To find home health care, experts advise: Go through an agency rather than hiring an individual. This is particularly important when dealing with health aides or homemakers, who are not licensed professionals. Contact the hospital social services department, if you are a hospital patient. Do this early; don't wait for the discharge planning team to approach you. Talk to your doctor. He or she may have a preference among agencies. Call your city or county health department or commission on aging. These are listed in the blue pages of the phone book. Get referrals from the American Cancer Society, if the patient has cancer.
When calling an agency, ask: Are you Medicare certified? This is essential if you expect Medicare to pay for your care. In any case, it is a useful indication of quality. Do you carry malpractice coverage? Are your personnel bonded? Do they receive ongoing training? Are you accredited? The National League for Nursing and the American Public Health Association accredit skilled-care agencies. The National HomeCaring Council accredits homemaker/health aide services. What services do you offer, and do you provide 24-hour coverage?
The National HomeCaring Council has published a book, "All About Home Care: A Consumer's Guide." For a copy, send $2 and a self-addressed, stamped envelope to: National HomeCaring Council, 235 Park Ave. South, New York, N.Y. 10003.
Medicare will help pay for home health care that is "therapeutic" -- designed to produce improvement. It will not pay for "custodial" care. In general, Medicare services must be "intermittent" (interpreted as up to three visits a week), but the program will pay for daily visits on a "short term" basis (recently clarified as two to three weeks).
Most insurance policies will pay for the one- to two-hour visits that Medicare calls "intermittent" care. Getting coverage for continuous nursing services is more difficult. They are unlikely to be covered under "home health care," but if you search your policy carefully, you may find them tucked away under "private duty nursing" or "outpatient services."