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When Caregiving is  Not Enough -
Finding Good Homecare

By Leah M. Pavela, LCSW

(Page 1 of 3)

Home health care, also known as domicilary care, is care provided in one’s own place of residence.  This can include skilled nursing services, speech-language pathology, physical and occupational therapy, home health aide services, as well as medical social services and the provision of durable medical equipment such as wheelchairs or walkers for use in-home when ordered by a licensed physician.  Anyone who has ever looked for home-based care for a loved one comprehends what a daunting experience it can be.  Browse through the “home health agencies” section of the phone book and there are an overabundance of listings—some counties have over 200 home care agencies, with new ones opening, closing, and merging weekly.  With so many choices, one might assume that the choice would be easy, but in fact it is not.  What follows are some tips to consider when considering homecare for a loved one:


Find out if the agency you are considering is licensed and bonded.  In the case of a home health agency, this means that the quality of care being provided has been surveyed/accredited by an outside accrediting agency such as Medicare or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).  The agency should also be licensed by the state in which it operates.  Agency outcomes can be researched by going to and going to their new “home health compare” tool, or calling the Medicare helpline at 1-800-MEDICARE. 


In terms of employees, confirm that all home health employees (nurses, physical therapists, home health aides, and social workers) are certified or licensed in the state they are working (regulations may vary by state), in order to ensure they meet minimum requirements to perform their duties.  Also important is to make sure that the agency does screenings of employees to ensure that not only do they not have a criminal background, but that they are free of communicable diseases which could affect the compromised immune system of a patient.


Ask what policies are in place to ensure patient confidentiality, and find out how far that policy extends.  Many caregivers, particularly ones who arrange for assistance long distance, find themselves frustrated after they arrange for care for a loved one, only to be told that due to HIPAA regulations, the agency cannot provide information on their health status.  At the outset of care, make sure of what the company’s policy for communication is and ensure that it is noted who may and may not receive information about the patient.


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