Help that a patient may receive from persons that are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) was not included in the Study.

Instrumental activities of daily living (IADL) refers to six daily tasks (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enables the patient to live independently in the community. The patient's need for assistance with these activities was measured in the Study by the receipt of help from agency staff. Help that a patient may have received from persons who are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) was not included in this Study. Licensure and providers in FloridaFlorida is a Licensure State which requires different levels of licensing depending upon the services provided. Companion assistance is provided by a Home Maker Companion Agency whereas Nursing Services and assistance with ADL's can be provided by a Home Health Agency or Nurse Registry. The State licensing authority is the Agency for Health Care Administration (AHCA) Licensure and providers in CaliforniaCalifornia is NOT a licensure state for non medical or custodial care services and therefore there are no barriers to entry, no consumer protection laws, no minimum standards yet and no official state oversight.

In California the consumers and their families must adopt a "buyer beware" approach, do their homework and hire caregivers that are bonded and insured. This is why it is important to use a full service agency that has supervision and oversight of staff. Full service agencies also do pre employment background check (criminal)DMV checks and reference checks.Staff become the agency's employee not an independent contractor or "under the table" person. Full service agencies also train, monitor and supervise the staff that provide care to clients in theire home. See link below in external links section for a checklist for selecting home care providers in Calfornia. Aide worker qualificationsIt is not a requirement that you have a GED or High School Diploma, you will need to check with your local Department of health for state requirements. Often aide workers have experience in institutional care facilities prior to a home care agency. Workers can take an examination to become a State tested Certified Nursing Assistant (CNA).

Other requirements in the U.S.A. often include a background check, drug testing, and general references. CompensationIn the United States, registered nurses employed in the home care field receive on average around $22.00 to $30.00 per visit.Payment / reimbursement of other Skilled Services vary according to the specific discipline.Home Health Aides are paid between $5.85 USD (current US minimum wage) to approximately $12.00 (or more) per hour. Currently there is high turn-over and frequent call-offs or no-shows by workers in the home health care / home care field.Agencies' fees for non-medical home care are traditionally NOT reimbursed by State, Federal, or private insurance. However, private long-term care insurance will often reimburse policyholders for part of the cost of non-medical home care, depending upon the terms of the policies. Recent Supreme Court case: Coke v. Long Island Home CareFor years, home care work has been selectively classified as a “companionship service” and exempted from federal overtime and minimum wage rules under the Fair Labor Standards Act (FLSA).

Home Care

Home care, (commonly referred to as domiciliary care), is health care or supportive care provided in the patient's home by healthcare professionals (often referred to as home health care or formal care; in the United States, it is known as skilled care) or by family and friends (also known as caregivers, primary caregiver, or voluntary caregivers who give informal care). Often, the term home care is used to distinguish non-medical care or custodial care, which is care that is provided by persons who are not nurses, doctors, or other licensed medical personnel, whereas the term home health care, refers to care that is provided by licensed personnel. Concept(The following definition is applicable in United States and United Kingdom.)"Home care" and "home health care" are phrases that are used interchangeably in the United States to mean any type of care given to a person in their own home. Both phrases have been used in the past interchangeably regardless of whether the person requires skilled care or not.

More recently, there is a growing movement to distinguish between "home health care" meaning skilled nursing care and "home care" meaning non-medical care. In the United Kingdom, "Homecare" and "domiciliary care" are the preferred expressions.Home care aims to make it possible for people to remain at home rather than use residential, long-term, or institutional-based nursing care. Home Care providers render services in the client's own home. These services may include some combination of professional health care services and life assistance services.Professional Home Health services could include medical or psychological assessment, wound care, medication teaching, pain management, disease education and management, physical therapy, speech therapy, occupational therapy.Life assistance services include help with daily tasks such as Meal Preparation, Medication reminders, Laundry, Light Housekeeping, Errands, Shopping, Transportation, and Companionship. In the United StatesWhile there are differences in terms used in describing aspects of Home Care or Home Health Care in the United States and other areas of the world, for the most part the descriptions are very similar.

Estimates for the U.S. indicate that most home care is informal with families and friends providing a substantial amount of care. For formal care, the health care professionals most often involved are nurses followed by physical therapists and home care aides. Other health care providers include respiratory and occupational therapists, medical social workers and mental health workers. Home health care is generally paid for by health insurance, public payers (Medicare, Medicaid), or paid with the patient's own resources. Activities of Daily Living and Instrumental Activities of Daily LivingActivities of daily living (ADL) refers to six activities (bathing, dressing, transferring, using the toilet room, eating, and walking) that reflect the patient's capacity for self-care. The patient's need for assistance with these activities for the Study mentioned was measured by the receipt of help from agency staff at the time of the survey.