Private duty home care used to be defined by what it wasn’t. Home care aides/caregivers assisted seniors and the disabled at home, but not with health care or medical care. People sometimes referred to this assistance as “non-medical home care.” Ugh. That’s like referring to cheese pizza as “non-pepperoni pizza.”

There are really two types of in-home care. One type performs custodial care — care for the aging and disabled that helps a person with activities of daily living (ADLs) such as bathing, dressing, feeding, and transferring. Custodial care also includes helping a person perform instrumental activities of daily living (IADLs). IADLs are tasks not involving physical contact with a client, but necessary for independent living such as light housekeeping, laundry, meal preparation and planning, shopping and errands, using communication devices (telephone, writing), and managing money. Most senior clients of Family Resource Home Care need help with both ADLs and IADLs.

The other type of in-home care is medical home care, also known as home health care. Home health care is performed mostly by nurses and physical and occupational therapists. It involves skilled procedures such as wound care, IV lines and infusion therapy, managing medications, physical and occupation therapy, and skilled nursing care.

So, why not refer to non-medical in-home care as custodial care? “Family Resource Custodial Care” would sound kind of catchy – if we were a cleaning service. But even that beats “Family Resource Non-Medical Care.”

Why not refer to agencies which primarily perform custodial care as . . . home care agencies? The problem is that the term “home care” had been taken by the National Association for Home Care and Hospice (NAHC), which is the national trade group for the home health care folks. It’s fine to call a private duty agency ABC Home Care and then explain the services more fully, but we needed a more specific term for the industry.

Private duty home care refers to the method of payment. Private duty home care services aren’t covered by Medicare or health insurance. With a few exceptions, they’re paid for privately by the client, or by long-term care insurance.

With a name to describe the industry, we could now have a trade group. The Home Care Association of America was founded in 2002. The Washington Private Duty Association (WAPDA) was founded in 2005. Even though families have been caring for each other for thousands of years, ours is a young industry whether you call it custodial care, home care, or private duty.