Types of Home Care
What Types of Home-Care Services Are Available?
You have many options when it comes to choosing the type of home-care services you prefer:
- Registered nurses (RNs) provide skilled services that can't be performed safely or effectively by nonprofessionals, such as dispensing drugs, administering wound care, changing dressings and delivering intravenous fluids.
- Licensed practical nurses (LPNs) provide basic bedside care, such as taking vital signs, temperature, blood pressure, pulse and respiration. They also prepare and give injections, monitor catheters, apply dressings treat bedsores and give alcohol rubs and massages. LPNs don't dispense drugs.
- Physical therapists work with patients to restore their strength and mobility through exercise, massage or other methods.
- Social workers assess the psychosocial factors affecting patients and provide counseling, serve as case managers to coordinate services and assist in identifying available community resources.
- Speech language pathologists work with patients to restore speech by retraining them in breathing, swallowing and muscle control.
- Occupational therapists assist patients who have disabilities that prevent them from performing activities of daily living (ADLs).
- Nutritionists provide counseling to patients who may benefit from dietary assessment and guidance to help in managing their illness.
- Home health aides (HHA) and home care aides (HCA) provide hands-on assistance with ADLs, such as bathing, getting out of bed, walking, toileting and dressing.
- Homemaker and chore workers help with light household chores such as laundry, meal preparation, cleaning and shopping.
- Volunteers provide a range of services, depending largely on their training and experience. Services can include transportation, companionship and emotional support, household chores and personal care.
What Types of Agencies Provide Home-Care Services?
You can get home-care services from the following:
- Home health agencies provide a range of services, instead of one or two specialized services such as nursing care.
- Homemaker and home care aide agencies employ homemakers and home care aides.
- Staffing and private-duty agencies generally provide nursing, homemaker, home care aides and companion services.
- Pharmaceutical and infusion therapy companies deliver drugs, equipment and professional services for patients receiving IV or nutritional therapies through tubes.
- Durable medical equipment and supply dealers provide and deliver respirators, wheelchairs, walkers, catheters and wound care supplies to homes. Typically, these agencies don't provide physical care for patients.
- Registries are employment agencies for home-care nurses and aides that match providers with clients then collect a finder's fee.
- Independent providers refer privately employed home-care workers, including nurses, therapists, aides, homemakers and companions.
How Do I Talk with My Doctor About Home Care?
Talk with your or your loved one's doctor directly about the types of services that may be needed at home. He or she must initiate a referral to an agency with a doctor's order for home-care services. If you'll be receiving home-care services following a hospitalization, typically the hospital social worker initiates contact with the home-care agency and coordinates services with you, your family and your doctor.
Discuss with your doctor the types of services you think you'll need at home. To make an informed decision, you'll need to be able to answer the following questions to help determine how many hours and what type of care is needed:
- How often is the patient typically alone during the day and night?
- How many hours can the family or caregiver assist the patient on average?
- What types of assistance can the family or caregiver provide (cleaning, cooking, laundry, assistance with walking?)
- How many flights of stairs does the patient have to walk to get to the bedroom? The bathroom?
How Can I Find a Home-Care Agency in My Area?
The National Association for Home Care and Hospice (NAHC) provides helpful information about home care, including:
- an online publication, How to Choose a Home Care Provider
- an agency locator, which contains a comprehensive database of more than 20,000 home care and hospice agencies
- a state-by-state listing of organizations that can help you get the care you need in your community
Your state and local health departments should also have a registry of licensed home care agencies in your community.
In addition, an information specialist from The Leukemia & Lymphoma Society can help with your questions and concerns.