Hiring Home Care Services

Approved by the Cancer.Net Editorial Board, 02/2021

"Home care" is health care and supportive services given by a trained professional at a patient's home. A person may need home care to recover from surgery or a long hospital stay. Other people need more long-term home care during and after cancer treatment.

There are many reasons to consider bringing a professional caregiver into your home. For example, home care can help you or your loved one spend less time in the hospital. This includes people with advanced cancer, who can receive hospice care in the home.

Home care is helpful for people who are actively receiving treatment or rehabilitation services. It is also a good choice for people who need help with daily tasks, such as bathing, cooking, or cleaning.

With this type of extra assistance, family caregivers can get support they often need to provide care for the patient. This means they will be able to take breaks and take care of themselves.

What types of professionals provide home care?

There are different kinds of providers who can help with home care for a person with cancer. These can include different levels of training, education, and certifications. Types of providers include:

Registered nurse or licensed practical nurse. A registered nurse (RN) or a licensed practical nurse (LPN) can be hired to provide health care in the home. The type of care these professionals can provide at home may vary. An RN has a degree in nursing, has passed an exam, and is certified by the state they work in to provide care. An LPN provides basic medical care, like changing bandages and administering medications.

Certified nursing assistant, home health aide, or home care aide. These providers help with daily tasks, such as bathing, dressing, using the toilet, and moving around the house. They may also be trained to provide services like wound care or administering medications. Home health aides work with their clients independently, but they are supervised by medical professionals.

Personal attendant or personal care aide. Personal attendants can help with light household tasks, such as cooking, laundry, and basic cleaning. They do not provide any medical services.

Companion. A home care companion offers comfort and companionship to people who cannot leave the home or stay at home alone. They may perform limited household tasks, such as preparing meals. These caregivers sometimes work as volunteers, but others are paid.

How can I find home care services?

Talk with the health care team to find out what home care services are needed or could be helpful. Ask a social worker or hospital discharge planner for recommendations and referrals. Also, develop a home care plan that would fit your situation best. This will help you feel prepared when you explain what you're looking for to potential care providers. There are different ways to find the right home caregiver for you.

Home care agencies. These professional agencies assign and supervise various types of home care personnel, depending on what you need. Professionals may include nurses, physical therapists, social workers, and home care aides.

Many home care agencies are Medicare certified. This means they meet federal patient care standards and provide services that are covered by Medicare and Medicaid. These agencies will screen, hire, and supervise the professionals. They also handle their salaries and take liability for the provided care.

Homemaker and home care aide agencies. These agencies provide home care aides, attendants, and companions. Most agencies will hire and supervise their own personnel, so they are responsible for the care provided. Some states require a license for these kinds of agencies.

Home care registries and staffing agencies. These organizations are employment agencies that match clients with nurses, therapists, aides, and other personnel. These services are usually not licensed or regulated, though the agencies may screen their personnel. When you hire someone from one of these services, you will be responsible for selecting, supervising, and paying the caregivers.

Independent providers. You can also hire a home care provider privately. You will be responsible for recruiting, hiring, supervising, and paying these caregivers. You will also have to confirm their credentials and check their references.

How can I pay for home care services?

You may be concerned about the cost of home care services. If you live in the United States, the following resources may be helpful.

Medicare and Medicaid. These government-run insurance programs may cover part-time home care provided by skilled medical professionals, such as nurses, doctors, or physical or occupational therapists. Keep in mind:

  • A doctor must approve and review the services provided.

  • The U.S. Veterans Administration (VA) has a program that pays for home care services for qualified military veterans. Learn more at the U.S. government's VA website.

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. Check with your insurance company before beginning any home care services.

  • Many insurance providers pay for skilled medical care, but not personal care. Some companies may require you to use certain home care agencies or personnel.

  • Private long-term care insurance can help pay for longer-term home care services.

Community organizations and state and local governments. These organizations may provide information, services, and funds to help pay for home care services at the local level. Each organization has its own criteria and range of offerings.

Volunteers. Volunteers from local places of worship, home care agencies, or community organizations may also be an option. These volunteers can provide companionship, limited personal care, respite care, meals, or transportation services.

Be sure to investigate the costs, insurance coverage, and payment details before starting any home care services. If services are not covered, this means paying out-of-pocket or needing to self-pay. Long-term care provided by an aide, attendant, or companion often requires that you pay out-of-pocket. In some cases, you may also have to pay employer taxes.

Questions to ask when hiring a home care professional

When interviewing potential professional caregivers, it is important to clearly describe the type of home care you need help with, such as specific medical services, personal care, and/or other tasks. And, asking questions is also important, to make sure their skills and services line up with what tasks you need done. Your questions will vary based on whether you are talking with an agency, a registry, or the candidate. If you are interviewing the potential caregiver, be sure to note whether you are comfortable with both their training level and communication style. Here are some possible questions as a starting point. Be sure to add others that are important to you.

  • How long have you been providing home care services?

  • Are you accredited?

  • Do you specialize in a specific aspect of home care?

  • What is your professional experience caring with people with cancer?

  • Are you able to deliver home care services during the timeframe needed?

  • Can you provide me with references?

  • How do you handle emergencies?

  • Do you provide a written treatment plan that states the tasks you will perform? Do you notify 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?

Related Resources

When You Need Help With Caregiving Responsibilities

How to Find a Caregiver When You Have Cancer

Financial Resources

Tips for Caregiving

More Information

CancerCare: Caregiving

Family Caregiver Alliance: Hiring In-Home Help

LIVESTRONG: Home Health Care Needs

The free ASCO Answers Guide to Caring for a Loved One With Cancer includes practical tips, advice for communicating with family and the health care team, and worksheets to help track medications and coordinate caregiving tasks. Download this guide as a printable PDF in English (44 pages) or in Spanish (40 pages).