In the ever-expanding health and fitness market, there are opportunities to do good work, and to expand business models. Wellness programs for the home healthcare market are a tremendous opportunity to do both.
According to the National Association for Home Care (NAHC), there are almost eight million persons in the US who require some form of home health care. This would entail basic activities for daily living (ADLs), nutrition assistance, shopping, and general home assistance. Almost two-thirds of home care patients are women, and a high percentage are over the age of 65. Most of the medical conditions that they suffer from (which may have an impact from active wellness instruction) include diabetes, skin ulcers, arthritis, and hypertension. To date, the NAHC estimates that there are over 20,000 home health care providers, and this number is growing rapidly each year. How big is this market? 
Over five years ago approximately $41 billion was spent on home health care. That number will certainly double by the end of this decade.
With this in mind – the home health industry is looking into working with wellness companies to provide wellness services for their clients, and continuing education for home care providers.
Traditionally not college educated – most home care providers earn at the low end of the health care pay scale. An average wage in most areas of the nation is around $10.00 per hour. By having an “advanced” certification in wellness, they may be able to earn more per hour through their employers, or (if working as an independent contractor), from their client base.
Home wellness programs are also important for personal trainers who are interested in working with one of the fastest growing markets in health care. This is important for two reasons. First – the number of clients who will need some level of home care wellness will increase by over 10% each year for the next 40 years. This means that a personal trainer at 25 years of age will be able to work (exclusively) with home care clients throughout their entire career – if they chose. Second – home care wellness programs, although a part of healthcare, represents a special niche, in that they don’t follow many of the regulations of hospital or rehab center programs. There is more freedom in working with home care clients – keeping in mind that they still may need a particular feeding, dressing, and medication regime that the trainer must be aware of. For this they can work with nurses, counselors, and therapists to design the proper exercise/wellness routine around any specific medical needs.
Home care wellness programs concentrate on the basics of exercise – such as balance, skill training, and foundational strength (legs, hips, arms, core). Regimes such as standing on one leg, half lunges, quarter squats, and light bicep curls make up the bulk of this program. Safety exercises such as getting out of the car, a chair, or a tub are also important. Nutrition advice such as types of foods, glycemic index, and supplements are also a part of the overall package. Lastly – improving one or more element of their quality of life is paramount to establish a fitness program as part of the standard of care for this group. Many gerontologists are reluctant to refer a fitness / wellness program for home care. Most are concerned with the basics (medications, ADLs, general caloric intake). If wellness programs are prescribed properly, there should be little concern for safety. Trainers will also learn the many other aspects of caring for persons outside of the health club environment.
Wellness can have a major impact on health care in the coming years. Not just in the areas we can see at present (such as hospital wellness, post rehab, nutrition education), but in areas that have business growth potential and have a need for this type of education (such as home health, assisted living, boutique medicine, etc.).
The number of healthcare areas that wellness can impact is a large as healthcare itself. It is this “out of the club” thinking that will allow fitness professionals to make an ever-greater impact on our nation’s healthcare market while working within their scope of practice, provide much needed education, and allow a new niche of healthcare clients to enjoy the benefits of fitness in a fun and safe format.
Eric Durak is President of Medical Health and Fitness – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.
