Home care in the United States
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.
Care assistants may help the individual with daily tasks such as bathing, cleaning the home, preparing meals, and offering the recipient support and companionship.
Individuals typically desire to remain independent and use home care services to maintain their existing lifestyle.
While this has been increasingly performed for younger populations with disabilities, these changes may also reframe the concept of home care in the future.
Home care services include help with daily tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship.
Home care is often an integral component of the post-hospitalization recovery process, especially during the initial weeks after discharge when the patient still requires some level of regular physical assistance.
However, it is important to note that there may be cultural differences in home care due to different familial structures - multigenerational households, multiple households, same-sex parents and single-parent families can compose networks of culturally diverse individuals who require home care.
In most cases, when ordered by a physician, Medicare will pay for short-term medically necessary services provided in a home setting.
They may also prepare meals, accompany the client to medical visits, grocery shop, provide companionship and do various other errands.
For example, Alaska had the highest annual wage of approximately $29,100 and West Virginia on the other end of the spectrum had the average salary of $18,020.
[10] Since 1974 until 2015, home care work was classified as a "companionship service" and exempted from federal overtime and minimum wage rules under the Fair Labor Standards Act.
The Supreme Court considered arguments on the companionship exemption in a case brought by a home care worker represented by counsel provided by Service Employees International Union.
A rule issued from the DOL, entitled "Application of the Fair Labor Standards Act to Domestic Service," and meant to be effective from 1 January 2015, was written to revise "the definition of 'companionship services' to clarify and narrow the duties that fall within the term; in addition third party employers, such as home care agencies, will not be able to claim either of the exemptions [from federal overtime or minimum wage rules.]
The major effect of this Final Rule [would be] that more domestic service workers will be protected by the FLSA's minimum wage, overtime, and record keeping provisions.
Home care fees can be quite high; few patients & families can absorb these costs for a long period of time.
[15] Prior to the expansion, specialty services like intravenous antibiotics, oncology therapy, hemodialysis, parenteral and enteral nutrition and ventilator care, were only available in the hospital setting.
[15] This newly available technology has proven cost effective and improves the quality of life, increasing independence and flexibility for patients.
[15] Whether hospice services are performed at home or in a medical facility, the emphasis of care are the same; pain and symptom management, which is referred to as palliation.
[16] The available home care services are provided by a mix of physicians, registered nurses, licensed vocational nurses, physical therapists, social workers, speech language pathologists, occupational therapists, registered dietitians, home care aides, homemaker and chore workers, companions and volunteers.
[17] In another 2002 article, Modin and Furhoff regarded the roles of patients' doctors as more crucial than their nurses and care workers.
[21] In 2011, Christensen & Grönvall published a study of the challenges and opportunities of providing communication technologies supporting the cooperation between home care workers and family members.
