4 Changes to Strengthen Home Care in the Future

There were more than 300,000 home care aides in New York in 2015, according to the Paraprofessional Healthcare Institute (PHI), making it one of the state’s largest workforce groups. However, with low pay and a growing need for these workers, home care leaders are hoping to find better solutions to address patient needs and boost the entire sector.

Home care leaders and executives from seven agencies and nonprofits in New York were brought together by PHI, which advocates for the direct care workforce, meeting in May 2017 to discuss the changing home care field and where the industry can be improved. Key takeaways from that meeting are explained in a newly released report.

“The critically important world of home care, which can provide a lifeline for older adults and people with disabilities, is too often overlooked, ignored or misunderstood,” Bruce Vladeck, senior advisor with Greater New York Hospital Association, said at the panel.


Changes in the following four domains could strengthen home care, as it becomes an increasingly important option for an aging population.

Defining Quality Home Care

The group pinpointed continuity of care, positive client outcomes and a strong relationship between the client and the home care aide as some components of quality care, in addition to clinical outcomes.


However, uniform measures of quality across the industry with all these components has lagged, they said. Discussions are also complicated “by the lack of recognition afforded to home care,” the report reads. For example, home care workers are often mischaracterized as unskilled labor, and outsiders believe the industry is “rife with fraud,” leaders said.

Role of the Home Care Aide

Leaders also agreed that the key functions of a home care aide have remained the same over the last five years, including providing hands-on care with a focus on the activities of daily living (ADLs).

Beyond those functions, aides are tasked with observing, recording and reporting the status of their clients in various ways, with this need rising. This is partly reinforced through the payment system that requires home care to monitor patients’ conditions. Yet, the skills for this part of the job aren’t always a part of training for entry-level caregivers. As patient acuity rises, the training standards for home care aides need to keep up.

“We will truly see the full value of home care aides when we figure out how to ensure that the information they hold about their clients’ health needs and preferences is communicated in a consistent and effective way to nurses, physicians and care managers,” said Rick Surpin, president of Independence Care System.


Advances in technology have many implications for home care, with one leader remarking it could be the “key” to the future of the field, the report reads. From smartphone capabilities to sensors in the home, new technology is an important component of home care, but better funding is needed to support pilot-testing tools, leaders said.

There are numerous ways home care leaders would like to increase their use of technology, including more smartphone capabilities for aides to communicate quickly and access health-related resources and documents, as well as to advance administration functions.

“However, leaders believed that a significant financial investment in technology is needed to realize these goals,” the report reads.

Improving Jobs and Care Delivery 

Above all, industry leaders are eager for solutions that will improve home care aide jobs and care delivery to patients. As the industry continues to change, agencies trying to keep up with the daily challenges are eager for opportunities to prepare for the future.

“Future conversation should also examine what additional training and supports are needed by both family caregivers and home care aides—the people who spend to most time with home care clients—to work together to provide high-quality care,” said Carol Levine, director of families and health projects at the United Hospital Fund.

Written by Amy Baxter

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