When the home environment is a trigger in the onset of disease or chronic symptoms of illness, it’s time to take stock of safety, quality of life, and the future of care.
By Rick Bayless
Much as a well-maintained home certainly supports optimum property value, a well-maintained home ecosystem supports optimum health. Since 2017, home healthiness has emerged as a leading trend, particularly in green and sustainable western North Carolina. Many of us believe that an unmistakable correlation exists between our living conditions and how well we feel.
Thanks to medical advances, most people can now expect to live longer lives. However, due to this longevity, they may also develop age related chronic conditions for which they are predisposed. This predisposition isn’t limited to genetics; it may be the result of the healthiness of their homes.
When homes make people sick, this phenomenon is called “sick house syndrome,” in which the conditions within the residence cause the symptoms of illness. The causes of sick house syndrome may be specific, when caused by risk factors such as pesticides, chemical pollutants, or other contaminants or physical hazards. Or, they may be nonspecific, the result of weather, the proliferation of microbes due to increased dampness, natural disaster, or pests. In our mountain climate, culprits such as radon or mold are always top of mind.
But what happens when the home environment is a risk factor in the cause – perhaps actually triggering the onset or increasing the severity – of diseases, such as cancer, heart disease, asthma, pulmonary disease, arthritis, Parkinson’s and depression, among others? In these instances, WNC’s aging adults will need to address the underlying questions of environmental home healthiness, particularly as it affects their quality of life.
A diagnosis, whether one’s own or that of a loved one, becomes the organizing principle of home life during serious, life altering illnesses. When a home is organized in order to facilitate care during extended illness, it may be termed a patient-centered medical home, according to the U.S. Department of Health and Human Services.
After a diagnosis, the prognosis often includes chronic, long term, and untreatable conditions that individuals may have to live with for many years to come. Treatments, decisions and daily support may be necessary. Eventually, many patients and their families will choose to manage and finance care regimens at home, bringing up significant questions of safety, affordability, and quality of life.
In the environmental home healthiness arena, asthma offers a classic example of a multi-trigger, multi-component disease which requires environmental intervention in the home. When asked to perform a healthy home examination in a home with a family member who suffers from asthma, my primary goal is to identify factors that improve quality of life or increase productivity. In many cases, like this one, indoor air quality is key to achieving optimum conditions for disease and symptom management.
After talking with family members about the diagnosis of asthma, for example, the home healthiness professional should perform a comprehensive assessment of the systems of the home. Working from the diagnosis and symptoms, it becomes possible to offer specific recommendations for immediate interventions within the indoor environment. Priority is placed on those changes known to reduce exposure to known or probable asthmatic triggers. Finally, the homeowner receives the information needed to maintain a home-based environmental focus which ensures optimum conditions for wellness.
Of course, asthma is not the only disease with implications suggesting the need for diagnosis-focused environmental home healthiness assessments. It is simply one of the most studied and well known.
In its online publication “Indoor Air Pollution: An Introduction for Health Professionals,” the U.S. Environmental Protection Agency lists a wide range of chronic illnesses ranging from rashes to pulmonary disease to cognitive impairment, and more, alongside the risk factors to be assessed in the home. This list reveals the merest tip of a growing iceberg.
This reality which predicates a growing movement within healthy homes programs to integrate the evaluation and management of health and safety risks with patient-physician discussions about home environmental health. The hope is that physicians will participate with the home examinations and interventions needed for their primary care patients, following up on risks that make it difficult to maintain optimum wellness and result in increasingly acute symptoms.
“For many, including the most complex patients, needs assessments may also have to include direct assessment of the home environment…” writes Wieland Boldt in the Journal of American Medicine in 2010. This assessment, he notes, “…can determine the feasibility of care plans and identify adaptations necessary to accommodate an individual’s need for assistance with daily activities.”
Though medical literature suggests it may be advisable for physicians to evaluate home healthiness through in-person assessment, it may not be feasible. Or, it may require education and experience which exceeds that available in medical school or other training. It’s my belief that qualified healthy homes practitioners are a necessary and important component of any person’s care team when assembled to deal with the day-to-day challenges of living with a serious, chronic illness.
The physical setting and home environment, then, are destined to become part of any commonsense plan which focuses on symptom management and improved quality of life. Unfortunately, many of these efforts focus on access or physical hazards and ignore other environmental risk factors such as mold or other toxins. From a home healthiness perspective, it becomes critical to the individual’s quality of life to attend to the environmental factors found in the systems of the home which are known to exacerbate symptoms.
According to the U.S. Office of Disease Prevention and Health Promotion, “…healthiness conditions in our environment where we live, learn, work and play…affect a wide range of health functioning and quality of life outcomes and risks.” Without doubt, environmental factors impact human healthiness. If our home does not provide clean air, water, food and safety, we have failed to ensure quality of life for its inhabitants.
As innovations in telemedicine and remote patient monitoring grow, we’ll also see the increasing use of smart home technology to improve healthiness outcomes. However, these technologies are sure to change the ecological balance within the systems of the house. Disease and symptom management concerns must be balanced with environmental healthiness considerations. Poor air quality, excess moisture and other factors could harm immune response and compromise care.
Environmental home healthiness risks contribute significantly to health problems, loss of independence, susceptibility to respiratory conditions and shortened life expectancy. By that same token, successful intervention can promote health and wellness. The goal of any worthwhile healthy homes initiative must include attention placed on the current and future care concerns and needs of an aging population. In Western North Carolina, this is especially so.
As we count down to 2020, many information sources are already sounding the alarm on increasing issues about housing, health care, and environmental impacts. According to a 2016 article in the Citizen-Times, western North Carolina will have seen an estimated 21% of unprecedented growth of its residential population of those aged 65-74. We must ask the big questions that hit very close to health, heart and home.
Rick Bayless owns and operates A Healthier Home, LLC, western North Carolina’s leading environmental home health services provider. Learn more about maintaining a green, healthy, and mold-free home at www.ahealthierhomenc.com, or address concerns after a diagnosis through systemic intervention with www.envirovention.com.