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Home Health Care vs. In-Home Care: What Your Patients Should Know (US)

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To an untrained ear, the terms “home health care” and “in-home care” can sound awfully similar. Because it’s easy for clients and patients to mistake one for the other, you may need to help them understand the differences. Explaining when each type of care may be needed, costs involved and resources available can help them make informed care decisions. Use the following points to help provide an easy breakdown for your senior patients and their families.

In the U.S. as the healthcare system continues to migrate from a fee-for-service-based system to a value-based payment model, the utilization of in-home care will likely increase as the care services provide can add value to the model and help mitigate the risk of hospital readmissions for elderly high-risk patients.

What is Home Health Care?
Home health care refers to care provided in the home by a licensed medical professional, such as a nurse or physical therapist. Generally, home health professionals are only authorized to perform the tasks prescribed by the senior’s physician.

When Home Health Care Is Needed
Medical home health care consists of a home health aide, supervised by a nurse or other medical professional, who has certified training to provide medical care. This care is done in the senior’s home for about one hour per day. Care provided can include:

  • Post-op Rehab
  • Skilled Assessments
  • Occupational, Physical or Speech Therapy
  • Wound Care
  • Mobility Training
  • Pain Management
  • IV Therapy/Injections

How In-Home Care Differs from Home Health Care
In-home care focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy. These activities can make up the remaining 23 hours of a day when a home health aide is not providing medical care. Family members or professional caregivers who do not have a medical license generally can perform these tasks.

When In-Home Care Is Needed
In-home care focuses on four key factors: Cognitive, Functional, Social, Wellness. Each factor supports various elements that impact a senior’s daily life including physical activity, social interaction, emotional well-being, and brain health to name a few.

8 In-home Care Needs from Home Instead

Home care aides and caregivers can help reinforce prescribed care instructions and act as the eyes and ear within a senior’s home. Many professional caregivers, including those from Home Instead, are specially trained to meet the needs of older adults.

Providing assistance with the following care tasks are examples of in-home care services:

  • Safety Assessments
  • Reinforce Plan of Care Compliance
  • Transferring
  • Toileting/Bathing
  • Continence Care
  • Medication Management/Reminders
  • Companionship
  • Meal Preparation/Hydration
  • Light Housekeeping
  • Transportation
  • Alzheimer’s and dementia care

Having someone to help senior clients with these care tasks and ADLs may help the senior avoid a preventable hospitalization. According to the Value of Home Care report, the U.S. saved as much as $25 billion in hospital costs in 2008 alone due to the growth of home care services over the previous decade.

Where to Find Personal In-Home Care
There are three options for finding the right in-home care.

  • Private Caregiver. This can be a family member or friend and is a relationship, including payment for care provided, is managed by the senior and/or senior’s family. The caregiver may or may not have caregiving training.
  • Registry. This model connects caregivers with clients, placing a caregiver in the home as an independent contractor. The senior and/or senior’s family is usually responsible for payment, scheduling, payroll taxes and possible work-related injuries of the caregiver. The caregiver may or may not have caregiving training.
  • Employer/Employee. This model minimizes client/provider risks as background checks, training, bonds and insurance are taken care of by the employer or caregiving agency. Professional office staff provide local support including: care team approach, skills assessments and certifications, legal support, ongoing training.

Seniors and their families should evaluate their options to find the best fit based on the senior’s needs, level of comfort and cost.

A Combination of Care Services
Often seniors and their families find a team approach of using in-home care services to supplement home health care services provides the best solution. Also, seniors and their families should be aware that there might be some overlap between services provided by the two types of care. Both may involve assistance with activities of daily living (ADLs) such as meal preparation for specialty diets. Before hiring an agency to provide services, seniors and their families should know exactly what types of care the agency’s professionals can provide, along with how they are trained.

Additional Cost and Care Considerations
Needs. The type of care services a senior patient should obtain depends on his or her needs. There could be issues related to medication, activities of daily living (ADLs), medical equipment, dietary or activity restrictions, along with other recommendations that should be considered. Families also must consider how much help they’re able to provide, especially if they don’t live close by or have other obligations. In addition to consulting with a senior loved one’s medical providers, here is a helpful checklist for families to assess the amount of care their senior loved one may need before a senior moves from hospital to home.

Coverage. What may be covered by insurance and what a doctor and family believe a patient needs may not be the same thing. The family should review the coverage of any supplemental, Medicare Advantage or long-term care insurance the patient holds. If unable to locate a policy, contacting the insurance provider(s) directly is a good place to try. The Navigating Long-Term Care Insurance Guide can help seniors and their families. They can also find information about Medicare coverage at

Seniors and their families should especially take note of what isn’t covered by Medicare. According to the Centers for Medicare & Medicaid Services (CMS), Medicare doesn’t cover 24-hour-a-day care, meal delivery, homemaker services like shopping and laundry if that’s all the patient needs, or personal care like bathing and dressing if there is not a skilled component already in the home. A skilled component requires a therapy completed by a clinician such as a nurse or therapist.

Costs. Be aware of copayments. Even if the senior has insurance, there may be some out of pocket expense for whatever care is provided. For instance, according to CMS’s Medicare and Home Health Care booklet, patients will have to make a 20 percent copayment for approved medical equipment.

Here are additional resources to share with your senior patients and their family members so they may make the best care decisions possible regarding home care.


Last revised: December 5, 2018

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Thoughts and stories from others
  1. February 18, 2019 at 1:34 pm | Posted by Betelihem Ergetie

    In-home care focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy and home health care refers to care provided in the home by a licensed medical professional.


  2. December 27, 2018 at 1:49 pm | Posted by Sister Kathy Weber

    Thank you for this information. It is helpful for professionals as well as family members.


  3. July 18, 2013 at 6:51 pm | Posted by Eileen Bostwick

    There are many organizations that provide non-medical in-home care. One of those that is not commonly known is the Senior Companion Program, a Senior Corps program under the Corporation for National and Community Service, a federal agency. Senior Companion Programs are not found in all areas of the nation, but a number of programs exist. They train older adults (age 55 and up) and place them through a local agency with several clients. These volunteers are dedicated, compassionate, competent, well-trained individuals. The minimum commitment for a SC volunteer is 15 hours a week, but many serve 20 or more hours. There is no cost to have a Senior Companion and the SC volunteer receives a small, tax-free stipend presently $2.65 an hour as an enabler to serve as well as a transportation reimbursement and supplemental insurance. Senior Companions do not bathe or toilet clients, but they can provide transportation to medical appointments and errands like grocery shopping, going to the bank or to a hair cut. They do provide companionship for isolated, lonely older adults. They can prepare light meals and do light housework. They are not chore workers. For more information on the program go to: On the home page under the programs tab is information on the 3 Senior Corps programs. Click on SCP and you will learn how to see if the program is available in your area.


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