Aid from those who live with or around the patient is the oldest form of medical assistance, but as the industrial age came about, people tended towards using facilities and hospitals more than sticking to these older methods. However, although informal assistance still ranks as the most common, there is a large amount of growth in the home care industry, caused by those who prefer to remain in their houses but cannot do it alone.
The idea of professional assistance for older and disabled people is not a new one. Gradually, this moved from mostly being in-home assistance to being mostly nursing homes as the industrial revolution occurred. A swing back in the other direction occurred after the boom of nursing homes in the 1960′s.
During the 1960′s there was a tax break available for setting up nursing homes. This unfortunately resulted in a low quality of life for many residents of facilities that were more concerned with money than patients. New rules resulted in both stricter regulations on nursing homes and funding for in-home care by Medicare.
The single largest payer of services from the home care industry is still Medicare. Some 37 percent of the industry is funded with Medicare dollars. Medical assistance includes things like wound care, dosing and administration of medication, and physical therapy, while other assistance might include help with bathing, toileting and feeding. The latter is mostly the purview of ‘unskilled’ aides, while nurses make up most of the former group.
Like other health services, this type of assistance is expensive. Care from an unskilled aide can run from $7 per hour on up, and nurses commonly make $40-$60 per visit. Some 600,000 people receive this type of assistance, and the cost is significant, for patients, insurance companies, and the US government.
Total estimates for the field are difficult to reach because of the variety of people paying for services, what does and does not meet the definition, and more. Medicare is estimated to be paying for 37 percent of this type of assistance in the US, and they spent approximately $428 billion on it in the year 2007.