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. Home care can help patients achieve this desire. It 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 address new issues and 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 team or organizations devoted to home care. A doctor, nurse, or social worker can provide information about patients' specific needs, the availability of home care services, and a list of local home care agencies.
Services provided by home care agencies may include access to medical equipment; visits from registered nurses, physical therapists, and social workers; help with running errands, meal preparation, and personal hygiene; and delivery of medication. The state or local health department is another important resource in finding home care services. The health department should have a registry of licensed home care agencies.
Public and private resources of financial assistance are available to patients to pay for home care. Government-sponsored programs, such as Medicare, Medicaid, the Older Americans Act, and the Veterans Administration, cover home care for those who meet their criteria.
Some people may qualify for Medicare, a health insurance program for the elderly or disabled that is administered by the Health Care Financing Administration (HCFA). Medicare may offer reimbursement for some home care services. Cancer patients who qualify for Medicare may also be eligible for coverage of hospice services if they are accepted into a Medicare-certified hospice program. Information about Medicare services and coverage is available from the toll-free Medicare Hotline at 1800MEDICARE (18006334227), or by writing to 6325 Security Boulevard, Baltimore, MD 21207. Deaf and hard of hearing callers with TTY equipment may call 18774862048. Medicare information can also be accessed at http://www.medicare.gov on the Internet.
Medicaid, a jointly funded, Federal-State health insurance program for people who need financial assistance for medical expenses, is also coordinated by HCFA. At a minimum, states must provide home care services to people who receive Federal income assistance such as Social Security Income and Aid to Families with Dependent Children. Medicaid coverage includes part-time nursing, home care aide services, and medical supplies and equipment. Information about coverage is available from local state welfare offices, state health departments, state social services agencies, or the state Medicaid office. Information about specific state locations is also available on the HCFA Web site at http://www.hcfa.gov/medicaid/medicaid.htm on the Internet.
The Older Americans Act provides Federal funds for state and local social service programs that help frail and disabled people age 60 and older remain independent. This funding covers home care aide, personal care, escort, meal delivery, and shopping services. Older persons, their caregivers, or anyone concerned about the welfare of an older person can contact their local Area Agency on Aging (AAA) for information and referrals to services and benefits in the community. AAAs are usually listed in the white pages of the phone book under the city or county government headings. A nationwide toll-free hotline operated by the Administration on Aging provides information about AAAs and other assistance for older people; the number is 18006771116.
Veterans who are disabled as a result of military service can receive home care services from the Veterans Administration (VA). Only home care services provided by VA hospitals may be used. More information about veterans benefits is available by calling 18008271000. Information can also be found on the VA's Web site at http://www.va.gov/vbs/ on the Internet.
Private health insurance policies may cover some home care or hospice services, but benefits vary from plan to plan. Policies generally pay for services given by skilled professionals, but the patient may be responsible for a deductible or copayment. Many health maintenance organizations require that home care or hospice services be given by authorized agencies. It is best to contact the insurance company to see which services are covered.
Many national organizations such as the American Cancer Society (ACS) offer a variety of services to cancer patients and their families. The ACS has free fact sheets and publications about home care. These materials can be obtained at http://www.cancer.org on the Internet, or by calling 1800ACS2345 (18002272345) for the address of a local ACS chapter. Services vary among ACS chapters. Many ACS chapters can provide home care equipment (or suggest other organizations that do). Other voluntary agencies, such as the Red Cross and those affiliated with churches or social service organizations, may provide free or low-cost transportation. These agencies may also be able to lend home care equipment.
With so many home care organizations and services available, it is sometimes difficult to decide which to use. In addition to the local health department, information about home care services is available from such organizations as the National Association for Home Care (NAHC). To obtain a copy of the publication How to Choose a Home Care Provider, contact the NAHC at 228 Seventh Street, SE., Washington, DC 20003. The telephone number is 2025477424. Information about the NAHC is also available at http://www.nahc.org on the Internet. An affiliate of the NAHC, the Hospice Association of America, offers publications such as All About Hospice: A Consumer's Guide. For a copy of this publication, send a self-addressed, stamped, business envelope to the NAHC address mentioned above.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an independent, not-for-profit organization that evaluates and accredits health care organizations and programs in the United States, also offers information for the general public. The JCAHO can be contacted at One Renaissance Boulevard, Oakbrook Terrace, IL 601814294; their telephone number is 6307925800. The JCAHO Web site is located at http://www.jcaho.org on the Internet.