As people age, activities that were once simple to do—laundry, grocery shopping, yard work—can become more difficult to complete. Difficulty with certain tasks, however, does not mean that an older person is ready to move into an assisted living facility or a nursing home. An alternative that is growing in popularity is home healthcare.
Home healthcare describes a variety of health and social services provided in the home by trained professionals. The services can range from skilled care that is provided under the direction of your doctor and may include such services as dialysis or physical therapy to home support services like housecleaning or running errands. Home healthcare allows older adults to continue to live independently in their homes and get help with the tasks they cannot do on their own. One example of a home healthcare organization that many are familiar with is Meals on Wheels, a program that delivers hot meals to a person’s home.
Almost two million people over the age of 65 are using home healthcare services—and with good reason. Studies have found that home health care costs less than institutional care, provides more satisfaction to those who receive it, and often results in fewer and shorter hospital stays.
Many different services can be provided in the home, from light housekeeping to meal delivery. The following table lists examples of services available in the home.
| Home Health Care Service Available | Category |
|---|---|
| Bathing, Hair washing, Dressing | Personal care |
| Housecleaning, Yard work, Shopping, Laundry | Homemaking |
| Grocery shopping, Meal preparation, Meal delivery | Meals |
| Bill paying/check writing, Account management | Money Management |
| Medication management, Administration of intravenous drugs (e.g. antibiotics or pain medications), Dialysis, Physical therapy, Hospice care | Healthcare |
| To shop for food, clothes, necessities; To and from medical appointments, social engagements, church activities | Transportation |
| Daily/weekly visits, Phone calls | Companionship |
The cost of services will vary depending on where you live and the type of services you need. Some home healthcare agencies have sliding fee scales, so make sure to ask. Home healthcare services can be paid for privately, but there are also a number of public and private funding sources. Funding sources include the following:
The first step in finding appropriate home care service is talking to your doctor to determine what type of services you will need. You may only need help with preparing meals or you may require sophisticated medical care at home. Determining level of help required and type of services will help you find an appropriate agency.
It can be a daunting task. By contracting with an agency, you are allowing someone to come into your home or the home of someone you care about. To help ensure you are working with a reputable organization and that they provide quality care at a cost you can afford, research the organization extensively and prepare a list with important questions. In addition, your nurse, physician, hospital social worker, or discharge planner may recommend a reputable agency in your area.
If it is possible, anticipate what your possible needs may be and do some research in advance. Planning ahead is difficult because you cannot be sure about what types of services you will need, but it will help when it comes time to make a decision. To help inform your decisions, educate yourself on the concerns and issues that may affect older adults, taking into consideration your own financial and health issues, including any chronic health conditions.
The United States Department of Health and Human Services Administration on Aging provides the following 20 questions to help guide your search for a home health service provider:
RESOURCES:
Administration on Aging
http://www.aoa.gov
American Academy of Home Care Physicians
http://www.aahcp.org
Meals on Wheels Association of America
http://www.mowaa.org
National Association for Home Care and Hospice
http://www.nahc.org
National Institute on Aging
http://www.nia.nih.gov
References:
Age page: There’s no place like home. National Institute on Aging website. Available at: http://www.niapublications.org/engagepages/home.asp . Accessed December 8, 2005.
Caregiving statistics. National Family Caregivers Association website. Available at: http://www.nfcacares.org/who/stats.cfm . Accessed November 27, 2005.
Characteristics of elderly home healthcare users: data from the 1996 National Home and Hospice Care Survey. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/ad/301-310/ad309.htm . Accessed December 6, 2005.
Getting the most out of home health care. Yale-New Haven Hospital website. Available at: http://www.ynhh.org/choice/home_health.html . Accessed December 6, 2005.
Home healthcare: a guide for families. United States Department of Health and Human Services Administration on Aging website. Available at: http://www.aoa.gov/press/fact/pdf/fs_hhealth_care.pdf . Accessed November 27, 2005.
JAMA patient page: Home health care. The Journal of the American Medical Association website. Available at: http://jama.ama-assn.org/cgi/reprint/287/16/2168.pdf . Accessed November 27, 2005.
Last reviewed December 2005 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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