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Among the increasing number of women who survive breast cancer, many older, long-term survivors remain frail. A new study out today in the Journal of the National Cancer Institute shows that in a given year, over half of these highly frail survivors had no Medicare home health care.

"When you beat cancer, it's a powerful moment—often a bell is rung on the ward and everyone celebrates. But once home, survivors face health challenges compounded by aging to the point where a lot of them still need help at home years later," said lead author Dr. Xuanzi Shirley Qin, an expert in access to cancer care and Medicare and an assistant professor at UMD's School of Public Health.

"We investigated whether frail survivors who are further out from their diagnosis had Medicare-covered home health care and found that in a given year, about 6 in 10 highly frail survivors had none."

Traditional Medicare covers personal care at home only when it is tied to a skilled need, and only for people who are homebound. So survivors who mainly need help with bathing, dressing and other personal care, or who are not homebound, fall outside of this coverage.

"This means many very frail people whose needs are mainly personal care may fall through the gap. Without support at home, this group can face heightened risk of falls or hospital stays," said Qin.

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