Kemper presented three ways to create a better system for long-term care.

The three ways to create a better system for long-term care:
1. Start with the foundation of all long-term care: the elder’s home and family.
2. Give families the coaching they need to navigate long-term care.
3. With the right technology, teach families how to coach themselves and provide effective care management for their elders.

1. The foundation of all long-term care is based in the elder’s home and family.
   • 80% of long-term care is provided by family members and informal caregivers.
   • Informal caregivers provide over $450 billion of long-term care each year.
   For 37 years, our Healthwise mission has been to help people make better health decisions—to help people do as much for themselves as they can, ask for the care they need, and say “no” to care that is not best for them. Nothing is more important to us than extending that mission to frail elders and their families.
    
2. Families need strong, clear coaching to help them navigate long-term care.
Long-term care as it’s now experienced by millions of families is uncoordinated, out of balance, wasteful, and stressful for everyone. Long-term care decisions extend beyond medical care to many of the basic rights of life: home, safety, dignity, and independence. These decisions are difficult, complex, and emotional. One of the hardest conversations that any family faces is when Mom must turn in her car keys.

On top of that, families are confronted with medical decisions:
• Does Mom need surgery?
• Should Dad be taking all 10 medications?
• How much medical testing is enough?
Even well-connected families caring for their elders struggle with these issues and decisions. They’re not easy.

The lucky families get help from geriatric care managers or other counselors experienced in helping people make these decisions. When a counselor can sit down with family members and the elder to go over each specific issue, it usually works quite well—better care, better life, and lower costs. But there simply aren’t enough counselors to meet everyone’s needs, so most families are left to figure out long-term care all on their own.


3. With the right technology, families can learn how to coach themselves and provide effective care management for their frail elders.
We know that late-life care counseling works, but we also know that there aren’t nearly enough counselors today to go around. And the boomers aren’t even at the door yet. So what are we going to do?

The next best alternative is for technology to guide family members and caregivers through the basics of late-life care management.

What we need in long-term care is a series of interactive coaching programs to help family members and caregivers learn the basics that a geriatric care manager might otherwise perform. Healthwise has spent the past five years developing an interactive conversation technology that provides virtual coaching programs in wellness and in chronic care management.

For each program, a patient visits with a virtual coach. The coach uses motivational interviewing and cognitive-behavioral therapy techniques to identify issues, and help each patient create a personal action plan. These programs can be easily scaled to thousands or millions of families—using nothing more than a browser.

At Healthwise, we have identified 15 critical points in long-term care where coaching would be particularly helpful to the frail elder and the family.
• Three points on safety—Choosing the best place to live, preventing falls, and knowing when to stop driving.
• Six points on medical management, ranging from surgery to medication management to care transitions.
• Three points on the issues of caregiving.
• Three points on hospice decisions and advanced care choices.
We’ve already built one of these virtual coaching programs that can be used by the elder and his or her caregivers—Preventing Falls. It is still early in testing, but so far it looks to be a home run. With more funding we could build out the other 14 virtual coaching programs.

We think these programs could be effectively inserted into the care plans of millions of people in advance of their long-term care needs. And we think it would make a huge difference to care, health, and costs.

It’s time to create a better system for long-term care, and the answer lies in our elders, their families, and the technology we develop to support them.