As they age, most people wish to stay in familiar surroundings and remain involved with their community and family. Thanks to this trend, home care is now one of the fastest-growing segments of the health care industry.

Many home health agencies provide a variety of medical, nursing, and social services to help people stay out of institutions (home care also happens to be more cost-effective, for everything but 24-hour care). Services may include medical care, equipment, respite care, homemaker services, chore services, home-delivered meals, nutrition management, home maintenance or repairs, companion services, counseling and rehabilitation, telephone reassurance, and emergency response systems. Services may be hourly, weekly, monthly, or another personally arranged schedule.

Home health care is divided into custodial (supportive) and skilled services:

Supportive services can include hands-on care (bathing, shampooing, brushing teeth, toileting, dressing); light housekeeping (personal laundry, meal preparation and planning, vacuuming, washing dishes); non-medical supervision (maintaining hygiene, monitoring health status, assisting with self-administered medications); assisting with mobility (bed to wheelchair, bed to commode); companionship (reading, walks, conversation); transporting and escorting (to doctor, grocery, bank, post office).

NOTE: Custodial care is not covered under Medicare when it is the only kind of care needed. Such care is primarily for helping with activities of daily living (ADLs) and not considered medically necessary by insurance companies. Medicare will pay for skilled health care in the home to treat an illness or injury if 1) the care is furnished by a participating home health agency, 2) the care needed includes intermittent skilled nursing care or physical or speech therapy, or 3) the patient is homebound and the care is physician-authorized.

There are a variety of ways to find a home care worker. You can look for one through friends and relatives, or through referral agencies such as family service agencies, Visiting Nurse Associations, Area Agencies on Aging, hospital discharge planners or social workers, physicians, the Red Cross, religious groups, civic organizations and clubs, nursing registries, and national organizations related to a particular illness or disability.

Home care is also provided by private home health agencies, hospitals, and public health departments. But if you decide to go to a referral agency, make sure to ask the right questions.

More on Home Care Workers

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