Those who make "house calls" to work directly with patients are among those celebrating November as National Home Care month.
"With great numbers of Baby Boomers becoming senior citizens, more people are needing help remaining independent and staying in their homes," said Registered Nurse Melissa Rush, of the Fulton County Health Department's In-Home Health Services agency.
The health department's in-home health service was one of the first to offer services in Fulton County.
Other organizations that now offer home health care in the area include Spring River Home Health Agency, White River Area Agency on Aging and North Arkansas HomeCare.
There are two types of home health care services: Home Health emphasizes the medical side of things, nursing care and physical therapy; In Home Services concentrate on daily care with aides who can do everything from bathing and dressing clients, buying groceries, cooking and cleaning.
Despite facing a variety of ailments, most seniors fight to stay in their homes as long as possible.
"That is where we come in," said Casey Oliver of In-Home Health Services. "When we get a doctor's referral, we can provide a variety of services. We can offer nursing care, physical therapy and help with day to day activities like grooming, cooking and cleaning."
Doctors often suggest home health care to help patients get back on their feet after a serious illness or surgery. In other cases, home health specialists can evaluate seniors who are relatively healthy but dealing with medical issues and declining energy and strength. A list of services is recommended that aides can provide to insure clients are well groomed, eating a good diet, taking their medications and living in a clean, safe environment.
"Home health care tailors specific services for each of those groups of patients," said Rush. "The patient's doctor will order an individualized package of services aimed at meeting each patient's needs."
Analysts say achieving that goal helps keep health care costs down, as well as helping individuals.
Home health services, which can range from just two to four hours a week up to 40 hours or more, are much cheaper than the $4,000 to $6,000 a month cost of nursing home care and services. That is why Medicare, Medicaid, the Veterans Administration and many private insurers cover home health services.
"Preventing early nursing home placement, by helping people stay independent and in their homes, is one of our main goals," said Oliver.
"Monitoring and working with patients in their home also helps reduce the need for acute care, hospital admissions," Carla Bassham, Director of North Arkansas HomeCare added. "There is a big push right now to hold down health care costs by decreasing the number of people admitted for hospital stays."
North Arkansas HomeCare, which just moved to new offices in the long-time hardware and lumber building near the square, is a good example of the growing demand for home health care. Four years ago, the office opened in Salem when its owner, the LHC Group, began paying the Fulton County Hospital $5,000 a month to lease its home health license. The local office has grown to the extent that LHC, a large Louisiana based home health provider, is now in the process of buying the license from the hospital for $1.7 million.
"It appears the demand for home health services is going to continue to grow," said Shanna Maguffee, CEO of the White River Area Agency on Aging. "While the majority of our clients are Medicaid patients with limited incomes, we are seeing more instances where long term care insurance is helping pay the bill or clients are 'private pay,' paying their own bill."
The National Association for Home Care and Hospice has tracked the explosive growth of home care.
In 1982, there were 3,000 home care agencies. 29 years later, there are 33,000 in operation.
While just 1.3 million people received home health care in 1982, more than 12 million now receive home care each year, creating a $100,000 billion dollar industry.
"We are a major employer in the 10 county region we serve," said McGuffee. "We employ about 600 people total, including about 180 in our offices in Fulton, Izard and Sharp Counties. The Home Health industry is always at the top of lists you see of top jobs of the future."
The National Association for Home Care and Hospice is among industry groups who are carefully monitoring efforts to cut federal spending and reform health care.
It says, despite the lower cost advantages of home health, $12 billion in planned Medicare cuts may mean less funding for low income home health patients. In addition, there has been talk of adding co-pays, requiring patients to pay part of the benefit cost, starting in 2017.