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Home Health vs. Home Care: Understanding the Differences

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Many older adults prefer to age in place or return home after a hospital or rehabilitation stay. In fact, 9 out of 10 older adults age 65+ hope to remain at home. However, for many (about 70%) assistance will be required at some point. When considering help in the home, many aging adults and their families do not understand the types of care available and their benefits.

Older adults, family caregivers and even professionals commonly recognize the term “home health,” but may not fully understand how this service differs from “home care.” These are two important services that can help make aging in place a reality for many. The confusion happens when home care is grouped with home health care. It is important to consider that while the two services are complementary, they provide different types of care.    

What is Home Health Care?

Home health care is prescribed by a healthcare provider as a medically necessary service. Depending on the individual’s needs, home health care can be provided by a combination of medical professionals, including physical therapists, occupational therapists, social workers, registered nurses or home health aides. These medical professionals are limited to the task at hand, making home care a nice option for additional support. Home health care may be covered by traditional Medicare in specific circumstances for a limited amount of time. Private health insurance may also cover home health care.

What is Home Care?

The home care industry was once seen as non-skilled or non-medical care, such as companionship, transportation or light housekeeping. Now agencies are expanding their offerings to include a range of specialized care, and even clinical services. Home care is provided by trained professionals who assist with a range of services, including personal care, activities of daily living (ADLs), medication management and administration, home helper activities, transportation and memory care support. Like home health care, these services are customizable based on each individual’s needs. The flexibility of home care allows for services to be provided in a variety of settings, including the home, assisted living communities and skilled nursing facilities. Traditionally, home care has been private pay but now may be covered by other funding sources such as long-term care insurance or some Medicare Advantage policies.

Home Care, Home Health Care or Both: When to Use Which Service

Gaining a better understanding of the differences between home health and home care can help to ensure the older adult receives the adequate support to achieve set goals. The following are several examples of how home health and home care are used – separately or together.

Example 1 – Home Health Care: Mrs. Smith had post-surgical complications that resulted in an open wound on her lower leg. Her physician ordered wound care every other day by a home health nurse. In this case, a nurse came to Mrs. Smith’s home to complete the specified care to her wound. The nurse did not provide any other services while in the home. Mrs. Smith could walk with a walker and was steady, so she could complete her other care needs. Her daughter took her to follow-up appointments until her wound healed. 

Example 2 – Home Care: Mr. Thomas had recently been hospitalized for congestive heart failure (CHF). He returned home but was asked to self-monitor his condition, specifically weight fluctuations. A change in weight indicated fluid retention and required a change in medication. He was also advised to wear compression stockings. Mr. Thomas had limited mobility and mild cognitive impairment. His son lived in town but worked full-time and could not help on week days. The assistance that Mr. Thomas needed did not qualify him for home health services but the social worker at the hospital recommended home care services. Each weekday morning, the home care professional assisted Mr. Thomas in checking his weight and putting on his compression stockings. If there was a significant change in his weight, the home care professional contacted Mr. Thomas’ healthcare provider to ensure medications were adjusted accordingly. The support he received from home care services also included meal preparation and assistance with household tasks.

Example 3 – Home Care and Home Health Care: Mrs. Jones had hip surgery and returned home instead of going to a rehab facility. During her recovery, home health came to provide physical therapy. In this case, the physical therapist came a few times per week to assist with mobility exercises. Mrs. Jones had no children or family nearby, so she temporarily hired home care to assist with meal preparation and grooming. The home care professional also reminded Mrs. Jones to continue the physical therapy exercises on days when the physical therapist did not visit, offered medication reminders, accompanied her to medical appointments, assisted with laundry and did the grocery shopping

To learn more about the differences between home health and home care, you can watch this webinar and earn a free Continuing Education (CE) credit*. For more about how home care services can support families after a hospitalization or assist with safe aging in place practices, visit www.HomeInstead.com.

*CE credits are only available for 60 days following the live webinar event.

Last revised: July 9, 2020

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