The use of home care services, particularly by older persons, has increased dramatically in recent years. This trend has been fueled by increased public funding for home care,shortened hospital stays that often result in a need for followup care, advances in medical technology that facilitate home care treatment, and the desire of individuals to continue living in their homes rather than move to get services. Home care services include skilled nursing care and personal assistance with basic activities of daily living, such as bathing and dressing, or a combination of skilled and personal care. Millions of older Americans rely on these services to remain in their homes. The growth in home care use has been accompanied by concerns about the quality of the care provided.
Many untrained workers care for people in the isolation of the home with little or no supervision.
Anecdotal reports or occasional media stories about fraud or abuse of home care recipients have raised fears about safety. Policymakers and regulators want to know if public monies are paying for effective services that result in better health or improved functioning for the consumer. Researchers question whether current quality assessment tools are capable of measuring quality of care. Consumers ask whether home care workers have been adequately trained for the services they provide. The extensive literature on quality of home care addresses these issues by examining the roles played by government regulators, researchers, home care workers, and consumers in assuring quality care.