A variety of providers deliver home care services including:
home health agencies
hospices
homemaker and home care aide agencies
staffing or private-duty agencies
medical equipment and supply companies
home infusion or pharmaceutical (medicine) companies
In addition, some home care providers are professionals who do not work for any kind of agency. Other agencies are registries that keep lists of professionals and workers for hire. Sometimes, several types of home care providers may work together to offer a wide variety of services through an integrated system or network.
The choice of a home care provider is an important one for you, your family, and your doctor. To help you make the best choice, we will discuss the types of home care agencies and suggest some questions to ask. In most locations, you can find a number of excellent home care services.
Home health agencies: If you need skilled home care services, they will usually be given by a home health agency. The same agency may deliver different kinds of home care services through nurses, therapists, social workers, homemakers and home care aides, medical equipment and supply dealers, and volunteers. Some agencies limit their services to nursing and one or two other specialties. If care is needed from more than one specialist, the home health agency will set up a team to provide care that covers your needs. Because home health agencies hire and supervise their personnel, they assume liability for all care. Home care services generally are available 24 hours a day, 7 days a week.
Hospice care: This type of care involves a core team of skilled experts and volunteers who provide all-around medical, psychological, and spiritual care when cure is no longer possible. It is usually based at home so that families take part in the patient's care. Trained hospice professionals are available 24 hours a day. They help the family care for the patient, ensure that the patient's wishes are honored, and keep the patient comfortable and free of pain. Many hospice programs are Medicare certified and licensed according to state requirements. For more information on this topic, please see the American Cancer Society document, Hospice Care.
Homemaker and home care aide agencies: These agencies help patients by preparing meals and helping him or her bathe, dress, and keep house. They may also sit with patients who cannot be left alone for medical or safety reasons, which is sometimes called companion service. Some states require that these agencies be licensed and meet minimum standards of care.
Pharmaceutical and infusion therapy companies: These companies deliver medicines, equipment, and nursing services for people who need intravenous (IV) fluids, nutrition, or treatments. They also give special feedings through tubes that are placed in the stomach or intestine (tube feedings.) Nurses teach patients and family members to give these medicines, fluids, or feedings in the patient's home. Some pharmaceutical and infusion therapy companies are certified by Medicare.
Durable medical equipment and supply dealers: These companies provide products ranging from respirators (breathing machines), wheelchairs, and walkers, to catheter and wound-care supplies. They deliver these products, install or set them up, and teach patients and caregivers how to use them. Most of these companies do not provide physical care for patients, but a few offer pharmacy and infusion services. They may provide a nurse to give medicine and tube feedings to patients and teach the patient and family the proper way to give these on their own. Some provide respiratory therapy services to help patients use breathing equipment. Those that bill Medicare are required to meet federal minimum standards. Some states require that these companies be licensed.
Staffing registries/private-duty agencies: Private-duty agencies provide people with nursing, homemaker, home care aide, and companion services. Generally, these agencies are not licensed or regulated by the government. Staffing registries serve as employment agencies for home care nurses and aides. They match the provider with the patient and collect a finder's fee.
Independent providers: These are nurses, therapists, aides, homemakers, and companions who are privately employed by those who need their services. The patient or family must recruit, hire, and supervise the provider. The patient pays the provider directly.
