Providing Care at Home

Approved by the Cancer.Net Editorial Board, 04/2015

Key Messages:

  • Home care is professional help with medical needs or daily tasks.
  • Home health aides, personal attendants, or companions often provide home care services. They may be volunteers or receive payment from the patient or family.
  • Talk with the health care team to learn about home care options and where to find these services.

Home care involves professional health care and supportive services given at home for people who need help. A person may need home care during specific times to recover from surgery or a long hospital stay. Those who need longer-term care may need home care for more time.

Receiving care at home often allows a person with cancer to spend less time in the hospital. It can also provide relief to family caregivers, whether they live in the same home or in a different location.

Home care is an option for patients who are actively receiving treatment or rehabilitation services. Also people who need help with daily tasks, such as bathing, cooking, or cleaning may consider home care. People with advanced cancer can even receive hospice care in the home.

Professionals who provide care in the home

A variety of professionals including doctors and nurses provide home care. More often, however, home care is home health aides, personal attendants, or companions.

Home health aide/home care aide. A home health aide helps with daily tasks, such as bathing, dressing, using the toilet, and moving around. Some home health aides receive training to provide more complex services along with a nurse. These services may include such as wound or ostomy care. An ostomy is a surgically created opening for getting rid of body waste.

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 who cannot leave the home or stay at home 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 receive payment from the person with cancer or his or her family.

How to find home care services

Talk with the patient's health care team to find out what home care services are needed. Develop a plan for home care and ask for recommendations. Types of agencies include:

Home care agencies. These agencies assign and supervise various types of home care personnel depending on the needs of each client. This includes nurses, therapists, social workers, and home care aides. In addition, some agencies can help you develop a care plan. Many agencies are Medicare certified. This means they meet federal patient care standards and provide 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 a license for such agencies.

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 ads 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 often 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. 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 for services not otherwise covered. Out-of-pocket payment is money paid by you or the person with cancer. 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 laws 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 one of the following groups.

  • Area Agency on Aging
  • The Department of Health and Human Services
  • The United Way
  • The American Cancer Society
  • CancerCare.

In addition, volunteers from local places of worship, home care agencies, or community organizations may be options. These volunteer can provide companionship, limited personal care, respite care, or transportation services. Find additional financial support resources.

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