Assuring the quality of in-home care: the "other" challenge for long-term care

Although the growth of in-home care has been praised for expanding long-term care options for people with chronic disabilities, questions surrounding the quality of in-home care have begun to arise. This paper discusses six critical factors that complicate efforts to assure quality including client and provider characteristics, fiscal constraints, inadequate regulation, lack of quality assurance methods, and lack of a coherent social policy for long-term care. A final section of the paper identifies three areas of policy to be addressed if efforts to deliver quality of care are to be successful.