Home care consists of a range of professional health care and supportive services delivered in the home to a person with cancer who requires assistance with daily activities. Home care can make an enormous difference at times of stress, such as the period following surgery or during recovery from a lengthy hospitalization, or for those in need of longer-term care. Care provided in the home allows a person the freedom to spend less time in the hospital. It also offers relief and peace of mind to caregivers caring for a family member who is in the home or in a different location.

Home care can be 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 may be appropriate for people 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. More often, home care refers to services provided by nurses’ aides, home care aides, or personal attendants.

Home health aide/home care aide. This person provides personal care services by helping people 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 (a surgically created opening for the elimination of body waste) care, under the supervision of a nurse.

Patient care attendant. This person provides personal care services and performs light household tasks, such as cooking, laundry, and basic cleaning.

Companion. This is a person who provides 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 so family caregivers can take 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 about what home care services will be needed and develop a home care plan. Ask them to recommend reputable agencies in your area that can provide home care services. Consider the following types of agencies:

Home care agencies. These 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 can 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. These 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. These organizations 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, paying caregivers, and paying employee taxes.

Independent providers. These 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 recommended by a social worker or hospital discharge planner, or they can be found through advertisements in a local newspaper or online job communities.

When choosing a home care provider, it is important to feel comfortable bringing the person into your home. Consider asking 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 specific task that you will carry out? Is the family notified 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 programs 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). They 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. 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 must often be paid for out-of-pocket.

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, Department of Health and Human Services, United Way, American Cancer Society, and CancerCare. 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

Exploring New Caregiver Options

Tips on Caregiving

Caregiving

Additional Resources

Lance Armstrong Foundation: Home Health Care

Medline Plus: Home Care Services

National Cancer Institute: Home Care for Cancer Patients