Home Care for Sale

Abstract

This chapter begins by assessing the psychological and emotional demands of home care work. It then explains how home care, like other aspects of health care in the United States, is a marketplace commodity. Because need is so great, this commodification of home health care has proved tremendously profitable to the agencies serving as middlemen. In theory, these agencies impose a certain quality control, carefully screening and training the aides they send out to work. Unfortunately, this is not always the case. Those agencies that work on a strictly private-pay basis and do not accept Medicaid clients are not subject to the federal regulations and are not legally required to provide aides with any training whatsoever. Moreover, the high cost of using agencies has generated a vast gray market for aides who work freelance and privately, without working for an agency or under any supervision other than that of the client and the client's family.