Home Health Care | Cancer.Net

Home care consists of a range of health-care and supportive services delivered in the home to patients who require assistance with daily activities. Home care can make an enormous difference at times of stress, such as the period following surgery or recovery from a lengthy hospitalization, or to those in need of longer-term care. Home care allows some patients the freedom to spend less time in the hospital. Home care services also offer relief to family caregivers caring for a family member in the home.

Home care is appropriate for people with cancer who are actively receiving treatment or rehabilitation services or those who need help with daily activities such as bathing, cooking, or cleaning. Hospice care also provides home care services and is appropriate for patients living with advanced cancer.

Home care services

Home care services are delivered by a variety of professionals. In some cases, it includes visits by doctors and nurses, but these services are usually limited to referrals from a doctor or hospice. More often, home care refers to services such as nurses' aides and homemakers.

Home health aide/home care aide: Provides personal care services by helping patients with activities of daily living, such as bathing, dressing, using the toilet, and moving around. Some home health aides are specially trained to provide more complex services, such as wound or ostomy care, under the supervision of a nurse.

Patient care attendant/homemaker: Provides personal care services and performs light household tasks, such as cooking, laundry, and basic cleaning.

Companion: Provides comfort and companionship to patients who cannot leave the home or be left alone. Some companions perform limited household tasks, such as preparing lunch. A companion may stay with the patient, so family caregivers can take a break. Companions are often volunteers, but some may be paid.

How to find home care services

Talk to your doctor or social worker to decide what home care services will be needed and to develop a home care plan. Ask them to recommend agencies or personnel in your area who can provide home care services. Consider the following types of agencies:

Home care agencies provide a variety of home care personnel, including nurses, therapists, social workers, and home care aides. The agency assigns and supervises a team of caregivers to provide the services needed by each client. Some agencies will also help you develop a care plan. Many agencies are Medicare certified, meaning they meet federal standards for patient care and are providers of services that are covered by Medicare and Medicaid. Screening, hiring, supervising, and paying salary and taxes are handled by the agency and the agency assumes liability for care.

Homemaker and home care aide agencies provide home care aides, attendants, and companions for a fee. Most agencies hire and supervise their own personnel and therefore are responsible for the care provided. Some states require these agencies to be licensed.

Home care registries/staffing agencies act as employment agencies that match clients with nurses, therapists, aides, and other personnel. These services are generally not licensed or regulated, but some agencies do screen their personnel. The client is responsible for selecting, supervising, and paying caregivers, and paying employee taxes.

Independent providers are home care personnel who are privately employed by the client. The client is responsible for hiring, supervising, and paying caregivers, and checking credentials and references. Independent providers can be found in the yellow pages by referral from a social worker or hospital discharge planner, or through an advertisement in a local newspaper.

When choosing a home care provider, it is important to feel comfortable bringing this person into your home. Consider asking the following questions:

How long has the provider been in business?
Is this provider accredited by a recognized agency?
Does this provider specialize in a specific aspect of home care (such as nutrition)?
Does this provider have references?
Does this provider have experience with cancer patients?
How does this provider handle emergencies?
Does this provider provide a written treatment plan that states specific tasks to be carried out by the provider? Is the family notified if the plan changes?
What is the billing process? Which insurance plans does this provider accept?
How does the provider oversee the quality of care a patient receives? Who is the contact for questions or complaints?

Paying for home care services

Medicare and Medicaid usually cover part-time home care provided by skilled medical personnel (such as nurses, doctors, or therapists). Services must be approved and reviewed by a doctor and be provided by a Medicare-certified home care agency. The Veterans Administration also pays for some home care services for qualified veterans.

Private insurance companies and health maintenance organizations (HMOs) typically cover some short-term home care services, but coverage varies from plan to plan. Many insurance companies will pay for skilled medical care, but not for personal care such as aide or attendant care. Check with your insurance company before beginning home care services as some companies may require you to use certain home care agencies or personnel. Private long-term care insurance may also pay for longer-term home care services.

Self-pay means out-of-pocket payment for services not otherwise covered. Long-term care provided by an aide, attendant, or companion must often be paid for out-of-pocket.

Community organizations, as well as state and local governments, may provide funds to help pay for home care services. Check with your local Area Agency on Aging, Department of Health and Human Services, United Way, or American Cancer Society. Volunteers from local places of worship, home care agencies, or community organizations may be available to provide companionship, limited personal care, respite care, or transportation services.

Additional Resources

Lance Armstrong Foundation: Home Health Care