Home Care

Home care services are given in your home to help you:

• Cope with an illness or injury.
• Recover from cancer treatment,
• Become stronger and more independent
• Better manage side effects from treatment.

What are home care services?

When looking into home care, it is important to understand some key terms.

• Home health care provides skilled care or services by licensed health care workers. It might include nursing care visits or physical or occupational therapy.
• In home personal care services focus on helping you with activities of daily living (ADLs), like bathing, dressing, running errands, or housekeeping.
• Hospice care is provided to people during their last phase of an incurable illness or near the end of life. This might include both home health care and personal care services.

If you need home care, your health care team or hospital discharge planner will work with you to figure out what type of care is best. Sometimes, this depends on your private insurance, Medicare, or Medicaid coverage. You can choose a home care provider from a list and then work with your health care team and the home care provider to set up your care plan.

The care plan should include:

• The services you need
• The type of staff best suited to provide those services
• How often the services are needed
• If you need special equipment at home

Payment for the care services, including any out-of-pocket costs, should be explained now so you know what to expect.

Who provides home care services?

Many companies offer home care services, including:

Home health agencies provide services by licensed health care workers.  Agencies might or might not be a part of the hospital, but you can always choose one that best fits your needs.

Because home health agencies hire and supervise their personnel, they assume liability for care given. Home care services are usually available 24 hours a day, 7 days a week. But, most home health services are given during the day if possible.

Hospices provide medical, psychological, and spiritual care to people with advanced, serious illnesses when treatment is no longer effective and a cure is no longer possible. Learn more about these services in Hospice Care.

Personal care agencies or home care aide and homemaker agencies  help with bathing, dressing, and getting around. They may also help prepare meals, keep the house tidy, or provide “sitters” to stay with patients who can’t be left alone for medical or safety reasons (companion care).

Durable medical equipment (DME) companies have products ranging from oxygen tanks, wheelchairs, and walkers, to catheter and wound-care supplies. In addition, they usually tell you how to use them. Some may provide clinical staff to give medicines or assist in the use of breathing equipment. But most do not give physical care.

Infusion therapy companies provide medicines, equipment, and nursing services to people who need to have IV fluids, nutrition, or treatments at home. They also make sure everything is working well and help deal with problems.

Government agencies like the VA and Medicaid can provide different services in the home. You should check with your case worker or health care team to see if you qualify for these services and what services they can offer you.

Private duty agencies have staffing registries that match nursing, homemaker, home care aide, and companion services with the patient and collect a finder’s fee. The patient or family is then considered the employer.

Independent providers are nurses, therapists, aides, homemakers, and companions privately employed by people who need their services. The patient or the family must find, hire, and supervise these providers. They also pay them directly, and may also be responsible for payroll, Social Security, and unemployment insurance.

Types of home health care services

Types of personal care services

Home health aides or home care aides

A home health or home care aide (HHA) can help with personal care, like getting in and out of bed, walking, bathing, and dressing. Some agencies that offer personal care services can provide aides that also help remind you to take your medicines, do light housekeeping, and run errands. Some aides have had special training and are qualified to give more complex services if they are supervised by an RN.

Homemaker/attendant care

A homemaker can do light household tasks , like laundry, meals, housekeeping, and shopping. These services help with housekeeping rather than any personal or health care. Some agencies offer both personal care and homemaker services.

Volunteers

A community organization, a church or faith-based organization, a home care agency, or hospice might offer a volunteer to sit with you, give emotional support, and help with personal care, paperwork, and getting to and from doctor visits.

Getting cancer treatment at home

Once home care visits begin, the type of care provided will depend on your needs and care plan. Remember that everyone’s care plan will be different and might not be the same as yours.

Most cancer treatments are given in a hospital or clinic. But certain types of treatment can be taken at home. This is usually the case for oral treatments, like pills, capsules, tablets, and liquids, or topical treatments that are rubbed on the skin. Sometimes, IV or injectable treatments can be given at home. These treatments might be types of chemotherapy, targeted therapy, immunotherapy, or hormone therapy

If you're getting IV or injectable treatments, a home care nurse or IV therapy (infusion) nurse might come to your home to give your treatment. If you're taking an oral treatment, a nurse might come to make sure you are set up with your medicines, taking them as prescribed, know what side effects to watch for, and are handling the medicines safely. If a nurse is coming to your home, they might continue to come for a specific period of time. Or they might teach you and your caregiver how to give or monitor home treatments.

It's not always possible to get your cancer treatment at home. Sometimes, it might not be safe. In some cases, treatments might not be covered by health insurance if they're given at home.

If you're not able to get your cancer treatment at home, but are having trouble making frequent visits to the office or clinic, talk to your cancer care team and health insurance company. There might be options to use some kinds of telehealth (telemedicine) or other home care services.

Intravenous (IV) treatment

IV treatments are given through a catheter or needle into a vein. These are usually given in a treatment center or clinic. But if you're going to get them at home, a home health nurse (infusion nurse) will come to your home to give the treatment. Sometimes, a family member is taught to give the infusion or disconnect the lines when it's done .

Special care or precautions may be needed when handling the treatment. You can learn more about IV lines and ports used for treatment and read more in Chemo Safety.

Treatment by injection (under the skin or into a muscle)

Injectable treatments are given through the skin with a needle. If you're getting these at home, a home health nurse (infusion nurse) will come to your home to give the treatment and will probably teach you to give it to yourself or teach a family member or caregiver to give it to you.

Treatment safety at home

Some cancer treatments are dangerous chemicals, no matter how they are given to the patient. Many are classified as hazardous drugs. In these cases, it's important that only the person being treated be exposed to them. No matter how you take these treatments, the chemicals remain in your body for hours to days after you take them. Small amounts are in your urine, feces, vomit, and even your sweat.

Ask your cancer care team if the treatment you'll be taking at home is hazardous and what safety steps you need to follow. Special care might be needed when handling the drug, depending on its type. You can learn more in safety precautions for chemotherapy.

What caregivers can do

• Learn what you need to do to help the person with cancer stay on track so they don't miss a treatment or dose.
• Help set up a good system for getting treatment at home. r Ask if a home health nurse can make a visit or two to check on the home set up. Make sure a good calendar or alarm system is in place as a dose reminder. If it's an IV or injectable treatment, you can help by making sure visits are set up and finding out what you can do to help with the set up at home.
• Be sure you know what safety precautions might be needed.
• Know the expected side effects and ask how they can be managed. Track any side effects that happen.
• Keep the cancer team’s office numbers (including emergency numbers) handy. If you have a home health nurse who helps with injections, keep their phone number nearby in case you have problems or questions.

Call the cancer team if the person with cancer:

• Is about to need a prescription refill
• Spills or loses medicine, or vomits a dose
• Learns that anyone, other than themselves, has taken their medicine
• Misses a dose
• Has redness, warmth, swelling, drainage, or pain at any injection site
• Has a temperature higher (fever) than the level taught to you by the cancer care team or home health nurse
• Has uncomfortable side effects, like nausea, vomiting, diarrhea, or pain
• Can’t give themselves the shots or take the pills for any reason, or if they refuse to have the treatment given by someone else
• Notices itching, dizziness, shortness of breath, hives (raised itchy skin welts), or other signs of an allergic reaction after taking any medicine. If this happens, call emergency medical services (911) before calling the cancer team.