and fiction for many years, and earned his bachelor’s degree in Creative Writing from San Francisco State University. For the last three years, Mr. Ramos switched to producing blog posts for CBSSports.com and writing professionally as an independent contributor for a number of Internet sites. His creative works have been featured in The Bohemian and The San Matean. He now contributes articles for OnlineDegrees.com, OnlineColleges.com, and AlliedHealthWorld.com.