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Home Health Care vs. Home Care

Most physicians and nurses understand the difference between Home Care and Home Health Care. But to the public, these services are sadly synonymous. But these terms are entirely different in the healthcare industry. Home Health Care tends to be short-term in nature, involves skilled care, and is covered by Medicare. Home Health Care is often referred to as “skilled” or “certified.”

home care and companionship

Home Care tends to be long term in nature, involves unskilled care and is not covered by Medicare. Home Care is also called “non-medical”, “in-home”, “unskilled” and “custodial.”

For clarity, when you see Home Health Care think of it as “skilled care” or “medical.” When you see Home Care think of it as “”unskilled care” or “non-medical.” Many of you will recognize that unskilled care is very demanding and requires its own special skills. Be that as it may, “unskilled” is often the term used to describe Home Care.

Because it’s easy for the public to mistake one for the other, all of us in the healthcare industry need to help the public understand the differences in terms of when each type of care may be needed, costs involved and resources available so they can make informed care decisions.

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. It is usually prescribed after a hospital visit and is targeted by the physician as a specific need, such as IV therapy. Other types of medical care that fall under the home health category include wound care, pain management, injections, occupational therapy, physical therapy and skilled nursing. If any skilled care is needed, the physician will write an order for the service with a definite time period, usually short term in nature, i.e., “IV therapy for 2 weeks.” At the end of the period, the physician will reevaluate the order.

How Does Home Care Differ from Home Health Care

Home Care focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy. Family members or professional caregivers who do not have a medical license generally can perform these tasks.

The tasks include things like:

  • bathing
  • transferring
  • toileting
  • continence
  • medication management
  • companionship
  • meal preparation
  • light housekeeping
  • transportation
  • errands

Recognizing and Solving the Needs for Home Health Care and Home Care

The need for Home Health Care is very clear as the physician has to order it and he usually assigns this order to 3 specific agencies. In most cases it is the physician who recognizes the need. However, unskilled Home Care is often overlooked as a real solution for seniors. In many cases, unskilled Home Care is the missing piece of the puzzle!

Physicians, nurses and social workers may be reluctant to suggest Home Care for a number of reasons:

  1. Home care is an additional expense for the senior and it is usually not covered by Medicare. These professionals know that it may be an added financial burden for the senior.
  2. The Medicare rules that cover Home Health Care prevent these professionals from referring a specific agency. Under freedom of choice rules, physicians and nurses may fear the repercussions of referring an agency in violation of Medicare rules. Although these rules do not apply to Home Care, this attitude carries over and hinders their ability to recognize the need and suggest Home Care.
    Home Care by its nature is Non-Medical and that is not their realm.
  3. These factors along with the additional cost of Home Care mean that it is often overlooked. However Home Care can be a vital part to the recovery procedure. By way of an example:

Mrs. Smith had knee surgery. After the surgery, she was sent home with orders for physical therapy and given the names of 3 agencies that provide Home Health Care. This order is for Skilled Care and was covered by her Medicare policy. Physical Therapy is a skilled need, and not custodial or Home Care.
Mrs. Smith is recovering well but decides to feed her dog. Long story short, she trips over her dog and is readmitted to the hospital. However, had her physician suggested she supplement her Home Health Care with Home Care, this fall may have been prevented altogether. This saves money and aggravation for Mrs. Smith as well as a readmittance to the hospital and all the associated costs.

All of us in the healthcare industry need to recognize the confusion regarding Home Health Care and Home Care and help seniors understand the difference. Through education, family and friends can understand and help recognize the need for their loved ones. Physicians, nurses and social workers need to recommend a team approach of using non-medical in-Home Care services to supplement Home Health Care services for more and more cases.