Providing Care at Home

Approved by the Cancer.Net Editorial Board, 12/2012

Key Messages:

  • Home care is professional health care and supportive services provided at home for patients who need help with medical needs or daily tasks
  • Home care services are often provided by home health aides, personal attendants, or companions who may be volunteers or receive payment from the patient or family
  • Talk with a doctor, nurse, or social worker to learn about options for home care services and where to find these services.

Home care consists of a range of professional health care and supportive services delivered in the home to a person with cancer who needs assistance. A person may use home care services during specific times of need, such as the recovery period following surgery or a lengthy hospitalization, or for those in need of longer-term care. The option to receive care in the home often enables a person with cancer to spend less time in the hospital, while also providing relief and peace of mind to family caregivers, whether they live in the same home or in a different location.

Home care is also appropriate for people with cancer who are actively receiving treatment or rehabilitation services, or for those who need help with daily activities, such as bathing, cooking, or cleaning. Hospice care can also be given in the home for people with advanced cancer.

Professionals who provide care in the home

Home care services are provided by a variety of professionals including doctors and nurses. More often, however, home care refers to services provided by home health aides, personal attendants, or companions.

Home health aide/home care aide. A home health aide helps with daily activities, 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 (a surgically created opening for getting rid of body waste) care, under the supervision of a nurse.

Personal attendant. A personal attendant provides personal care services and performs light household tasks, such as cooking, laundry, and basic cleaning.

Companion. A companion offers comfort and companionship to people with cancer 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 person to give family caregivers a break. Companions are often volunteers, but some may be paid.

How to find home care services

Talk with the patient's doctor, nurse, or social worker to determine what home care services may be needed, develop a plan, and ask for recommendations. Types of agencies include:

Home care agencies. These agencies assign and supervise various types of home care personnel including nurses, therapists, social workers, and home care aides, depending on the needs of each client. In addition, some agencies can 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. These agencies screen, hire, supervise, pay the professionals' salary, and assume liability for care.

Homemaker and home care aide agencies. These agencies provide home care aides, attendants, and companions. Most agencies hire and supervise their own personnel, making them responsible for the care provided. Some states require such agencies to be licensed.

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

Independent providers. These are home care personnel who are privately employed by the client. The client is responsible for hiring, supervising, and paying these caregivers, as well as checking their credentials and references. A social worker or hospital discharge planner my recommend independent providers, or they can be found through advertisements in a local newspaper or online job board postings.

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

  • How long have you been in business?
  • Are you accredited by a recognized agency?
  • Do you specialize in a specific aspect of home care (such as nutrition)?
  • Do you have references?
  • Do you have experience with people with cancer?
  • How do you handle emergencies?
  • Do you provide a written treatment plan that states the specific tasks that you will perform? Do you notify the family if the plan changes?
  • Which insurance plans do you accept?
  • What is the billing process?
  • How do you oversee the quality of care a person receives? Who is the contact for questions or complaints?

Paying for home care services

Medicare and Medicaid. These government-run insurance programs usually cover part-time home care provided by skilled medical personnel, such as nurses, doctors, or therapists. A doctor must approve and review the services, which must 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). Insurance companies typically cover some short-term home care services, but coverage varies from plan to plan. Many 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 because 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. This means out-of-pocket payment (money paid by you or the person with cancer) for services not otherwise covered. Long-term care provided by an aide, attendant, or companion often requires out-of-pocket payment. In some instances, you may be responsible for taxes; talk with your accountant or tax preparer about the tax requirements in your area.

Community organizations and state and local governments. These organizations may provide funds to help pay for home care services. Check with the local chapter of groups like the Area Agency on Aging, the Department of Health and Human Services, the United Way, the American Cancer Society, and CancerCare. In addition, 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. Find additional financial support resources.

More Information

Managing the Cost of Cancer Care

Exploring New Caregiver Options

Cancer in Older Adults: Caregiving Considerations

Additional Resources

LiveStrong: Home Health Care

Family Caregiver Alliance: Assessing Your Home-Care Needs