Total Homecare Solutions: Interview With Adam Shoemaker, President

John Gambill Jr., interviewed Adam Shoemaker, President at Total Homecare Solutions (THS). Adam started THS in 2007 as a supported living provider, then extended its offering about five years ago to include remote supports for disabled individuals who want to regain their independence. THS is now a leader in remote support technology and implementation, wherein they’re able to monitor individuals using various technologies, sensors, and cameras, allowing them more freedom.

How did you get started working with disabled individuals?

In 2007, we started as a supported living agency – providing staff to directly aid disabled individuals within their homes. Five years ago, we were hit with a multitude of challenges with regards to health insurance, caregiver shortages, and various other changes in the marketplace. We needed to find a way to combat some of these significant changes in the provider landscape, while paying our employees a better wage.

At the time remote supports had been around for quite a while, but few people seemed to be taking advantage of it. We decided to try it ourselves, gathered information from every avenue available to us, and slowly developed our system. In 2018 the State began to actively promote the service, which really allowed us to hit the ground running as we had a leg-up in the development process. Timing was on our side, and the service really began to grow from there. Today we provide off-site monitoring all throughout the state of Ohio.

What’s your primary focus now?

We still have a number of individuals that we do hands-on care for, but our new division of remote supports is taking off. We naturally work closely with our own supported-living agency but have now branched out to work with other large supported-living providers throughout the state. People seem to want more independence without staff in their homes all the time, so it’s been successful for that reason.

When the state decided to embrace the service, significant progress was made. People are realizing they can be happy, healthy, and independent – without needing someone around all the time. We’re quite focused on remote supports because we want to be part of the solution. Ohio is quite ahead of other states with regards to this type of innovation.

How does this help alleviate the challenge of workforce development and availability?

We’ve learned a lot on the supported-living side because we know what goes on every day. We’re a provider, so when we work with other providers, we know what they’re looking to achieve. The entire concept when we started out was finding new ways to save money on personnel, so we could in-turn pay our staff better during hours where in-home care is critical to an individual’s success.

Remote supports have really helped us meet that goal. Instead of having someone within each individual’s home around-the-clock, we’re able to give them peace of mind and reassurance – keeping an eye out remotely to give them reminders, track various activities, and make sure the home is safe when staff isn’t there.

What type of technology do you use and support?

We like to stay nimble. It’s a lot of off-the-shelf hardware that the individual or family members may already use and interact with daily, which is great because they know how to use it. As long as we can get it into our system and respond to it, we can support it. If a new piece of technology comes out, we’re able to accommodate. If we can tie it into an API or text/email integration, we can respond.

It can be very simple, such as monitoring for when the door opens, then calling to make sure the individual is okay. It can also be quite complex using sensors to gather data on wellness. We partner with local companies so we can leverage the latest and greatest solutions out there.

Individuals are able to get their homes to themselves more often which in-turn increases their confidence and independence – the entire goal of the state-wide program.

How customizable is the remote support you’re offering?

For some individuals, we provide a few reminders each day. For others it’s almost like there’s a team of caregivers available to them, simply offsite. Flexibility is a necessity because some people want communication “now and then” whereas others want to feel like someone is around more often. We’ve seen many individuals so far truly thrive on our remote supports. It’s been very eye-opening from my standpoint because although we’re accustomed to in-home staffing, that’s not always necessary to keep individuals happy and safe.

What about the simple tasks that some people take for granted every day?

Stoves and cooking, in general, are huge. They’re frankly one of the biggest reasons we have in-home staff. But with technology, we can help with many of these things remotely. There’s a lot of great options. We can walk them through cooking techniques or simply monitor for safety in terms of smoke, fire, etc. It can go from very simple to quite complex. We’d like to incorporate telemedicine as we grow.

Do you have anything in mind when it comes to telemedicine?

Right now, we do wellness checks and we’re looking at working with some providers to offer triage. Getting individuals to and from medical appointments can be challenging, but in the future, we’d love to incorporate that. We do have a nurse on staff to help with triage, but if the need grows, telemedicine will certainly follow.

What is the biggest challenge you’ve faced so far?

The biggest one is information. The state has done a great job of getting information out there, but providers really need to drive it. They know the individuals and the families involved. They have the direct connections and have built the relationships that matter to those individuals, so their recommendation holds weight. My goal is to do a better job of teaching providers about the advantages of remote supports. If they learn how to use and operate our services, they can go out and do it themselves without relying on us or another vendor to spread the message.

Families can also have quite the adjustment period. They’re used to having staff around all the time – caring for their loved one within the home. They’re usually a bit hesitant to drop that amount of in-home care down, but once they do, they tend to see the value. I’ve met with families who were initially against remote supports but realized how much their loved one thrived on it after implementation.

Click here to find out more about THS and what they do with remote support for disabled individuals.