What it's like to bring the hospital home

The family of a patient in ICU queuing up outside the doctor's door hoping to get queries answered, groups of people scurrying to pay up before they can admit a patient in distress, grieving relatives running on a Sunday to settle the final bill so they can take the body of their loved one… a visit to a hospital tells stories we wouldn't wish on anyone.

Enter home healthcare systems to take away these and many related worries. Several organisations offer elaborate healthcare systems at home so families don't have to worry about waiting in a hospital room while getting their loved ones treated in their comfort zone.

Zoctr founder-director and CEO Nidhi Saxena says she set up the company after her father's botched up spinal surgery. "He lost a lot of cerebrospinal fluid and the surgeon washed his hands off the operation. We then brought him to Mumbai where he was treated and had a successful surgery. It was then that I realised the importance of home healthcare for a patient," she says, adding that Zoctr is operational in six cities.

Apart from Zoctr and Care24, other firms such as Health Care at Home (backed by Dabur India), Vatsalya, which specialises in oral healthcare, Zozz and Life Circle Health Services are also in the business of catering to patients at home. Services include physiotherapy, elderly care, mental illnesses and even pregnancy care. Some treat patients who are unable to afford the daily care of a hospital and need care for the long term. "We normally treat patients suffering from Alzheimer's, Parkinson's as well as those suffering from post-trauma oncology," adds Saxena.

The best aspect of such services, feels a Mumbai user wishing to remain anonymous, is that the patient is in familiar territory, i.e. in his/her home. "The nurse is available at all times; we don't have to worry about hospital bureaucracy and most importantly, we know that we can be around our loved ones at all times. If you don't want to visit a hospital, bring the hospital to your home," he says.

Bouquet of services, at a cost

Basic services include a nurse for 12 hours. A basic 12-hour shift costs approximately Rs1,200 per day, and can go up to Rs1,500 for cancer patients. The cost doubles if the family insists on 24-hour help. "The nurse usually speaks to the doctor and notes down instructions to ensure the patient is treated well. Furthermore, the doctor may also make home visits to check on the patient," says Saxena.

For those willing – and able – to spend, monthly expenditure can go up to Rs70,000 per month. This includes a rental of Rs12,000 per month for an air bed and Rs5,000-Rs6,000 for oxygen supply, with the rest depending on the amount of medical equipment required. "Sometimes, a part of the house may have to be converted into a mini-ICU," says Saxena.

Stumbling blocks

The challenges for home healthcare providers are many, says Vipin Pathak, co-founder and CEO of Care24. "The skill of caregivers needs to be upgraded. Furthermore, the protocols for home healthcare are not set," he says. "A lot of expectation management has to be done between the caregiver and the customer."

According to Dr Parul Tank, a psychiatrist with Fortis Hospital, home healthcare services usually comprise paramedics, physiotherapists, occupational therapists and support staff such as nurses. "While they are equipped to deal with physical illnesses, it is a different situation when it comes to mental illnesses and illnesses like dementia and delirium that come with old age," she says. "More work needs to be done to train staff in mental health care needs and also for the staff to offer emotional support. Often, they need to counsel family members, which can make them more efficient if they have trained in 'psychological first aid'."