Home Healthcare: Helping Older Adults Live at Home Longer

As people age, activities that were once simple to do, such as laundry, grocery shopping, or 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.

Home Healthcare Services Available

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.

Paying for Home Healthcare Services

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:

• Medicare
• Medicaid
• The Older Americans Act
• The Veterans’ Administration
• Private insurance

Information about federal, state, and local government benefits can be found on the US benefit finder website.

Deciding What Services You Need

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 the level of help required and the 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.

Questions to Ask

The US Department of Health and Human Services provides the following 20 questions to help guide your search for a home health service provider:

1. How long has the agency been serving this community?
2. Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one.
3. Is the agency an approved Medicare provider?
4. Is the quality of care certified by a national accrediting body such as the Joint Commission?
5. Does the agency have a current license to practice if it is required in the state where you live?
6. Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for?
7. Does the agency write a plan of care for the patient with input from the patient, his or her doctor, and family, and update the plan as necessary?
8. Does the care plan outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver?
9. How closely do supervisors oversee care to ensure quality?
10. Will agency caregivers keep family members informed about the kind of care their loved one is getting?
11. Are agency staff members available around the clock, 7 days a week, if necessary?
12. Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
13. How does the agency ensure patient confidentiality?
14. How are agency caregivers hired and trained?
15. What is the procedure for resolving problems when they occur, and who can I call with questions or complaints?
16. How does the agency handle billing?
17. Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services?
18. Will the agency provide a list of references for its caregivers?
19. Who does the agency call if the home healthcare worker cannot come when scheduled?
20. What type of employee screening is done?

Revision Information

• Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
• Review Date: 08/2017
• Update Date: 10/31/2013