Medical implications of organization of the home help service

The organizational structure and of the role of home help service is described. Doctors working in both geriatric medicine and the community are aware of the home help service through shared contact mainly with frail elderly patients. They are usually well informed about the practical value of the home help service to the patients but seem to lack knowledge about the internal structure of the home help service and its value as an important source of information about the mental and physical ability of the elderly in the community. In our experience direct contact with the home help service is more effective than indirect contact--through the hospital Social Worker. Home care organizers should be part of the multi-disciplinary team when discussing the possible discharge of a frail elderly patient. All medical staff caring for the elderly, whether community or hospital based, should be aware of the administration structure of the home help service to facilitate the interchange of information.