When you or a loved one needs help at home, you will often hear the terms home care and home health care and assume they mean the same thing.
They do not.
Both services allow people to receive assistance in the comfort of their own home, and the two often work together. However, they serve very different purposes.
Home health care provides intermittent skilled medical services and requires an order from a physician or other authorized healthcare provider. Home care does not require a doctor’s order and provides the ongoing personal care, supervision, companionship and day-to-day assistance a person may need to remain safely and comfortably at home.
Understanding the difference can help you choose the right type of care. In many situations, a person may benefit from having both home health and home care at the same time.
What Is Home Health Care?
Home health care is skilled medical care provided in a patient’s home.
Home health services require an order from a physician or other authorized healthcare provider and are generally prescribed following an illness, hospitalization, surgery, injury or significant change in health.
For Medicare-covered home health services, the patient must meet Medicare eligibility requirements, including having a need for intermittent skilled nursing or qualifying therapy services.
Home health is designed to address a specific medical or rehabilitation need. It is not intended to provide continuous caregiving, supervision or household assistance throughout the day.
What Services Does Home Health Provide?
Depending on the patient’s condition and medical plan of care, home health may provide:
- Skilled nursing visits
- Medical assessments
- Vital sign monitoring
- Wound care and dressing changes
- Medication assessment and education
- Injections and certain medical treatments
- Monitoring of medical conditions
- Patient and family education
- Physical therapy
- Occupational therapy
- Speech therapy
- Medical social worker services
- Rehabilitation after an illness, injury or hospitalization
- Home safety evaluations
- Limited home health aide services when the patient qualifies
- Assistance with bathing or certain personal care needs when included in the approved home health plan of care
The frequency of home health visits depends on the patient’s medical needs and plan of care.
For example, a nurse may visit once or twice a week, while a physical therapist or other clinician may visit on a different schedule. Some patients may also receive visits from a home health aide for bathing or other limited personal care needs.
The important thing for families to understand is that these are usually individual, scheduled visits. Home health does not normally provide a caregiver who remains in the home for several hours to assist with everyday needs.
Does Home Health Require a Doctor’s Order?
Yes.
Home health is a medical service and requires an order from a physician or other healthcare provider authorized to order home health services.
The provider determines that skilled home health services are medically necessary and establishes or approves a plan of care.
What Is Home Care?
Home care is different.
Home care provides the hands-on, non-medical assistance, supervision and companionship people need in their everyday lives.
Most importantly:
You do not need a doctor’s order to start home care.
A client, family member or responsible party can contact a home care agency directly to discuss services and arrange care based on the individual’s needs.
At Experienced In Home Care, we can meet with the client and family, discuss their needs, complete an in-home evaluation and develop an individualized care plan.
Home care can be provided for several hours at a time, throughout the day, overnight or around the clock depending on the client’s needs.
What Services Does Home Care Provide?
Home care can assist with many of the daily activities that home health does not provide on an ongoing basis.
Services may include:
- Bathing and shower assistance
- Personal hygiene
- Dressing and grooming
- Toileting assistance
- Incontinence care
- Assistance transferring from a bed, chair, wheelchair or commode
- Walking and mobility assistance
- Fall-prevention supervision
- Safety monitoring
- Companionship
- Dementia and memory care assistance
- Meal planning
- Meal preparation
- Encouraging proper nutrition and hydration
- Medication reminders
- Light housekeeping
- Laundry
- Changing bed linens
- Grocery shopping
- Errands
- Transportation
- Assistance getting to medical appointments
- Accompanying clients to appointments
- Assistance with everyday routines
- Respite care for family caregivers
- Assistance following hospitalization or rehabilitation
- Overnight care
- Extended-hour care
- 24-hour care when needed
- Care management and coordination
- Communication with family members and healthcare professionals when appropriate
Home care helps fill the gaps between skilled medical visits and provides the ongoing assistance many older adults need to remain safely at home.
A Simple Example of Home Health and Home Care Working Together
Suppose an older adult returns home after being hospitalized or spending time in a rehabilitation facility.
Their physician may order home health care.
A home health nurse may visit periodically to:
- Assess the patient’s medical condition
- Check vital signs
- Evaluate medications
- Provide wound care
- Educate the patient and family
- Communicate medical concerns to the physician
A physical therapist may also visit to work on:
- Walking
- Strength
- Balance
- Transfers
- Rehabilitation exercises
If appropriate, a home health aide may also visit to provide limited assistance with bathing or personal care.
But once the home health visit is over, the patient may still need help for the remainder of the day.
They may need someone to:
- Help them safely get out of bed
- Assist them to the bathroom
- Prepare breakfast, lunch or dinner
- Help them dress
- Remind them to take medications
- Encourage fluids
- Prevent falls
- Provide supervision
- Take them to appointments
- Pick up groceries
- Do laundry
- Provide companionship
- Remain with them because they are confused or unsafe when left alone
Those are home care services.
This is why home health and home care frequently work together rather than replacing one another.
Home Health Companies We Have Worked Alongside
Over the years, Experienced In Home Care has worked alongside and coordinated care with a number of home health organizations in the San Diego area.
Some of these have included:
- Tri-City Home Health
- Silverado Home Health
- Kaiser Permanente Home Health
- Seaport Scripps Home Health
The home health company and the home care company are separate organizations, but they can communicate and work together to help provide continuity of care for the client.
For example, a home health nurse may identify a medical concern during a skilled nursing visit, while the client’s home care aide may be present for several hours each day and can report changes in the client’s condition to the appropriate family member, agency nurse or healthcare provider.
Home Health Does Not Replace Home Care
This is one of the most common misunderstandings we hear from families.
A physician may tell a patient that they are being discharged home with “home health,” and the family understandably assumes someone will be at the house for several hours every day.
That usually is not what home health means.
Home health generally provides intermittent skilled medical visits, not a caregiver who remains in the home for several hours assisting with meals, housekeeping, supervision, errands, companionship and everyday personal care.
A home health nurse may come to assess the patient, perform wound care or provide another skilled service and then leave when that visit is completed.
The patient may still need someone there for the rest of the day.
That is where home care comes in.
Home health and home care often complement each other very well. The home health team addresses the patient’s skilled medical and rehabilitation needs, while the home care team assists with the person’s daily routine, personal care, safety and quality of life.
Does Medicare Pay for Home Health Care?
Medicare may cover qualifying home health care when the patient meets Medicare’s eligibility requirements and receives services from a Medicare-certified home health agency.
Covered services may include:
- Intermittent skilled nursing
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Medical social services
- Certain home health aide services when eligibility requirements are met
However, Medicare generally does not pay for continuous supervision, 24-hour care in the home, routine housekeeping, meal preparation, shopping, companionship or ongoing personal care when those are the only services a person needs.
How Is Home Care Paid For?
Home care is generally paid for differently than Medicare home health.
Common payment options include:
- Private pay
- Long-term care insurance
- Other qualifying programs or benefits when applicable
Long-term care insurance policies may reimburse for home care services when the policyholder meets the requirements of their individual policy.
Our office can also work with families who have long-term care insurance and help provide the documentation commonly requested by insurance carriers.
Quick Comparison: Home Care vs. Home Health Care
Home Health Care
Doctor’s order required: Yes
Primary purpose: Skilled medical and rehabilitation care
Typical providers: Registered nurses, licensed vocational nurses, physical therapists, occupational therapists, speech therapists, medical social workers and home health aides
Visit length: Generally shorter, intermittent visits based on medical necessity
May include: Nursing, wound care, therapy, medical monitoring, education and limited home health aide assistance
Medicare: May be covered when eligibility requirements are met
Home Care
Doctor’s order required: No
Primary purpose: Ongoing assistance with everyday living, personal care, supervision and companionship
Typical providers: Registered Home Care Aides and care management staff
Visit length: Can range from several hours to extended shifts or 24-hour care depending on need
May include: Bathing, dressing, toileting, transfers, meal preparation, transportation, errands, housekeeping, companionship, dementia care and safety supervision
Payment: Typically private pay, long-term care insurance or other qualifying benefits
Which Type of Care Do You or Your Loved One Need?
A simple way to think about it is:
If you need a nurse or therapist for a medical or rehabilitation need, you may need home health care.
If you need someone to help you safely get through your day, you may need home care.
And many people need both.
For example, a person recovering from a hip fracture may receive physical therapy through home health while also having a home care aide present to assist with bathing, dressing, meals, toileting, transportation and fall prevention.
The two services can work together to help make staying at home safer and more manageable.
Experienced In Home Care: Serving San Diego County
Experienced In Home Care is a family-owned, locally operated home care agency, licensed by the State of California as a Home Care Organization, serving seniors and families throughout San Diego County.
Our Registered Home Care Aides are background checked through the State of California, and our agency is bonded and insured.
We provide care ranging from shorter scheduled shifts to extended and 24-hour care based on the client’s individual needs.
A doctor’s order is not required to contact us or arrange home care services.
If you’re unsure whether you or your loved one needs home care, home health care or a combination of both, we are happy to help explain the difference and discuss what may work best for your family.
Call Experienced In Home Care at 760-941-CARE (2273) to learn more or schedule a free in-home consultation.
Experienced In Home Care, Inc.
217 Civic Center Drive, Suite 5
Vista, CA 92084
California Home Care Organization License #374700153
Home Care vs Home Health: Which One Do You Need?
If the need is help with daily activities, safety, or company, home care is the place to start. If a doctor has ordered nursing or therapy, that is home health. If you’re not sure, call us at (760) 941-2273. A nurse can talk it through with you and schedule a free in-home evaluation.