Within the next 10 years, the population of adults over 65 years of age will outnumber the population of people under 18, and according to Pre-op Solutions Owner Kaitlin Reph, many communities are ill-equipped and ill-prepared to support this shift. The numbers of people entering fields like home health care and in-home, non-medical support or looking to grow careers working in retirement communities do not match the percentage of aging retirees who will soon need those services.

Working in healthcare since she was a teenager and in home health for more than eight years, Reph has seen shifts in the home healthcare workforce, especially through and following the height of the COVID-19 pandemic. During that time, the number of nurses visiting the homes of patients declined, elective surgeries were put off, and assisted living facilities were not accepting new patients. Some workers in these fields changed careers or retired themselves, and as people have been returning to normal, many of these disciplines have not fully recovered.

Following the pandemic, more people are deciding to age in place, creating other challenges for this population. Many homes are not well-suited for retirees as they age, and Reph has seen an increase in demand for custom home renovations with a focus on universal design, allowing older adults with varying conditions to remain safely at home.

“I don’t know many people who are in their 50s, 60s, or 70s planning to relocate to a nursing home at any point,” Reph said. “Aging in place is a huge part of the conversation. There is also a huge opportunity for new businesses to help organize all the things people will need to be as comfortable, safe, and happy as possible for the length of their lifetime, without going into a nursing home.”

Demands for home health care have increased, and businesses supporting that are increasingly searching for staff to meet the demands. In addition to nurses, those offering chiropractic, physical therapy, and body work services travel to see clients in their homes. There is also an increase in demand for non-medical services; the same clients are often searching for help shopping for groceries, light housework, and light yard work, but these services are outside the scope of home healthcare businesses.

Considering the ability of older adults to successfully age in place, Reph conducted research on experiences of adults over age 55 with major surgeries and recoveries, with 65% of those surveyed residing in Western North Carolina. She discovered 95% of respondents reported feelings of anxiety, worry, fear, or in some cases, depression, before their surgery, which profoundly impacts the mental well-being of patients. The survey also indicated about 1/3 of patients had low or no understanding of the procedure and rehabilitation processes, and of the remaining 2/3 who did understand, nearly half of those indicated a negative outcome from their surgery.

Ninety-six percent of respondents reported an in-home pre-op visit helped them feel more prepared for their upcoming surgery and recovery, yet only 16% said they received home visits to help them properly prepare. She found 70% reported that an in-home visit reduced their recovery time.

“It was cool to see numbers demonstrating services like these can help people get back out hiking or watching their grandkids sooner,” Reph said. “From an economic standpoint, that’s 70% of people who got back to work sooner. What I ultimately hope, though, is that pre-op care in this capacity becomes part of surgical protocols in the near future.”

Reph hopes to see Medicare and other insurance companies considering more options for preventative care, in terms of surgical experiences as well as supporting aging adults in general.

“I ultimately want to demonstrate that people who have better preoperative care have a smaller likelihood of having falls, infections, or other negative outcomes,” Reph said. “It would help people have better outcomes with their surgeries, as well as with choosing to go home after surgery rather than depending on long-term rehabilitation facilities. Providing preventative care would ultimately cost insurance companies much less in the long run.”

Offering preventative care should lead to fewer people in need of larger medical support, according to Reph. She believes this could free up more providers and clinicians to be able to help more people — a significant impact on an industry with fewer people than needed entering careers in that sector.

“People are thinking of more than what they need; they’re thinking of what they want regarding their care,” Reph said. “If we can preemptively prepare and maintain wellness now, then there will be less need for care later, and that also means better, happier, and healthier people in our aging community."