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How Equality in Healthcare Improves Care for LGBTQ+ Hospice & Home Health Patients

Regardless of sexual orientation, gender identity, or who you love, everyone deserves to feel safe receiving the care they need. For LGBTQ+ folks, hospice and home health care can look different than they often do for cisgender, heterosexual people. As a healthcare care provider, we take the time to understand patients’ personal needs and guide them through their journey with patient-centered, inclusive practices.

What Does Equality in Hospice and Home Health Care Look Like?

A 2018 AARP study showed that 60% of LGBTQ+ people worry about a lack of sensitivity in their healthcare. Having multiple barriers to high-quality healthcare, such as poverty, racism, disability, and location, can also make it more challenging to find a provider who can meet their needs.

To practice equality in healthcare, everyone should receive care tailored to their needs and get information that will help them most according to those needs. Making hospice and home health care more accessible to marginalized groups, like LGBTQ+ people, means we must understand their experiences beyond physical symptoms, too.

person wearing LGBTQ+ pride mask and holding pride flag

Inclusive care in a hospice or home health setting involves treating each patient individually while validating the varied parts of their identity and taking the time to learn about the unique experiences within the LGBTQ+ community. It can be as simple as using the person’s correct name and pronouns and treating them with the same respect you would for any straight, cisgender patient.

Many LGBTQ+ patients have “found family” involved in their care instead of, or in addition to, blood relatives to support them. Additionally, if the patient wants spiritual guidance, a hospice or home health care provider should be able to help find an LGTBQ+ friendly chaplain and other supportive resources that respect the person’s identity and wishes. Plus, showing sensitivity about the patient’s previous healthcare experiences can help them feel more comfortable receiving care from their current provider.

Why We Focus on Equality in Our Care

Healthcare focused on equality creates a broader understanding of diverse experiences that allow providers to offer specific care and help patients with thorough knowledge. It gives patients and their families more support and well-rounded information that applies specifically to them.

Many LGBTQ+ patients have their symptoms and concerns dismissed or devalued in typical medical settings. As a result, many are reluctant to share their needs or experiences for fear of discrimination. When we as providers understand this reality, we can help the LGBTQ+ community feel safer receiving hospice and home health care. It ensures that patients have to do less work to be understood and receive the necessary care, especially while healing or going through the hospice journey.

Why We Focus on Equality in Our Care

Healthcare focused on equality creates a broader understanding of diverse experiences that allow providers to offer specific care and help patients with thorough knowledge. It gives patients and their families more support and well-rounded information that applies specifically to them.

Many LGBTQ+ patients have their symptoms and concerns dismissed or devalued in typical medical settings. As a result, many are reluctant to share their needs or experiences for fear of discrimination. When we as providers understand this reality, we can help the LGBTQ+ community feel safer receiving hospice care. It ensures that patients have to do less work to be understood and receive the necessary care, especially while healing or going through the hospice journey.

lgbtz+ pride pins

By validating and including patients’ identities and being mindful of them in their care, providers give loved ones the space to be with the patient while they receive care. While communication between patients, providers, and others involved in care is important, having a provider who understands that the LGBTQ+ community has unique needs and struggles reduces the burden on patients.

How Do We Provide Inclusive Care?

We focus on healing, support, and balance between offering physical care and emotional healing. We want our patients to feel comfortable asking difficult questions, sharing their experiences, and knowing they have someone who will listen to and advocate for their needs. We know how overwhelming home health care and hospice can feel for many LGBTQ+ patients and their loved ones, and to us, inclusivity means providing care that reduces anxieties and makes end-of-life transitions as comfortable as possible.

Our care is all about love and healing, whether that be physical pain or emotional support. By presenting all options and giving patients control, we offer excellent palliative care that extends to emotional, mental, and spiritual needs.

Please contact us to learn more about how we provide equitable, compassionate hospice and home health care.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774548/
  2. https://www.lgbtagingcenter.org/resources/resource.cfm?r=854
  3. https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01408
  4. https://www.sageusa.org/equality-in-life-death-palliative-and-hospice-care-for-lgbtq-elders/
  5. https://spcare.bmj.com/content/12/2/142
  6. https://cancer-network.org/cancer-information/cancer-and-the-lgbt-community/lgbt-palliative-care/
  7. https://hospicenews.com/2020/10/28/hospices-work-to-reach-underserved-lgbtq-communities/

How to Know it May be Time for Hospice

Watching someone you love suffer from Alzheimer’s or another memory debilitating illness is incredibly difficult, and it can be even more challenging to decide when it’s time to consider hospice care. Here, we are sharing five signs it may be the right time to consider the extra support of hospice care for an Alzheimer’s patient.

Physician determines they are at or beyond stage 7 of the Functional Assessment Staging Scale

The Functional Assessment Staging (FAST) Scale is a tool used to determine if changes in a patient’s condition are related to Alzheimer’s disease or another condition. If due to Alzheimer’s, the changes will occur in sequential order. Alzheimer’s disease-related changes do not skip FAST stages.  

Unable to ambulate independently

This means a person is no longer able to get around on their own. For example, they require assistance getting from room to room.

Requires assistance to dress or bathe

Without assistance, you may notice they put their shoes on the wrong feet or their day-time ‘street’ clothes on over their pajamas. They are also unable to bathe without assistance.

Becomes incontinent

This includes urinary or fecal incontinence or both.

Unable to speak or communicate 

This may begin as the patient only saying 5-6 words per day and gradually reduce to only speaking one word clearly until they can no longer speak or communicate at all. This will also include the inability to smile.

Why Choose Hospice

Hospice care is for patients with a life limiting illness and a life expectancy of six months or less. The main focus is to manage pain and symptoms and ultimately keep the patient comfortable. When you choose hospice for your loved one, their care team can help you to understand what to expect in the final stages of Alzheimer’s. They will also provide support to you and the rest of your family throughout the end-of-life process.

If you would like more information on hospice care for Alzheimer’s patients, please contact us. We are here to answer any questions you may have.

Mental Health Awareness

In the United States, one in five adults will experience a mental illness in any given year. This includes a large number of people who are living with a terminal illness—and their caregivers—who must cope with facing the end of life and making the necessary arrangements.

May is Mental Health Awareness Month. As one of the country’s leading hospice providers, our team is devoted to connecting you with the care you need if you are living with a mental illness.

mental health concept

What Is Mental Health Awareness Month?

Mental Health Awareness Month was established in 1949 by Mental Health America. The goal of this observance is to help Americans understand the importance of achieving good mental health and to empower people with mental health issues to seek treatment. Mental Health Awareness Month is an opportune time to learn about the causes, symptoms, and treatments of various mental health disorders.

This year’s theme for Mental Health Awareness Month is “Look Around, Look Within.” It calls for Americans to focus on how one’s surroundings can impact their mental health. Specific topics that align with this year’s theme include:

If you can identify specific factors that may be impacting your mental health, it’s time to make changes to your surroundings that can get you on the path to feeling better. For example, if you have a serious, debilitating health condition affecting your ability to carry out normal everyday tasks, it may be time to seek assistance from a home health care provider.

The Importance of Treating Mental Health

Caring for your mental health is just as important as caring for your physical health. Experiencing mental health symptoms like sadness, depression, anxiety, and stress every day for a long period can affect your career, relationships, social life, and general well-being. An untreated mental illness can also increase your risk for a wide range of physical health problems including diabetes, stroke, and heart disease.

Unfortunately, stigma continues to surround mental illness and prevents many people with mental health problems from seeking the help they need to become healthier and improve their quality of life.

Mental health treatment can help you identify the factors in your life that are causing your symptoms and empower you to make changes that can reduce their impact on your mental well-being. If you are living with a terminal illness, seeking mental health treatment is especially important given how terminal illness places you at higher risk for anxiety and depression.

shining light on mental health

Does Hospice Include Mental Health Treatment?

Having a terminal illness—such as cancer—is one of the top risk factors associated with mental illness. If you have a terminal illness or are caring for someone with a terminal illness, you may need help coping with certain treatments and with facing the end of life.

We offer hospice services that are personalized for every patient based on their mental, physical, spiritual, and emotional health needs—including mental health treatment. Counseling, bereavement, and support group therapy are some of the many mental health services offered by our hospice care providers. Our interdisciplinary teams are comprised of compassionate physicians, nurses, social workers, chaplains, and others who are dedicated to helping you and your loved ones navigate a terminal illness while caring for your mental health.

How to Find a Hospice Care Provider for Mental Health

If you are suffering from a mental health issue, don’t hesitate to speak up and come to us with your concerns. We will be more than happy to connect you with the help and treatment you need and guide you and your loved ones toward finding the right treatments that can improve your quality of life.

Contact us today to speak with one of our representatives and learn more about our hospice and mental health services.

Counseling in the Post-Acute Healthcare Setting

the future is

In acute healthcare settings, such as an inpatient stay at the hospital, the quality care delivered to patients is facilitated by readily available resources such as multidisciplinary healthcare teams all operating out of one facility. A multidisciplinary team can include your doctor, spiritual counselor, social worker, and bereavement counselor to name a few. Following discharge from an acute healthcare setting, more senior patients are often sent to post-acute healthcare settings. These are settings that reside outside of the hospital and can include skilled nursing facilities (SNFs), long-term care hospitals (LTCHs), inpatient rehabilitation centers and home care agencies. At these facilities, individuals traditionally experience longer stays and therefore continue to benefit from the multidisciplinary services mentioned above. In all of these settings, the availability of such resources, especially counseling, is critical to the long-term health and wellness of residents. April is recognized as National Counseling Month, and we can’t overstate the importance of counseling for individuals in any stage of care. Fortunately, a number of counseling services are readily available to individuals requiring long term care. Three of these services in particular include social work, bereavement, and chaplain services.

Social Workers

Social workers work within a healthcare team as vital advocates for patients and primarily serve individuals that are identified as “high-risk”. In that high-risk category fall senior citizens. Older individuals often reach a point where they can no longer care for themselves independently and rely on family or friends to provide care. This is sometimes the turning point at which you or a loved one may turn to long term care as the best option moving forward. In long term care, social workers can play a pivotal role in identifying where an individual may require the most help, whether that be emotional, financial, family, or other support. Social workers work closely with the rest of the healthcare team and take the lead as a case manager for individuals with psychosocial or financial issues. They also operate as a collaborator for high-risk clinical issues. Not all individuals in long term care will require extended counseling from a social worker, as it will depend on how high risk an individual is. Nonetheless, knowing the services available to you or your loved one can make a difference in receiving the support you need and resting assured that you are being well taken care of by your healthcare team.

Bereavement Counseling


Bereavement counseling is unique in that it is a service dedicated to your family after your loved one has passed away. The primary purpose of bereavement counseling is to help families navigate their grief following a loss. This particular service is incredibly valuable as it is virtually impossible to be fully prepared for what life after loss looks like, regardless of how long a loved one has been ill or how much a family has tried to prepare themselves. Bereavement counselors can be a helpful resource when dealing with the emotions that accompany the loss of a loved one, the disruption of daily routines, the stress of managing the logistics, and the possibly changed outlook on life and mortality. When your loved one passes, care should not stop there; and with the help of bereavement counselors, it doesn’t. Having a supportive team who is familiar with navigating loss can be tremendously impactful and can often eliminate undue stress.

Chaplain Services


Spirituality can be an especially helpful source of groundedness during challenging times, transitional periods, or throughout the grieving process. Through that lens, chaplains can be vitally important to both your loved one as they move into longer term care and you, as the supporter and caregiver.

Many emotions can accompany the transition from living at home or occasional acute care stays into long term care facilities. Some individuals experience anxiety, sadness, loss of identity, fear, and anger to name a few. All of these emotions can present their own challenges and can negatively impact one’s experience if left unaddressed. Chaplains offer more than just spiritual guidance and can often help individuals navigate some of these confusing, frightening, or unfamiliar emotions. Among the many things chaplains can do for patients, some of the most beneficial services include cultivating new hobbies, facilitating new relationships, providing referrals to appropriate experts, and talking through tough emotions. Chaplains can help individuals see beyond the negative and find acceptance and hope even in challenging times.

As the family of a loved one in long term care, the burden of this transition weighs just as heavy on you. Fortunately, many of the long-term care services are available to help you navigate these challenging times as well. Chaplains can often serve as a guide for the new challenges that arise with putting a loved one into long term care. Similarly, the emotions you face may feel unfamiliar. Be sure to give attention and time to your own emotions, just as you do for your loved one, and consider utilizing chaplain services if you are seeking support during this time. Chaplains not only help to facilitate the sustainment or discovery of spirituality but also contribute to the acknowledgement and interpretation of emotions for individuals and families experiencing change, grief, or loss.

Review Your Options

If you or a loved one are preparing to transition to a post-acute healthcare setting of any kind, be sure to discuss with your team of providers what counseling services are available to you and your family. The amount of support and care these services can provide outside of the hospital is extensive and can greatly impact the quality of a more long-term healthcare stay.


Image 1:


Image 2: https://veteranlife.com/veteran-benefits/va-bereavement-counseling/

Image 3: https://www.yourtango.com/self/what-happens-after-spiritual-awakening

American Hospital Association: https://www.aha.org/advocacy/long-term-care-and-rehabilitation

MedPac: https://www.medpac.gov/research_area/post-acute-care/#

Net Health: https://www.nethealth.com/the-importance-of-in-home-bereavement-support-services-for-hospice-care/

Relias Media: https://www.reliasmedia.com/articles/148131-the-role-of-the-social-work-case-manager-across-the-continuum-of-care

Research Gate: https://www.researchgate.net/publication/337140540_THE_IMPACT_OF_SOCIAL_WORKERS_ON_POST-ACUTE_CARE_DISCHARGE_OUTCOMES

NCAA: https://www.nacc.org/vision/2012-nov-dec/chaplaincy-in-long-term-and-short-term-home-care-advantages-disadvantages-and-challenges/

Healthcare Decisions Day

April 16 is National Healthcare Decisions Day (NHDD), designed to “inspire, educate, and empower the public and providers about the importance of advance care planning.” Being diagnosed with a terminal illness can be overwhelming for individuals and their families.

When diagnosed with a terminal illness, knowing where to turn next can be difficult. Furthermore, many people have misconceptions about hospice and when it should be introduced. This article will break down these common misconceptions surrounding hospice.

post it questions

What Is Hospice Care?

Hospice care is for people with a prognosis of 6 months or less if their disease runs its natural course. This type of care focuses on making those with a terminal illness as comfortable and pain-free as possible. Hospice care includes social, medical, emotional, and spiritual support. The goal of hospice care is to provide terminally ill patients the opportunity to live the last stages of their life with comfort and dignity.

Hospice Care Misconceptions

Unfortunately, many common misconceptions surrounding hospice may prevent individuals from taking advantage of hospice’s many benefits. One common misconception is that “hospice is a place.” However, hospice can be provided wherever a patient is located, which sometimes includes right in their home. Another common misconception is that “hospice is giving up,” but this could not be further from the truth. Many people end up living longer in hospice or sometimes graduate from hospice and no longer qualify.

While on hospice, patients can choose to keep their primary care physician (PCP). Hospice care staff will work with your PCP and other healthcare professionals to provide collaborative care. Some people also avoid hospice care because they feel it is “pointless” as their illness is terminal. While curative treatment may no longer be an option, that doesn’t mean other efforts serve no purpose. Living with a terminal illness can often cause individuals lots of pain. That’s why hospice care is a great option, as it serves to make individuals as comfortable and pain-free as possible. These supportive measures are key in the final stages of a person’s life.

nurse and patient

Taking Full Advantage of Hospice Care

Instead of waiting until the very end to receive hospice care, individuals with a terminal illness can fully benefit from hospice care sooner rather than later. Others may decide to stop hospice to try another experimental treatment. Hospice can be designed to work for each patient’s individual needs. With hospice, you or your loved one are in the “driver’s seat” of your own healthcare decisions.

Learn More About Hospice Care

Hospice care is a great healthcare option when curative treatment is no longer viable. Furthermore, hospice isn’t just for the last days or weeks of life. Hospice can support individuals for several months. Don’t let the common misconceptions surrounding hospice hold you or a loved one back from receiving supportive care.

Our care team supports patients in determining their own goals of care during the final stages of their illness. Our hospice care service focuses on comfort, support, quality of life, and education. Contact us today to discuss your questions and personal needs.

World Health Day

World Health Day is observed every year to bring awareness to the importance of practicing and achieving optimal health and wellness. In honor of World Health Day, our goal is to help you learn and understand more about specific healthcare services that can improve your quality of life if you are living with a chronic illness.

What Is World Health Day?

World Health Day occurs every year on April 7. It was created by the World Health Organization and founded on this day in 1948. The purpose of World Health Day is to promote and celebrate the importance of physical, mental, and emotional well-being.

April 7, 2023, marks the 75th anniversary of the founding of the World Health Organization. This year’s theme is Health For All. This day is the perfect time to reflect on the many public health successes that have shaped today’s healthcare industry and have greatly improved the quality of life for billions of people worldwide.

world health day concept

The Importance of Home Health and Hospice Care

Suffering or recovering from a serious illness can be extremely stressful. Debilitating symptoms like chronic pain can greatly interfere with your quality of life, as can spending lots of time in sterile, hospital-like environments that take you away from your family and home. Home health and hospice care can make you feel happier, more comfortable, and less stressed—regardless of whether you are recovering from a short-term condition or coping with a terminal illness.

Home health focuses on helping you recover from an illness, injury, or surgical procedure. It can help you become more independent and teach you how to successfully live with and manage a chronic condition such as kidney disease, heart disease, or lung disease. This type of care is given to you in the privacy and comfort of your home.

Hospice care focuses on making you feel as comfortable as possible when living with a terminal illness, such as cancer. This collaborative approach involves physicians, social workers, spiritual advisors, hospice aides, and other healthcare professionals who strive to make your last days as fulfilling as possible. This type of care can be delivered anywhere you call home.

Who Can Benefit From Home Health and Hospice Care?

Home health is ideal for anyone in recovery from an illness, injury, or surgery who needs help getting back to their daily activities, but whose condition doesn’t necessarily require hospitalization. For example, home health may benefit you if you recently had open-heart surgery and must stay home for several weeks to recover and take it easy. Your doctor can determine whether home health services are ideal for you based on your unique condition and situation.

Hospice care is ideal for those with a terminal illness who want to reduce their pain and feel as comfortable as possible until the end of life. You may be eligible for hospice care if you have a terminal illness and need continuous oxygen, have difficulty swallowing, suffer from constant pain, or frequently experience shortness of breath. Your doctor can talk to you in greater detail about hospice care and determine whether you’re an ideal candidate for this service.

health blocks

How to Choose the Best Home Health and Hospice Services

Knowing about various types of healthcare solutions, such as home health and hospice services, can help you make more educated decisions for yourself or your loved one.

We understand how overwhelming it can be to navigate and choose the best type of health care when you or your loved one is managing or living with a serious illness. Let us help you choose the right program to provide you or your loved one with the best possible quality of life.

Contact us today.

Kidney Health Awareness Month

Did you know that March is National Kidney Health Awareness month? Each March helps raise awareness about promoting good kidney health and highlights how home health and hospice care can help support those with kidney disease.

Sadly, kidney disease is often referred to as a silent disease that can manifest without the presence of many symptoms in its early stages. Often, individuals diagnosed with Chronic Kidney Disease (CKD) are unaware of their condition until it has advanced to later stages.

person holding kidney diagram

Role of Kidneys in the Body

Before you can understand ways to protect your kidneys, it’s vital to understand the critical function of kidneys in the body. Kidneys help regulate the body’s fluid levels, filtering out waste and toxins from the bloodstream. In addition, your kidneys release an essential hormone in blood pressure regulation. Kidneys also serve many secondary purposes, such as activating Vitamin D to maintain healthy bones and keeping blood minerals like potassium and sodium in the correct balance.

With all these vital functions in mind, it’s clear that protecting your body’s kidneys is crucial to good health.

Protecting Your Kidneys

Promoting good kidney health starts with protecting your kidneys. First and foremost, drinking enough fluids daily keeps your kidneys functioning effectively. Adults who do not have a diagnosed kidney condition should drink about 9 to 13 cups of fluid daily, according to the National Kidney Foundation.

Your diet and lifestyle are also quite important to maintaining good kidney health. By eating a well-rounded diet and maintaining a healthy body weight, you’ll help protect your kidneys from many factors that contribute to kidney damage. Aim to get at least 30 minutes of physical activity every day. It may take time, but developing a regular exercise routine can go a long way in helping support your overall health, as well as your kidney health.


Drinking too much alcohol can also wreak havoc on your kidneys and put them at risk for kidney disease. Consume alcohol in moderation. In addition, smokers are at an increased risk for kidney disease.

Home Health and Hospice Services

If you or a loved one has received a kidney disease health diagnosis, there is help. Our team offers supportive in-home services for individuals in need. We review services for individuals on dialysis on a case-by-case basis. Some individuals can continue dialysis treatments while also receiving supportive home health or hospice services. To learn more about how home health and hospice services can help you or a loved one, speak to a representative to discuss your unique situation.

Learn More About Dialysis and Hospice Care

Interested in learning more about the home health or hospice services available to individuals receiving dialysis? Contact us today.

Frailty Assessments: 7 Keys to Improve Outcomes, Quality of Life

“Frailty is everyone’s business, and recognizing it improves outcomes and helps people live well longer,” said William Mills, MD, BrightSpring Health Services’ senior vice president of medical services, during Frailty: Why It Is Important, How to Identify It, and Programs to Help, a 2023 Clinical Impact Symposium webinar.

Addressing frailty is essential on many fronts. As Mills said, “Evidence shows that age, frailty, chronic disease load, and ADL dependency are predictive of mortality, hospitalization, and total cost.” At the same time, severe frailty is associated a five-fold higher risk of death at one year.

Frailty not only needs to be on your radar; you need a methodical, team-based, person-centered system to address this. The following are 7 elements your efforts should include:

1. A commonly used and accepted definition.

Mills noted that frailty generally is “a clinically recognizable state in which the ability of older people to cope with everyday or acute stressors is compromised by an increased vulnerability brought by age- associated declines in physiological reserve and function across multiple organ systems.” He added that the most commonly used definition is the “frailty phenotype,” which consists of five physical components: weight loss, weakness, exhaustion, slowness, and low physical activity level.

2. An understanding of how people express growing frailty and/or difficulty handling ADLs and IALDs.

Individuals aren’t likely to report that they are getting frail or weak. Instead, they may say things like: “The stairs are getting so hard to climb;” “Since my wife died, I just open a can of soup for dinner;” “I’ve lived here 40 years, and no other place will seem like home;” “I’m having more trouble getting around;” and “I’ve had a couple of falls – not too bad, though.” Family and team members need to be alert for signs that a patient is experiencing increasing frailty or frailty-related issues.

3. Consistent use of a proven assessment tool.

Mills said, “A clinical frailty tool should be quick, inexpensive, reliable, and easy to use in clinical settings because the identification of frail older people at risk is an important initial step potentially leading to appropriate preventive or treatment interventions and ultimately to higher quality care for this vulnerable population.” He noted that FRAIL scale is a simple questionnaire consisting of five yes or no questions addressing fatigue, resistance (inability to climb stairs), ambulation (inability to walk a certain distance), Illnesses (more than five comorbidities) and weight loss.

This scale, he said, has been shown to be able to predict mortality and incident ADL and IADL disabilities among community-dwelling older people in recent meta-analysis studies.” Other potentially useful instruments include the Clinical Frailty Scale, Edmonton Frail Scale, INTER-FRAIL Prisma-7, Sherbrooke Postal Questionnaire, Short Physical Performance Battery, and Study of Osteoporotic Fractures Index.

elderly man with cane at bottom of steps

4. Promote individualized, person-centered care.

Mills said, “An exciting project we have worked on involves a claims-based assessment to detect frailty. This is a unique opportunity to identify patients who may need specific interventions and provide them with those services.”

5. Include an exercise prescription to reverse frailty.

This should include resistance training, aerobic exercise training, balance training, and flexibility training. Mills and Renee Lach-Sharon, PT, MS, CPHQ, manager of therapy clinical and quality services at Rehab Without Walls NeuroSolutions, who also spoke at the webinar, talked about a new BrightSpring exercise program adapted from a program at the University of Otago in New Zealand. “The Otago program initially focused on falls prevention and found it useful in this regard. It has shown that even in higher risk populations, it was able to reduce falls by 35%, and it improved things like mobility and hand grip strength. We are looking at using it with very old adults who have multiple risk factors such as arthritis and deconditioning,” said Lach-Sharon.

This involves an individually tailored, home-based balance and strength falls prevention program delivered by a physical therapists and available via home health. Lach-Sharon stressed that intensity is key to the success of this program. This means sessions three days a week for each category of exercise, with a rest day between exercising in the same category. “We are looking to roll this out in the home health environment. Each visit would be about 45-60 minutes, then we would conduct follow-up calls to check in. This is key to the success of the program, as we are trying to make this a lifestyle change,” said Mills, adding, “One goal is to get these individuals into community-based exercise programs for socialization. This makes a tremendous difference in compliance.”

6. Have a way to measure outcomes.

This should include the use of your frailty assessment tool as well as measurements of gait speed, 30-second chair rise, and balance (4-stage balance test: stand with feet side by side, place instep of one foot so it is touching the big toe of the other foot, place one foot in front of the other – heel touching toe, and stand on one foot). Mills noted that, according to research, “The inability to stand on one leg for 10 seconds in mid to later life is linked to a near doubling in the risk of death from any cause within the next 10 years.”

7. Maximize your reach with technology and staff involvement.

Ideally, a good frailty program should be led by a trained physical therapist. BrightSpring is rolling out a national program currently. After starting the program led by physical therapy, leveraging technology, including efforts such as exercise videos and remote therapeutic monitoring can be useful as well. Make effective use of non- skilled staff and caregivers. For instance, consider using a standardized assessment tool to enable caregivers to address social determinants of health. “It is important to provide structure, clinical assessments and support between visits to assess frailty, falls risk, etc.,” Mills said, adding, “Make sure you provide a system for patients to get access to medications and maximize compliance with medication regimens.”

By assessing and addressing frailty, providers can manage patient proactively, instead of reactively. “We think an exercise prescription will be an innovative and exciting way to positively impact frail elders,” Mills said.

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