Allowing Seniors to Live at Home Longer
At present, there are approximately 5.8 million seniors in Canada, 5.5 million of whom live at home.1 It is likely that the number of seniors living at home will continue to increase as it has been estimated that seniors will reach a population of 9.5 million by 2030.2
Ways in which we can support aging in place is an ongoing discussion with multiple facets including care coordination, safety, and overall quality of life. Conditions such as chronic disease and Alzheimer’s disease and related dementias (ADRD) add another layer of complexity and require greater attention in ensuring effective healthcare support. At present, 90% of Canadians aged 65 and over live with at least one chronic disease or condition, such as cardiovascular disease, cancer, respiratory conditions, diabetes, dementia, arthritis, or obesity2, making it more important than ever that we look to address effective means of supporting the aging population within their own home.
Looking to Existing Infrastructure
Aging in place is very much a community topic, with support required from family, friends, and community at large. Any solutions that aim to support our elderly population in living at home longer will need to that take that existing networks of support into consideration.
The partnership between NexJ Health and Call&Call aims to do just that by leveraging the existing infrastructure of the Jersey Post in the Isle of Jersey and that of the Royal Mail in the UK. Both projects leverage the same approach: using postal workers on their usual postal rounds to check in on the well-being of vulnerable members of society and connecting them with supportive community resources, all for the cost of a registered letter. The key to these innovative projects has been leveraging the existing community infrastructure. Neighborhood postal operators offer two distinct strengths:
- They’re the only service provider with the infrastructure in place to visit every house
- They have a relationship of trust with the residents of the community
The Call&Check project, which first launched in Jersey, targets people over 65 years of age who are living alone and isolated from their community. The project was aimed at supporting the role of the carer and healthcare professional, while not replacing it. In their supporting role, postal workers received a short training course from the St. John’s Ambulance team on how to watch out for ‘low level’ medical situations (e.g., signs of hyperthermia).
The project consists of postal workers making regular visits to “call & check” on participants and asking them five short questions to find out how the individual is feeling and if they require any additional support. Our virtual care platform, NexJ Connected Wellness runs seamlessly on the postal worker’s handheld device; answers are shared immediately with the person’s Circle of Care, and the appropriate support can be triggered as needed (for example, social services, or community support), enabling efficient coordination of care and increased access to care.
Acting as the Glue that Brings Together Community Resources, Health, and Safety Services
The benefit of using a virtual care platform such as NexJ Connected Wellness lies in the fact that detailed measurements can be taken on the effectiveness of the service from the patient’s experience. It can also provide measures of savings to healthcare budgets.
Addressing the Health Burdens and Associated Cost of Loneliness
The Safe and Connected project in partnership with Royal Mail in the UK was based on the success of the Jersey project and leverages postal workers in North Yorkshire, Liverpool, and the Borough of Kingston to provide support to the lonely and isolated in these neighborhoods.
This program is funded by the UK Government’s Home Office Department and directly supports its strategy for tackling loneliness as outlined in A Connected Society: A Strategy for Tackling Loneliness – laying the foundations for change and is now part of the UK Governments strategy to address loneliness within communities.
Outlined in the strategy, the health burdens and associated cost of loneliness cannot be ignored:
- Feeling lonely is often linked to earthy deaths on par with smoking or obesity
- Loneliness is linked to increased risk of coronary heart disease and stroke, depression, cognitive decline, and increased risk of Alzheimer’s
- Lonely people are more likely to be readmitted to hospital or have a longer stay
As with the Call&Check project in Jersey, Safe and Connected involves postal workers visiting lonely older people who sign up to participate in the project. As part of their usual delivery rounds, postal workers “check in” on participants to ask them a short survey of questions about their wellbeing.
Key Innovative Aspects of both Projects
Both the Call&Check and Safe and Connected projects offer an innovative way of addressing our elderly population. Key aspects include:
- Extending the Circle of Care to include support from postal workers, volunteer and social services, enabling people-centred health and population health management
- Increased social contact and improved connection to the community, so that people can live well and independently in their own homes for much longer
- Valuable saving for health providers, local and central governments by taking a preventative approach that helps avoid significant downstream costs associated with episodic care, including doctor visits, emergency department visits, and the need for mental health services
- Social fulfilment and job satisfaction for postal workers and new strategic revenue streams for postal services
As Joe Dickinson from Call&Check indicated in his article from the International Journal of Care Coordination, clients who receive the service have found it of benefit by connecting them with their community and at the same time giving them that extra support, especially when living alone.
Both the Call&Check and Safe and Connected projects also provide support for carers, helping to remove the burden while also giving them peace of mind that their loved ones are happy and healthy.
Both projects have received global recognition, attracting interest from media around the world:
- CBC News: The National
- UK Press Release: PM launches Government’s first loneliness strategy
- BBC News: Small island’s postal service takes on a global problem
- Canadian Healthcare Technology: Posties to check on lonely, aged people at home
- Call & Check Media: UK posties to “call and check” on vulnerable and isolated Brits
- Liverpool Express: Liverpool to pilot scheme to tackle loneliness
As further testament to the success of both projects, Call&Check are now working with other advising jurisdictions.
Scalability and Applicability Across other Communities
One of the key takeaways from both projects is how easily scalable they are. Given that postal operators already have a digitally connected workforce infrastructure operating within communities, it’s relatively easy to leverage this existing delivery network as a trusted and familiar neighborhood resource.
These projects also extends to a wide range of individuals. Although the Call&Check project was initially created for people who were lonely or isolated over the age of 65, it was extended to include:
- Anyone who is isolated from the immediate community, due to a disability or health issue;
- Anyone who is living alone, or away from family and friends; and
- Those who require support as part of the step-down process leaving the hospital.
The launch of Safe and Connected in direct support of the Home Office’s strategy for tackling loneliness also speaks to the ability for the program to support a range of population health needs.
Although not yet been published, we are confident that results of the Safe and Connected project and that of Call&Check will show the use of community infrastructure paired with virtual care technology to an effective and cost efficient means of supporting elderly populations age in place.
1 Dementia in home and community care. Canadian Institute for Health Information. https://www.cihi.ca/en/dementia-in-canada/dementia-across-the-health-system/dementia-in-home-and-community-care
2 Government of Canada – Action for Seniors Report. https://www.canada.ca/en/employment-social-development/programs/seniors-action-report.html