Home care (also referred to as domiciliary care, social care, or in-home care) is supportive care provided in the home. Care may be provided by licensed healthcare professionals who provide medical treatment needs or by professional caregivers who provide daily assistance to ensure the activities of daily living (ADLs) are met. In-home medical care is often and more accurately referred to as home health care or formal care. Home health care is different non-medical care, custodial care, or private-duty care which refers to assistance and services provided by persons who are not nurses, doctors, or other licensed medical personnel. For patients recovering from surgery or illness, home care may include rehabilitative therapies. For terminally ill patients, home care may include hospice care.
Home health services help adults, seniors, and pediatric clients who are recovering after a hospital or facility stay, or need additional support to remain safely at home and avoid unnecessary hospitalization. These Medicare-certified services may include short-term nursing, rehabilitative, therapeutic, and assistive home health care. This care is provided by registered nurses (RNs), licensed practical nurses (LPN's), physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), unlicensed assistive personnel (UAPs), home health aides (HHAs), home care agencies (HCAs) and medical social workers (MSWs) as a limited number of up to one hour visits, addressed primarily through the Medicare Home Health benefit. Paid individual providers can also provide health services through programs such as California's In-Home Supportive Services (IHSS), or may be paid privately.
The largest segment of home care consists of licensed and unlicensed non-medical personnel, including caregivers who assist the care seeker. Care assistants may help the individual with daily tasks such as bathing, cleaning the home, preparing meals and offering the recipient support and companionship. Caregivers work to support the needs of individuals who require such assistance. These services help the client to stay at home versus living in a facility. Non-medical home care is paid for by the individual or family. The term "private-duty" refers to the private pay nature of these relationships. Home care (non-medical) has traditionally been privately funded as opposed to home health care which is task-based and government or insurance funded. California's In-Home Supportive Services (IHSS) also offers financial support for employing a non-medical caregiver.
These traditional differences in home care services are changing as the average age of the population has risen. Individuals typically desire to remain independent and use home care services to maintain their existing lifestyle. Government and Insurance providers are beginning to fund this level of care as an alternative to facility care. In-Home Care is often a lower cost solution to long-term care facilities.
Home care has also been increasingly performed in settings other than clients' homes, as home workers have begun assisting with travel and performing errands. While this has been increasingly performed for younger populations with disabilities, these changes may also reframe the concept of home care in the future.
Overview
"Home care", "home health care" and "in-home care" are phrases that have been used interchangeably in the United States to mean any type of care—skilled or otherwise—given to a person in their own home. Home care aims to make it possible for people to remain at home rather than use residential, long-term, or institutional-based nursing care.
Non-medical in-home care is also called companion care or unskilled care. It is a valuable service for seniors in need of household help, social interaction, or transportation to appointments. Home care is most utilized by elderly people who live alone with impairments with their activities of daily living and have low social support. For those with adequate social and familial support, home care is delayed until the impairment level becomes severe or their caregiver is no longer able to support them independently. Home care services include help with daily tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship.