Sustaining Healthiness After a Diagnosis

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

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 home healthiness 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 status of their homes. 

Your house could be sick

When homes make people sick, this phenomenon is called “sick house syndrome,” conditions within the residence that 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. Poor air quality, excess moisture and other factors could harm immune response and compromise care. 

When the home environment actually triggers the onset or increased severity of diseases such as cancer, heart disease, asthma, pulmonary disease, even arthritis, Parkinson’s or depression, the “sick house” needs to be addressed. 

Diagnosis is critical

A diagnosis, whether one’s own or that of a loved one, becomes the organizing principle of home life during serious, life-altering illnesses. And, at this writing, “stay-at-home” recommendations due to COVID 19 are impacting all of us and increasing our vulnerability of experiencing health-related symptoms. Western North Carolina’s high risk residents – especially aging adults – will need to address the underlying questions of environmental home healthiness as it affects their quality of life.

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.

Once a home is diagnosed as the possible culprit in causing health issues, 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.

Asthma, a classic example

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 where a family member suffers from asthma, my primary goal is to identify factors that improve quality of life or increase productivity. In many cases, indoor air quality is key to achieving optimum conditions for disease and symptom management.

First, any home healthiness professional should perform a comprehensive assessment of the systems of the home. Secondly, 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. And, 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.

The EPA, JAM weighs in 

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 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 common sense plan that 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.

Uncertain times require additional consideration

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 we have already seen during the pandemic, innovation in telemedicine and remote patient monitoring grow and have become more mainstream; 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. 

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. Nearly 1 in 4 residents in WNC counties surrounding Buncombe are over the age of 65 (Carolina Public Press; “Coronavirus poses greater risk for populations in some NC counties,” by Kate Martin, posted March 21, 2020) 

With an estimated unprecedented growth in our residential population expected of those aged 65 to 74 in Western North Carolina by 2030, we must ask the big questions that hit very close to health, heart and home.