Louisville resident Debbie Watson last year faced a decision that many adults dread: How to convince an ailing parent that they can no longer live independently.
Watson’s father, William Beltle, who turns 101 in May, had developed short-term memory problems and could not adhere to his medication regimen. Sometimes he would take too many pills. At others, he would not take any. When he forgot to take one of the medications, his health issues got worse: Fluid built up in his legs and seeped out through large cracks.
Four years earlier, Watson took away her father’s car, because he had started backing into things.
Last summer, Watson and her brother, Craig Beltle, discussed how to proceed.
“We really didn’t know which way to go,” she said.
Watson said she asked him repeatedly about going to a retirement center, where he could go to church and which would provide meals.
“He would shake his head and say, ‘No, I’m not going.’”
Beltle, a retired mechanical engineer, has lived in the Barbourmeade neighborhood out Brownsboro Road for more than 50 years, including more than 20 in his current home and the last 10 by himself.
“He likes staying here,” Watson said. “He likes sitting outside.”
According to AARP, 87 percent of adults age 65 and older “want to stay in their current home and community as they age.”
Watson said she also worried about removing him from familiar surroundings at his age.
They sought advice from his doctor, Robert Palmer-Ball, and he suggested they look into ResCare, a Louisville-based diversified health and human services provider. The company, which employs 45,000 and serves more than 60,000 in 42 states, Canada and Puerto Rico, supports therapy, vocational training and job placement services for people with disabilities and is “the largest privately-owned home care company,” according to its website. The company is owned by Canada-based private equity firm Onex, which bought ResCare, formerly publicly traded, in 2010.
ResCare CEO Jon Rousseau told Insider that ResCare generates about $2 billion in annual revenues, with about a quarter coming from the home care business and half from services for people with disabilities. The company also has several smaller, but quickly growing businesses, including pharmacy services and at-home rehabilitation.
Watson said she had never heard of ResCare, but after meeting with a company representative and learning about the services, she and her brother decided to help their father through a ResCare aide.
Company officials interviewed and observed her father to determine his capabilities and advised the siblings that Beltle did not need a nurse because he could do many things by himself, except making dinner and keeping track of medications.
Now an aide visits Beltle from noon to 6 p.m. daily to provide lunch and dinner, to perform some housekeeping duties — garbage, mail, laundry — and to make sure he takes his medications, walks with a cane to prevent falls and raises his feet when he sits, to aid blood circulation.
ResCare also helped the siblings navigate long-term health insurance, although the home aide service — which costs $120 per day — initially was not covered. Months later, however, the insurance company has reconsidered and agreed to pay a share of the service; Watson said she expects the company to pay for about 80 percent. Medicare does not cover homemaker services or personal care.
Rousseau, the CEO, said that retiring baby boomers increasingly are demanding health care services that help them remain fairly independent and in their homes.
And the number and share of older Americans is expected to continue to rise: The Census Bureau projects that in 2030, 21 percent of Americans will be at least 65, up from 15 percent in 2014. During the same span, the number of people in that age group, at 46 million now, will rise to 74 million. And the number of Americans over 85 will triple by 2040.
Meanwhile, the Home Care Association of America says 70 percent of people who reach 65 “will be unable to care for themselves at some point.”
Better health, lower cost
Having seniors stay at home can help families, states and the federal government save money — and brings “social and emotional benefits to both seniors and the broader community,” according to the U.S. Department of Housing and Urban Development. Government programs Medicare and Medicaid pay for the majority of nursing home and home health care and other long-term services.
Some care models prevent elderly people from activities that the young and healthy take for granted, such as just going out into the community to involve themselves in activities, Rousseau said. And many of those things are directly tied to mental and physical health, he said.
ResCare is well-positioned to play a central role as governments and health care providers and insurers try to figure out how to keep people in their homes longer because it improves physical and mental health and cuts costs, the CEO said.
Technology is playing an ever more important role in helping ResCare keep people in their homes. Through touch-screens, patients can chat with family members or call for help around the clock. That means family members who live far away can easily keep an eye on loved ones.
Smart homes have motion detectors and room temperature monitors, even mats in the bathroom that tell caregivers how much the patient weighs to identify any potential health problems as early as possible. Sensors under mattresses let caregivers know when a client has gotten out of bed, which provides information about sleep patterns.
Eventually, a connected toothbrush will provide information about oral health, and flush sensors will provide data about bowel movements.
The trend toward caring for older people in their familiar surroundings will continue, Rousseau said, and as patients’ health improves, governments and insurance companies will want to encourage such practices and increasingly will want to pay for them to avoid incurring higher costs down the line.
Watson said she and her brother still visit their father frequently for a chat or to drop off groceries, but she said the ResCare aides have helped the family immensely.
“If we didn’t have these caregivers in here, you know, he wouldn’t be able to stay here,” she said. “It’s a major help.”
And although her father would prefer not to have a caregiver in his house, because he likes to be alone and independent, he has gotten used to the arrangement. He has always liked music, especially opera, and he watches sports or the news on TV. He still votes, by mail, Watson said, though he does not know who the current president is, because of his short-term memory problems.
When he is by himself, he sometimes goes into the garage to work with tools, Watson said. She knows because she sometimes finds his cane there.
She suspects that when no one else is in the house, he may also use the chair lift to go into the basement, where he also keeps tools.
“Who knows what he does down there,” she said with a chuckle.