Eating disorders (EDs) are a serious concern for health professionals and families alike – they have some of the highest mortality rates for any mental health condition [1]. Over recent years, there’s been a considerable rise in the prevalence of disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder [2]. Since treatment can be challenging because these illnesses stem from a mix of various factors, there is a rising demand for specialist ED services.
The UK, in particular, has observed a concerning upward trend. Hospital admissions for EDs have surged, and waiting lists are at an all-time high. While this was alarming in general, the COVID-19 pandemic added an unprecedented strain. Lockdowns, social isolation, and the anxiety brought by the pandemic have exacerbated the frequency and intensity of binge episodes, relapses, and new diagnoses.
Despite the stereotype that many mental health conditions require inpatient care, growing evidence demonstrates this is not necessary in all cases, and home-based care can offer more personalised and flexible care options.
Traditional Treatment Modalities: A Glimpse into Stepped-Care
When treating eating disorders, treatment should always reflect the severity of the disorder and be measured by factors like BMI, overall health, and previous treatment history, and the stepped-care model, which emphasises tailoring interventions to individual needs and has seen success in other mental health treatments, can also be applied to this condition.
Initially, outpatient psychotherapy with a mental health professional might be the primary strategy if the client’s health is not at immediate risk. This form of treatment offers supportive therapeutic tools while allowing clients to maintain their everyday routines. However, if the condition is serious or escalating, i.e. clients experiencing drastic weight loss, physical health complications, or other risk factors, more intensive treatments may be required. This could range from outpatient treatments, where people receive therapy and medical care during the day but return home in the evenings, to inpatient treatment and more intensive monitoring. Inpatient care is usually reserved for those at significant medical risk or those who haven’t responded to less intensive treatments.
It’s absolutely vital for carers and patients alike to be well-informed and advocate for the appropriate level of support, as not all inpatient settings or residential treatment centres deliver the specialist care required. Some may group people with EDs alongside those with addictions or other mental health conditions, potentially not offering the dedicated care necessary.
Introducing Home-Based Treatment: The New Frontier
Home-based care is quickly gaining popularity for managing certain groups with eating disorders, with one pilot study recently showing its efficacy, especially for adolescents with anorexia nervosa [3].
The home-based model isn’t just a copy of a hospital protocol inside a home – it’s a carefully crafted plan executed by a multidisciplinary team, including dietitians and other mental health specialists, with nurses playing a key role in hands-on, front-line delivery.
As well as helping people who are unsuitable for inpatient treatment, this approach can also support those transitioning out from that level of care as they gradually integrate their recovery with everyday life. The blend of carers and professionals working in familiar surroundings makes the recovery journey smoother and potentially reduces the length of hospital stays, and when nurses are mental health-informed and trained, their involvement ensures that physical and psychological health needs are met.
The Benefits of Home Treatment for Eating Disorders
The shift toward home-based treatment options for eating disorders is due to several reasons that can improve the client’s experience and overall treatment outcomes. Some of the reasons that more and more services are choosing to offer treatment at home rather than traditional settings include:
- Being in the comfort of our home can significantly reduce the anxiety and stress associated with unfamiliar and sterile clinical environments, leading to better engagement with the therapeutic process. One study found that inpatient treatment isn’t necessarily more effective than outpatient care, especially in the long run [4].
- Family can play a role in the recovery journey. When combined with professional intervention, their presence and support can enhance the healing process.
- Eating disorders are deeply personal, and the involvement of a dedicated nursing team means they can understand the personal nuances of the client. It creates a more personal support network for them rather than treatment centres with transient staff and clientele.
Beyond the therapeutic benefits, home treatments are often more cost-effective than traditional in-patient modalities. Research has pointed out that outpatient care might not only present similar results but also come at a reduced cost [5].
Is Home-Based Care for Everyone?
Home-based care for eating disorders offers many advantages; however, it isn’t universally suitable. Hospitalisation becomes essential when specific criteria are met, such as a BMI less than 14, rapid weight loss, unstable vital signs, or severe psychiatric symptoms like active suicidal ideation.
Additionally, key indicators, including blood test abnormalities and the severity of eating disorder symptoms, can signal the necessity for intensive, inpatient care, and certain environments or age groups, such as those under 18, may not be apt for home-based treatment.
While the comfort and personalised nature of home treatment appeal to many, the relevant medical, psychiatric, and environmental benchmarks must be considered when determining the best course of action. Due to the high mortality risk, the decision between home care and hospitalisation must always prioritise the client’s safety and overall well-being.
Contact Us Today
Nursing care in your home for eating disorders can hugely benefit you and your family in the right circumstances. At Assured Healthcare and Wellness, we’re proud to offer this approach, and we envisage a world where the need for hospitalisations diminishes and long-term recovery outcomes improve.
If you or your loved one are affected by an eating disorder, contact us to see how we can help.
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