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Most Americans want to remain in their own homes as they age, but safety concerns, limited mobility and difficulty with daily activities can make outside help essential.

As the nation’s older population grows, home care has become an increasingly important part of the healthcare system. More than 4.5 million people work as home health aides or personal care aides across the United States.

Providers gathered on Capitol Hill for National Home Care Advocacy Day on April 9, urging lawmakers to address the industry’s needs and help families afford care.

“Home care is getting more and more focused in the continuum of healthcare,” said Mitch Opalski, CEO of Synergy Home Care of Arlington/Alexandria. “Awareness is a big part of our advocacy. It’s important that people know that home care is vital in keeping people healthy and out of the hospital.”

Home care generally covers nonmedical support, including cooking, laundry, companionship, personal care and help with walking, bathing and other daily activities.

Home health care is different. It must be ordered by a doctor or nurse practitioner and is provided by licensed professionals such as registered nurses and physical therapists. Medicare and Medicaid are the country’s largest payers for home health services, though families also face substantial out-of-pocket expenses.

Opalski said many nonmedical home care services are covered only by specialized long-term care insurance policies, which relatively few people have. Families that cannot pay privately may have to provide the care themselves, go without it or rely on Medicaid.

“What we’re telling Congress is if there’s no government program to pay for our kind of care, if it’s not covered by Medicare, give us some other kind of relief,” he said.

Opalski joined other Virginia home care advocates for meetings with congressional representatives, including staff from U.S. Sen. Mark Warner’s office.

They promoted three proposals aimed at easing caregiving costs:

• The Credit for Caring Act, introduced in the 118th Congress as S. 3702 and H.R. 7165, would provide eligible caregivers with a tax credit of up to $5,000 for 30 percent of qualifying long-term care expenses exceeding $2,000 in a taxable year.

• The Lowering Costs for Caregivers Act, introduced in the 119th Congress as H.R. 138, would allow people to use tax-free health savings and flexible spending accounts for medical expenses incurred by parents and other loved ones.

• The Homecare for Seniors Act, introduced in the 118th Congress as H.R. 1795, would permit tax-exempt health savings account distributions to cover qualified home care services such as assistance with eating, bathing and dressing.

Opalski argued that aides can help manage chronic health conditions by monitoring medication compliance, nutrition, exercise and mental stimulation. That support, he said, can keep people out of hospitals and nursing homes while reducing broader healthcare costs.

The financial strain already reaches deeply into household budgets. An AARP report found that family caregivers spend an average of more than $7,200 annually on caregiving, equal to about 26 percent of their income. Those caring for veterans spend an average of $11,500 of their own money each year.

Opalski pointed to the passage of the Elizabeth Dole Act, following two years of advocacy over home care services for veterans, as evidence that sustained lobbying can produce results.

“The advocacy works,” he said. “It takes time but still it’s worth it to take a day out of our busy lives and go on the Hill and try to keep home care somewhere in the mix.”