Home care and home health are distinct types of care which are both provided in a home setting, but most people aren’t aware of the differences and use these terms interchangeably. The key difference is that “home care” is non-medical care and “home health” is medical care.

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 two 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.

HOME HEALTH CARE

Home health care is clinical medical care provided by an registered nurse, occupational therapist, physical therapist or other skilled medical professionals, and is often prescribed as part of a care plan following a hospitalization.

HOME HEALTH SERVICES

Home health care services include:

Therapy and skilled nursing services

Administration of medications, including injections

Medical tests

Monitoring of health status

Wound care

WHEN TO USE HOME HEALTH

Situations in which home health is prescribed include:

Following an inpatient hospitalization, rehabilitation, or a stay at a skilled nursing facility – to help the senior transition back to independence

When a senior has had a recent medication change, in order to monitor for side effects and assure a new medication is effective

When seniors experience an overall decline in functioning – in order to help them to regain independence through therapy or learning new skills to compensate for their deficit.

HOW TO PAY FOR HOME HEALTH

Since it is considered medical care, home health is covered by medical insurance, including Medicare and Medicaid.

Covered by Medicare when prescribed by a physician

Medicaid for qualified individuals

Private pay (in rare cases when home health is not prescribed, but a senior desires such services)

HOME CARE

Home care is provided by caregivers, usually called home care aides, who are trained and licensed to provide in-home care. Home care aides can help older adults with activities of daily living, or just offer some friendly companionship. Unlike home health, home care is classified as personal care or companion care and is considered “unskilled” or “non-clinical.”

WHEN TO USE HOME CARE

You might consider hiring a home care aide for older adults who:

Need assistance with activities of daily living ranging from personal care (hygiene, incontinence care, etc.) to meal preparation

Do not drive and require transportation

Live alone, may be at risk for social isolation and need companionship

Adults at risk for wandering such as individuals with Alzheimer's and Dementia

HOW TO PAY FOR HOME CARE

Private pay

Long-term care insurance

Medicaid for qualified low-income seniors

HOME CARE SERVICES

Services provided by home care aides may include:

Meal preparation

Laundry & Light Housekeeping

Helping dressing, bathing and grooming

Transportation

Medication Reminders

Running Errands

Companionship

HOME HEALTH & HOME CARE COMPARISON

Home health and home care are not mutually exclusive services. Many families find that utilizing these services in tandem best help a senior who, for example, is recovery after a hospitalization. The home health staff address clinical and rehabilitative needs during the transition home, while a home care aide can help with personal care-giving and household chores that the senior requires assistance with during his or her recovery.