Domiciliary Treatment in Older People - Opportunities and Challenges

Introduction

Domiciliary means involving someone’s home. Both private and public healthcare spaces describe the kind of home care for older adults and veterans. The domiciliary visit will only be at someone’s home, nursing home, or care facility. A carer may visit a few hours a day for an indefinite period, helping an older person live a safer and more comfortable life. Domiciliary treatment may often be referred to by other names like visiting and hourly care. This can be considered traditional home care.

What Is Domiciliary Treatment in Elderly People?

Domiciliary treatment is a treatment that is provided to elderly individuals. This is related to something that happens at or related to an individual's home. As the name implies, domiciliar treatment is the situation where an individual receives medical treatment at home. In this treatment, the normal course requires hospitalization, but the individual takes treatment confined at home under specific circumstances.

What Are the Types of Domiciliary Care?

Domiciliary care is not that fits all. There are different ways to tailor the type that suits an individual personally and with the required type of care. The main types of domiciliary types are

• Companionship Care: Little extra company, perhaps after losing a spouse.

• Nursing Domiciliary Care: Specific health needs such as changing a dressing or stoma care.

• Multiple Visits Per Day: Individuals who need little extra help at specific times of the day, like meal times.

• Housing Support: Help with general things around the house, such as cleaning and paying the bills.

What Are the Conditions Where Domiciliary Treatment Can Be Provided?

Domiciliary treatment is a benefit offered by health insurance companies where the policyholder can get hospital-like care and treatment at home. This treatment method is adopted for severe injuries like illness, lack of hospital beds, and other reasons. Domiciliary treatment in elderly individuals is provided in the following conditions:

• Asthma.

• Bronchitis - Inflammation of the lining of the bronchial tubes that carry air from the lungs.

• Epilepsy - A nerve disorder in which the cell activity in the brain is disturbed, which can lead to seizures.

• Chronic nephritis.

• Cough.

• Cold and influenza.

• Hypertension.

• Nephrotic Syndrome - A kidney disorder that causes the body to excrete too much protein in the urine.

• Diabetes.

• Chronic nephritis.

• Tonsillitis - An inflammation of two oval-shaped pads of tissue that are placed at the back of the throat.

• Pharyngitis.

• Upper respiratory tract infections.

• Rheumatism - A condition that causes pain in muscles where the bones join together.

• Gout - Arthritis characterized by severe pain, tenderness, and redness in joints).

• Psychiatric disorders.

• Any traumatic injuries or fractures.

What Are the Advantages and Disadvantages of Domiciliary Treatment in Elderly People?

Care homes and families provide everything required for a safe environment for loved ones. Comfort and familiarity of being at home are often overlooked as an option. The benefits of domiciliary care may depend on the level of care required for an individual. The following are the advantages:

• The individual can have a homely environment. Less stress from changing environments.

• Medication support is available, and a personal care plan is provided.

• Alleviates some strain on family members but costs less than home care.

• Activities, routines, and meals are personalized.

• Support is provided around the clock.

The disadvantages are

• The carer may differ each time, not suitable for nursing care.

• Carers may be stretched for time as they are visiting others.

• Immediate medical support is not available when it is needed.

• Geographical limitations may not have many choices of carers.

• Often thought to be an expensive option.

• Home adaptations may be required.

What Is the Relationship Between Domiciliary Treatment and Health Insurance Companies?

Domiciliary treatment is not a common phenomenon. This can be extremely useful for those in need. Usually, in the case of domiciliary treatment and it is covered under a health insurance policy:

• When the healthcare provider states that it is best for the patient to be treated at home.

• The insured individual cannot be admitted to the hospital due to severe health conditions or lack of accommodation.

• In cases where treatment is completed, the claim is settled as per the policy and terms.

• Care is provided to the individuals at home as it is provided at the hospital.

Important points of domiciliary treatment in health insurance:

It is vital to make sure that health insurance covers domiciliary treatment:

• When the condition goes beyond hospitalization, only insurance coverage is needed.

• Coverage in cases the insured cannot be moved to a medical facility.

• Covers medical expenses in case of a lack of beds and the peak of pandemic conditions like COVID-19.

• Offers peace of mind.

What Are the Criteria Necessary for Domiciliary Treatment and Acceptable by Health Insurance?

The criteria where domiciliary treatment can be required are

• A medical condition of an individual that prevents from being moved to a hospital.

• The need for more availability of the requisite infrastructure in selected hospitals and the non-availability of beds and required medical equipment.

• In certain circumstances where there is, the continuous hospitalized treatment of an individual and an individual may not be possible or preferable. In cases where minors are involved, the minor's parent, who is not comfortable with a long stay in the hospital, can opt for domiciliary treatments.

• Conditions where hospitalization is a medical condition or accidental injury that can be treated at home. Individuals who require care at home rather than being isolated are confirmed at the hospital.

• Many insurance policies do not cover voluntary domiciliary hospitalization, so it is crucial to read the wording of health insurance plans before selecting domiciliary treatment for elderly individuals who are required to get benefits from insurance companies.

Conclusion:

Domiciliary treatment in elderly individuals is one of the somatic treatments. There is emerging research in other countries on the safety and feasibility of domiciliary care in elderly individuals. The maintenance can be delivered by telepsychiatry with appropriate training and caregiver supervision. Still, many clinical trials are required to determine the effectiveness and feasibility of domiciliary care in elderly individuals.