Institutional health care delivered in hospitals and nursing homes is expensive. To reduce costs, hospitals have begun to discharge patients earlier. Many people who are discharged have not recovered their strength and stamina. Many require skilled assistance or monitoring. Others need only short-term assistance at home. Most insurance companies are willing to pay for a part of this care because it is less expensive than a long hospital or nursing home stay.
The growing numbers of older people and chronically ill people are also creating a demand for home care services. Family members who in the past would care for aging or ill relatives frequently leave hometowns to live and work in distant areas. In addition, they often have other responsibilities or problems that interfere with their ability to provide care. For example, family members who work or who care for young children may be unable to look after aging relatives as they become frail and less functional.
Most people who need some medical care prefer the familiar surroundings of home to an institution. They choose to live alone or receive care from a relative or friend. Home health aides can provide assistance to the chronically ill, the elderly, and family caregivers who need relief from the physical and emotional stress of caregiving. Many home health aides also work in assisted living facilities. Assisted living facilities allow independent living in a home-like environment, with professional care available as needed.
As advances in medicine and technology extend the lives of people with chronic illnesses, the number of people needing health care will increase. Home services will be needed to provide continued care and assistance as chronic illnesses progress. For example, people with acquired immunodeficiency syndrome (AIDS), a chronic illness that is infecting more and more people throughout the world, will require in-home assistance. They will also require disease-specific health care as their illnesses progress. Improvements in medications and better management of the disease have already shown that people with AIDS can live longer, with an improved quality of life.
One of the most important reasons for health care in the home is that most people who are ill or disabled feel more comfortable at home. Health care in familiar surroundings improves mental and physical well-being. It has proven to be a major factor in the healing process.