Searching for question 1 throws up multiple domestic solutions services such as washing, cleaning, maids, cooks, repairs etc and is hence not a good search phrase. Question 2 is a more precise search that shows what kind of health support services can be accessed from home.

Questions 3 & 4 mixes up age related services and elderly patient care services available at home. Many companies provide a random blend of these requirements with varying degrees of specialist input and quality control, and accountability. Question 5 about best elderly home care services need to meet health & safety criteria, gender, race, and age sensitive interventions, provide practical help at home, support disabilities, medically and psychiatrically guided, psychological needs met, good administration, logistics, communication, coordination, and management. However, question 5 like question 1, shows other domestic services and is not specific to health needs required. Question 6 is specific to nursing needs of medically or psychiatrically unwell elderly people.

Questions 7 – 12 is about providing nursing care at home. Carer staff are less qualified and not nursing trained but have some varying abilities to provide humane care and support under guidance. Nurses are variously qualified and have some prior nursing work experience from various medical backgrounds. Carers can be supervised by nurses; but nurses need to be guided by doctors. Any medical intervention at home needs a hierarchy of carer – nurse – doctor and only minimal interventions can occur at home without intense monitoring. Different agencies provide varying degrees of home health care under varying quality based on willingness to pay by the client, ability to engage by patient & family in advice and support provided, and quality of home nursing care provided by the agency. Families should have realistic expectations of outcomes to their loved ones needing care at home, based on the condition of the patient. Families should also be honest and transparent about the health needs and disabilities of the patient (many cover up facts to reduce fees paid to agencies) and this leads to expectations not being met and poor quality of care being offered to patients in their home. Question 13 about the best in this category implies that the costs incurred by the family will be high, they should have realistic expectations, the agency providing such services should offer a high degree of medical, nursing/carer profile; and the management of the agency should be of good governance, and offer proactive/ credible undertakings.

Question 14 implies that a person in any age category (child, adult, elderly) of any gender is in a sick role and needs help and assistance to live their daily life at home. This could be a temporary or permanent status. If families are reluctant to keep patients in hospital for long, either due to incurred costs, or the wishes of the patient/family; the risks of managing such patient at home without intense medical monitoring & intervention should be acknowledged by the patient and family. Their expectations of care should be realistic. The services should reduce care burden of the family and provide a tangible improvement in quality of life to the patient. Adverse life outcomes should be acceptable to the family and patient if choosing home health care as intense monitoring and wide repertoire of specialists required to avert adverse health outcomes are unavailable in a home health care service. Health is an interconnected aspect of our existence and once ill health sets in, one condition could lead to another new problem that may be missed in home monitoring due to unpreparedness, and lack of intense monitoring and investigations required to detect onset of new issues or interconnected issues. Higher the standards of home health care provided by an agency, higher the incurred costs per month; and still, adverse outcomes cannot be fully averted. However, agencies providing such care should demonstrate responsible behaviour in their undertakings and be transparent about what they can provide at home or not.

Questions 15 – 17 is about arranging a carer to look after your child at home as you have less helping hand at home due to family circumstances. The child should be of reasonably good health and mental functioning to provide this service. Unwell children and disabled children cannot be looked after at home in this search category. The carer can keep the child reasonably safe and engaged at home, while the family members attend to other matters. They are not teachers or health workers and families should not expect this from the service provider.

Questions 18 – 20 on google search will identify services geared to provide health monitoring and support at home. The realistic care provided by such services at home for children will have the same limitations that an adult or elderly service will provide. Families should accept the associated risks with home child health care despite a reasonable standard of healthcare provided by the agency at home.

Questions 21 – 27 is specific to differently abled or disabled children. Depending on which specially trained staff are available for home care, the service provided will be different. It is a highly specialised and multidisciplinary effort to keep a special child at home. It should provide reduced burden of care to families, maintain or improve reasonable quality of life to the affected child, minimise harm to child. However, there are currently no fully specialised home health care services in Nayandahalli for this category of children. The family should expect high incurred monthly costs to seek such a service at home.