Home Care Is … Or Is It Home Health?

There is a lot of jargon out there when it comes to health and well-being. Until someone is giving or receiving a particular service, they may not know the subtle ways in which similar-sounding services actually differ.

Home care and home health care are often mistaken for one another, but are in fact distinctly different in the types of services provided and how they are paid for by clients or patients. To make things a little more complicated, these services can overlap and complement one another so they are not mutually exclusive.

What Is Home Care?

The need for home care often arises when an individual struggles with completing Activities of Daily Living (ADLs) such as daily hygiene, light housekeeping, meal preparation and more or Instrumental Activities of Daily Living (IADLs) such as grocery shopping, paying bills, transportation and more. This care is categorized as custodial care or personal care or companion care.

Home care is typically delivered by caregivers, who ideally have received training so that they are able to deliver meaningful, safe and quality care to their clients. Home care is sometimes referred to as “unskilled” care because an advanced, clinical degree is not needed in order to provide companion care and personal care.

Who Needs Home Care?

A person living with a chronic condition or degenerative disorder such as MS, Parkinson’s or COPD may need help with ADLs or IADLs, or someone who, due to age, may need additional help at home. People living with developmental disabilities may also need assistance in the home. These groups of people may also benefit from the companionship of an in home caregiver who visits on a regular basis to go for a walk, play a game, or help run an errand.

Home care services can be delivered in a private single-family home or in an assisted-living facility which may not have enough staff to provide optimal one-on-one care.

Who or What Pays for Home Care?

You may have heard that home care costs are not covered by insurance, but this is only partly true. Home care is covered by some long-term care insurance policies, but is not covered by health insurance. Low-income seniors on Medicaid may qualify for home care services too. The majority of people pay for home care costs out of pocket, or what is called “private pay.”

What is Home Health Care?

A health care provider prescribes home health care services to be delivered by a registered nurse (RN), occupational therapist (OT) or physical therapist (PT) in order to extend services in the home after a hospitalization.

A PT, OT or RN may come to the home of a patient to do medical tests, wound care, manage medication prescriptions, physical therapy exercises and more. There are times when these appointments take place at a medical office and that is when an in home caregiver can assist with transportation. Other times, an in home caregiver may be needed to help a client bathe and dress to be ready for their home health care appointment as those services are not included with a PT, OT or RN.

Who Needs Home Health Care?

After a surgery or hospitalization, a patient may be discharged and allowed to return home but may not be ready to live independently again. Physical therapy or occupational therapy may help them get back on their feet, so to speak.

Who or What Pays for Home Health Care?

Home health care is covered by medical insurance, including Medicare and Medicaid. It is an option to pay privately for these services, but that is rare since they are generally covered through insurance. Note that like any prescription there are limits to how frequent and how long care can be provided, and a doctor will need to review current progress and condition of a patient to determine if additional home health care is necessary.

In many instances families will create a long-term care plan that includes a variety of services including family caregivers, home health care, and private pay home care so that their loved ones get the most complete care possible.