When someone thinks about home care, they assume home care and home health care are one in the same, but that is not the case. Below is a side-by-side comparison of these services.
|Service||Home Care||Home Health Care|
|Help with Activities of Daily Living||
|Personal Care – grooming, dressing, bathing||
|Home Therapy – speech, occupational, physical||
|Payment Options||Private Pay, Long Term Care Insurance||Medicare, Medicaid, Veterans Benefits|
Home care services are non-medical and provide companionship and assistance with activities of daily living. These services do not require a prescription from a doctor and are most often paid for out of packet, but can also be covered through a long term care insurance policy. It is possible for a total bed bound patient to receive home care, but additional help would need to be provided to set up medication boxes or administer any sort of injections or therapy. Home care aides can provide bed baths, lights housekeeping, help with dressing, assistance with those using disposable undergarments, meal prep as well as transportation. These services can be provided from four hours a day up to 24 hours a day.
Home health care refers to medical skilled services that require a written order from a doctor. This type of care is usually ordered for someone who may be recovering from an injury or operation on a more short term basis than home care; patients are often coming home after a stay in a hospital or rehab facility and need extra support at home while they are recovering. All in home therapy and IV treatments are included. This service is primarily paid for by Medicaid, usually up to 8 hours a day, depending on the doctor’s orders. Medicare will cover a few skilled services, but normally not more than one or two hours per day.
It is possible to receive a combination of these two services and it is often beneficial to do so, as home health care cannot be provided for 24 hours a day. When looking for care at home it is best to understand what type of care you will need to make the best decision for you are your loved one.
The Difference Between Home Care and Home Health Care
The terms home care and home health care are not as interchangeable as they might seem. This makes it confusing for individuals searching for the right type of care – and the right care providers.
At the most basic level, home care refers to any services that help to keep an individual safe and comfortable in their own home – without requiring any specific healthcare treatments provided by the home care aid.
Home care services can also provide peace of mind for children or grandchildren who live too far away from loved ones to schedule regular visits.
These services are most often requested to help a senior age in place. It is important to note that non-medical home care services are not covered by insurance unless they’re advised by a doctor under specific, temporary circumstances (more on that in the next section). General home care expenses are usually paid out of pocket, although they’re significantly more affordable than moving into an assisted living or nursing home community.
Home health care refers to home care that involves more skilled, medical assistance. In this case, the individual has a medical condition or is in some version of post-surgical or outpatient status, requiring assistance from a licensed medical care provider.
In many cases, home care needs precede home health care needs. But, a perfectly young and agile person may require home health care after a specific surgical procedure, or following their hospital, rehabilitation center or skilled nursing facility stay, until they recover and can take care of themselves again.
What Services are Included in Standard Home Care?
Again, home care services are available for those who find it a challenge to execute the activities required in basic, day-to-day life. Without assistance, they would find themselves at risk for injury, malnourished, more prone to depression and may experience diminished mental, physical and/or emotional health without the support of a compassionate caregiver.
Home care services also include options, such as:
Even those who enjoy living alone get lonely, and that loneliness intensifies if you’re housebound, let alone if you’re mostly chair- or bedbound. Companionship is one of the most requested home care services.
Within the “companionship” umbrella lives everything from attending social engagements together, playing cards, reading, listening to music, gardening, walking the dog, listening to stories, crafting and other activities desired by the client.
Memory lapses are normal as we age, even without dementia or Alzheimer’s. This is compounded for seniors who’ve been retired for a while because it’s easy to lose track of dates or days without a daily work routine.
While a home care aid cannot legally administer medications (that falls into the health care department), they can remind seniors to take their meds as prescribed and call in/pick up medication refills.
Cleaning the house, changing sheets and doing laundry, watering plants, taking care of pets, reorganizing closets and cabinets so they’re more accessible, and more – general housekeeping services can help to conserve energies so seniors have more interest and stamina for more enjoyable activities and hobbies.
Regular house cleanings also ensure living conditions are safe and sanitary, that burned out light bulbs are replaced and that responsible parties are alerted when maintenance issues need to be addressed.
Grocery Shopping & Meal Prep
Cooking for one is rarely any fun. It also requires a lot of energy to prepare, cook and clean up. Add that to the fact that many seniors can’t get to the grocery store easily and you can see why malnourishment, bone density loss and weakening of muscles and joints is a risk for seniors who live alone or are not capable of preparing healthy meals.
Grocery and meal prep services ensure there are always healthy foods and snacks available, as well as delicious, easy-to-heat meals so seniors can have three square meals per day. Home care aids are also happy to keep clients company while they eat, which promotes better appetites.
Basic hygiene and toileting
Basic hygiene is another thing that can slip by the wayside as one day fades into another, or if stiff joints or a fear of falling make it more difficult to get dressed or take regular showers.
A caregiver is happy to assist with these basic, daily necessities. Not only is it nice to be bathed and dressed, caregivers can also style hair, trim and file nails, put on accessories, etc., so seniors can feel like themselves again.
These are some of the most requested home care services. Visit our At Home Care Services Guide for more information about the ins-and-outs of standard home care services.
What Are Home Health Care Services?
Home health care services are typically provided after a person has had an inpatient stay – or an outpatient surgery – and are either unable to get to follow-up appointments on their own and/or are unable to perform any of the basic recovery recommendations prescribed by their physician or surgeon.
In this case, a doctor’s referral allows the client to contract with a licensed home health care agency who will send out the appropriate caregiver, ranging from RNs, LVNs, CNAs and occupational or physical therapists.
Because the services are medical in nature, they may be covered by Medicare, Medicaid and/or a private health insurance carrier, depending on the specifics of your case and the policy.
These services include:
Medical case management
Usually, under the remote advisement of a physician, an RN is assigned as a medical case manager. The manager will check-in regularly to monitor the patient, read caregiver notes, make changes as necessary and discuss the case with the doctor if it’s felt further intervention/prescription changes are needed.
Under the RNs supervision, other members of the health care team provide medical care on a daily or multiple-days per week basis. Depending on the medical treatment provided, medical care may consist of things like:
- Wound care and dressing changes
- Catheter care
- Administration of medications
- Intravenous (IV) care
- Parenteral nutrition (PN)
- Patient and caregiver education
- Occupational and/or physical therapy
- Medical equipment such as hospital bed, showering aids, oxygen, bedpans, etc.
This medical-care-at-home model provides care that is equivalent to the level of care provided by a hospital, outpatient surgical care center, rehabilitation center and so on, but it tends to cost less.
Studies show that the home health care services make a notable difference in hospital readmission rates. Plus, it’s a rare patient who prefers to recover in a hospital when home health care is an option.
Home Care Services Often Overlap with Home Health Care Services
It’s not uncommon for home care services to overlap with home health care services. Sometimes the one leads into the other, other times a person who had home health care services never fully recovers to their original “self.” Employing home care providers’ assistance can improve the client’s quality of life.
Here is a very typical example of how home care services can merge with home health care services: Let’s say Mary is an 80-year old woman who enjoys bi-weekly visits from a home care provider. She’s employed the same caregiver for three years and they have an established, caring bond.
Mary undergoes a knee replacement and experiences a few complications. The doctor allows her to return home but prescribes home health care services to help her with the recovery instructions and aspects of basic care that Mary isn’t able to perform on her own.
At this point, any of those services recommended by her doctor for the recovery periods (bathing/hygiene, meal preparation, etc.) previously handled by her licensed, home caregiver may now be covered by her insurance – along with the medical home health care services that are provided by a licensed home health care provider.
Once Mary is fully recovered, the doctor will sign off on the health care aspect of her services. The medical care providers will phase out, while her home care provider will likely remain in place, paid for by Mary once again.
Do you have a senior loved one who would benefit from home care – either to age-in-place or to augment their home health care services? Contact us here at Georgetown Homecare.
Our compassionate team will work with you to personalize our services to meet the client’s needs, and we’re also happy to partner with your home health care team to improve the level of care provided for your loved one.