Home Health Care
I always have choices… sometimes
it’s only a choice of attitude.
— Judith Knowlton
Most breast cancer patients
do not require home health care. However,
knowing what is available may be helpful.
You may have a need for home health care
services after your breast surgery or during
your chemotherapy treatment for a variety
of reasons. Or you may require home health
care if your disease has progressed.
is home health care?
Cancer patients often feel more
comfortable and secure being cared for
at home. Many patients want to stay at
home so that they will not be separated
from family, friends, and familiar surroundings.
health care is professional healthcare
that is provided to you in your home.
It is normally recommended by a physician,
medical social worker or hospital discharge
planner. Home care often involves a team
approach that includes doctors, nurses,
social workers, physical therapists,
family members and others.
Home care can
be both rewarding and demanding for patients
and caregivers. It can change relationships
and require families to cope with all aspects
of patient care. To help prepare for these
changes, patients and caregivers are encouraged
to ask questions and get as much information
as possible from the home care agency
and healthcare team.
To obtain home
health care, you must be under the care
of a doctor who will prescribe and manage
a treatment plan; you must have a need for
skilled healthcare services; and you must
be a home-bound patient or have approval
by a private insurance company.
you may be able to receive from a home
health care provider include:
- nursing care,
and physical therapy,
- medical social
- personal care,
- wound care/dressing
- pain management,
collection for laboratory procedures,
errands and preparing meals, and
medical equipment and supplies.
How should I choose a home
With so many home care organizations
and services available, it is sometimes
difficult to decide which to use. It is important
that you carefully choose a home care agency that
meets your needs. Many communities
have several providers to choose from. You can talk with
your doctor, nurse, hospital
discharge planner or medical social worker about the home care
agencies in your area. Also,
your local health department may know of home care services.
If you are looking
for a Medicare-certified agency, call the
Medicare Hotline at 800.638.6833. You can
also contact the National Association for
Home Care (NAHC), which lists phone numbers
for state agencies that have directories
of home care and hospice agencies. NAHC also
has a free publication, “How
to Choose a Home Care Provider,” which
provides excellent information on many aspects
of home health care.
The Joint Commission
on Accreditation of Healthcare Organizations
(JCAHO) and other organizations have information
on accredited home care agencies. See
the Resources at the end of this section
for more information.
Who pays for home health care?
These services can be paid for directly
by the patient and family
or through various public or private
sources. Some agencies receive help
through community grants. Others may
receive funding from local and state governments
to assist patients in paying
for their care if they cannot do so themselves.
If you do not have private
health insurance or do not qualify for home
health care benefits, you may want to speak with
a medical social worker at
your hospital who can help you find other ways
to pay for home care.
care services may be covered partially
by Medicare, Medicaid, private health
insurance, Veterans Administration benefits,
HMOs or workers’ compensation.
Many home health care
agencies are able to arrange for special
financial counseling and payment arrangements,
Should I think about
getting long-term care
Many insurance companies now offer
long-term care insurance
to pay for care in a nursing home or
in the patient’s home. Long-term
care can be very expensive. Bringing an aide
into your home just three times a week (two
or three hours per visit) to help with dressing,
bathing, preparing meals, and similar household
chores, can cost $1,000 a month, or $12,000/year.
That doesn’t include the cost of skilled
help, such as physical therapists.
Long-term care insurance
cheap either. Here’s
an example. In 1999,
a policy offering a
care benefit for four
years, with a 20-day
$409 per year,
- a 65-year-old about $1,002
- a 79-year-old about $4,166
Policy prices are based on
age, the size of the
benefit, the length of time benefits will be paid and other factors.
Some policies have
limitations for pre-existing conditions and benefits will not be paid
for six months after
the policy begins.
If you are interested
in long-term care insurance,
be sure to compare policies
before you buy. See the Resources
at the end of this section for organizations
that give guidance about long-term
What if I need home health care but
cannot afford to pay
There is a range of services
available in the community to
help meet long-term care needs.
Care given by family members
or friends can be supplemented
by friendly visitor programs,
home-delivered meal programs
such as Meals on Wheels, chore
services, adult daycare centers, and
respite services for caregivers who
need a break from daily responsibilities.
Your local area Agency on Aging can
help you locate the services you need.
Call the Eldercare Locator at 800.677.1116
to identify your local office.
Portions of this section were
adapted from, A Guide to Long-Term
Care Insurance from the Health Insurance Association
of America (www.hiaa.org)
and Home Care for Cancer Patients
from the National Cancer
Accreditation Commission for Home Care,
Provides information about accredited home
care organizations in North Carolina.
American Association of Retired Persons
202.434.3470 or 800.424.3410
In North Carolina:
919.755.9757 or 877.434.7598 (TTY) (Raleigh)
Comprehensive information about caregiving,
insurance options, Medicare and other topics
(also available in Spanish). Free publications
for people over age 50 and their caregivers.
American Cancer Society (ACS)
800.ACS.2345 or 866.228.4327 (TTY)
Provides information and services for all
forms of cancer, diagnosis, treatment and
many other topics. Has a free booklet about
Association for Home and Hospice Care of
919.848.3450 or 800.999.2357 (in North Carolina)
Has locations and services of hospices and
home care in North Carolina and information
about hospice and home care.
Health Insurance Association of America
The HIAA offers “A Guide to Long-Term
Care Insurance” on their web site.
Joint Commission on Accreditation of Healthcare
Has information on accredited home care and
hospice agencies in the United States.
800.MEDICARE (633.4227) or 877.486.2048 (TTY/TDD)
Answers questions about Medicare benefits
and coverage for home care. Some publications
available in Spanish, large print, audio
and Braille. Web site also available in Spanish
National Association for Home Care
Has information about how to choose a home
care provider, what home care involves, hospice
care and rights of patients.
North Carolina Department of Insurance
Health Insurance Counseling Program (Raleigh,
919.733.2032 or 800.JIM-LONG (546.5664)
Contact for help in learning about and choosing
a long-term care insurance plan.
North Carolina Division of Aging (Raleigh,
Contact if you have questions or concerns
about choosing a health care organization.
Has information on home care and hospice,
health, long-term care and other services
in North Carolina.