Home Health Therapies

Home care includes a wide range of therapies that can be curative, palliative, or restorative. These therapies are delivered in a person's residence, whether it is a private or a group home (e.g., an assisted living facility or other type of senior housing). Home health therapies include medical, nursing, social, and rehabilitative treatments. These therapies are classified as "skilled needs" and must be provided by a health care professional. Registered nurses (RNs) and licensed practitioner nurses (LPNs) provide skilled nursing care and home infusion care. RNs also serve as case managers, perform the home care assessment on the first home visit (or in the hospital or nursing facility before discharge), and create and manage the care plan. Physical therapists, occupational therapists, and speech pathologists all provide rehabilitation therapy. Social workers help patients to deal with social and emotional issues, such as living arrangements, family problems, and financial matters.

In addition to skilled needs some people need help with the essential activities of daily living (ADLs)—bathing, dressing, getting around inside, toileting, transferring (e.g., from bed to chair), and eating. People also have difficulties with activities that are less basic than ADLs. These instrumental activities of daily living (IADLs) include paying the bills, shopping, cleaning, and doing laundry. Both home health aides and personal care attendants provide personal care (assistance with ADLs) and homemaker services (assistance with IADLs). In addition, home health aides are trained paraprofessionals who change dressings, help with medications, and provide other services that support skilled care.

The major services involved in each of the therapies are outlined in Table 1.