National Cancer Institute

Why do some cancer patients choose home care?

Cancer patients often feel more comfortable and secure being cared for at home. Many patients want to stay at home so 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 a patient’s specific needs, the availability of home care services, and a list of local home care agencies.

What services are provided by 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.

How can cancer patients get assistance paying for home care?

Financial assistance to help patients pay for home care is available from public and private sources. The U.S. Department of Veterans Affairs (VA) and some government-sponsored programs, such as Medicare, Medicaid, and the Older Americans Act, cover home care for those who meet their criteria.

Some people may qualify for Medicare, a government health insurance program for the elderly or disabled that is administered by the Centers for Medicare & Medicaid Services (CMS). Cancer patients who qualify for Medicare may also be eligible for coverage or reimbursement of home hospice services if they are accepted into a Medicare-certified hospice program. Information is available online, from the toll-free Medicare hotline at 1–800–633–4227 (1–800–MEDICARE), or by writing to 7500 Security Boulevard, Baltimore, MD 21244–1850. Callers with TTY equipment may contact Medicare at 1–877–486–2048. The Home Health Compare website has information about Medicare-certified home health agencies and patients’ rights.

Medicaid, a jointly funded, federal-state health insurance program for people who need financial assistance for medical expenses, is also coordinated by CMS. Coverage varies by state but may include part-time nursing care, 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. Check the local telephone directory for the number to call. Information about specific state contacts is also available by searching the CMS.gov Contacts Database (select State Health Departments as the Organization Type).

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, meal delivery, and escort 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. The Eldercare Locator, which is operated by the U.S. Administration on Aging, provides information about AAAs and other assistance for older people. The Eldercare Locator can be reached at 1–800–677–1116 or searched online.

Veterans who are disabled as a result of military service can receive home care services from the VA. Only home care services provided by VA hospitals may be used. More information about these benefits is available at 1–877–222–8387 (1–877–222–VETS) or on the VA website.

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 co-payment. Many health maintenance organizations require that home care or hospice services be given by authorized agencies. Contact the insurance company to see which services are covered.

Many national organizations, such as the American Cancer Society (ACS), offer services to cancer patients and their families. Services vary among ACS chapters; however, many of the chapters can provide home care equipment or suggest other organizations that do. The ACS can be reached at 1–800–227–2345 (1–800–ACS–2345) or on its website. For callers with TTY equipment, the number is 1–866–228–4327. The ACS also has fact sheets and materials about home care. For example, the ACS publication Caring for the Patient With Cancer at Home is available online or can be ordered by calling the ACS. 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.

How should I choose a home care provider?

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 organizations such as the National Association for Home Care & Hospice (NAHC). The NAHC publication How To Choose a Home Care Agency: A Consumer’s Guide is on the NAHC website or can be ordered from NAHC at 202–547–7424 or 228 Seventh Street SE, Washington, DC 20003. The Hospice Association of America, an affiliate of NAHC, offers publications such as All About Hospice: A Consumer’s Guide. The publications are available online or can be obtained by sending a self-addressed, stamped, business envelope to NAHC.