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Home Care for Cancer Patients
Key Points
* 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.
* 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.
* Medicare may offer reimbursement for some home care services.
* Medicaid, a jointly funded, Federal-State health insurance program for people who need financial assistance for medical expenses, covers part-time nursing care, home care aide services, and medical supplies and equipment.
* Veterans who are disabled as a result of military service can receive home care services from the U.S. Department of Veterans Affairs (VA).
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 a patient’s 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.
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 health insurance program for the elderly or disabled that is administered by the Centers for Medicare & Medicaid Services (CMS). Medicare may offer reimbursement for some home care services. Cancer patients who qualify for Medicare may also be eligible for coverage of home hospice services if they are accepted into a Medicare-certified hospice program. Hospice provides medical, psychological, and spiritual support for terminally ill patients. Information about Medicare services and coverage is available 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. Deaf and hard of hearing callers with TTY equipment may call 1–877–486–2048. Medicare information can also be accessed at http://www.medicare.gov on the Internet. Information about Medicare-certified home health agencies can be found on the Home Health Compare Web site, which is located at http://www.medicare.gov/HHCompare/Home.asp on the Internet. This site also has general information about home health care 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. Although the Federal Government establishes general guidelines for the program, Medicaid program requirements are established by each state. Medicaid coverage includes 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 at http://www.cms.hhs.gov/apps/contacts on the Internet (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. The 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 U.S. Administration on Aging, the Eldercare Locator, provides information about AAAs and other assistance for older people. The Eldercare Locator can be reached by phone at 1–800–677–1116, or at http://www.eldercare.gov/Eldercare.NET/Public/Home.aspx on the Internet.
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 veterans benefits is available by calling 1–877–222–8387 (1–877–222–VETS) or visiting the VA’s Web site at http://www1.va.gov/health/ on the Internet. Information about the VA’s home- and community-based care programs is available at http://www1.va.gov/HCBC/ 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 co-payment. 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. 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 by phone at 1–800–227–2345 (1–800–ACS–2345), or at http://www.cancer.org on the Internet. 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: A Guide for Patients and Families is available at http://www.cancer.org/docroot/MBC/MBC_2x_OtherEffects.asp on the Internet 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.
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 publication How To Choose a Home Care Provider: A Consumer’s Guide can be obtained by contacting the NAHC at 228 Seventh Street, SE., Washington, DC 20003. The telephone number is 202–547–7424. The booklet can also be ordered on the NAHC’s Web site, which is located 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. The publications are posted at http://www.nahc.org/haa/consumerInfo.html on the Internet or can be obtained by sending a self-addressed, stamped, business envelope to the NAHC address mentioned above.
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Related NCI materials and Web pages:
* National Cancer Institute Fact Sheet 8.9, How To Find Resources in Your Own Community If You Have Cancer 1
(http://www.cancer.gov/cancertopics/factsheet/Support/resources)
* National Cancer Institute Resources for Financial Assistance for Patients and Their Families Database 2
(https://cissecure.nci.nih.gov/factsheet/FactSheetSearch8_3.aspx)
* When Someone You Love Is Being Treated for Cancer 3
(http://www.cancer.gov/cancertopics/When-Someone-You-Love-Is-Treated)
How can we help?
We offer comprehensive research-based information for patients and their families, health professionals, cancer researchers, advocates, and the public.
* Call NCI’s Cancer Information Service at 1–800–4–CANCER (1–800–422–6237)
* Visit us at http://www.cancer.gov or http://www.cancer.gov/espanol
* Chat using LiveHelp, NCI’s instant messaging service, at http://www.cancer.gov/livehelp
* E-mail us at cancergovstaff@mail.nih.gov
* Order publications at http://www.cancer.gov/publications or by calling 1–800–4–CANCER
* Get help with quitting smoking at 1–877–44U–QUIT (1–877–448–7848)
Glossary Terms
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
hospice (HOS-pis)
A program that provides special care for people who are near the end of life and for their families, either at home, in freestanding facilities, or within hospitals.
nurse
A health professional trained to care for people who are ill or disabled.
physical therapist
A health professional who teaches exercises and physical activities that help condition muscles and restore strength and movement.
social service (SOH-shul SER-vis)
A community resource that helps people in need. Services may include help getting to and from medical appointments, home delivery of medication and meals, in-home nursing care, help paying medical costs not covered by insurance, loaning medical equipment, and housekeeping help.
social worker
A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.
Table of Links
1 http://www.cancer.gov/cancertopics/factsheet/Support/resources
2 https://cissecure.nci.nih.gov/factsheet/FactSheetSearch8_3.aspx
3 http://www.cancer.gov/cancertopics/When-Someone-You-Love-Is-Treated
