Home care vs. home health: what each one is and when you need both

A discharge planner says 'we have set up home health.' A daughter hears 'someone will be there.' Two days later she learns that home health is a nurse visiting for 45 minutes on Tuesdays and Fridays, and her father is alone the other 166 hours of the week. This happens constantly, and it is the reason we explain the difference to every family we meet.

Home health

• Skilled, medical care: nursing, physical therapy, occupational therapy, speech therapy, wound care, injections, IV management.
• Ordered by a physician and delivered by a licensed home health agency.
• Intermittent visits, usually a few times a week for a few weeks.
• Typically covered by Medicare or health insurance when medically necessary.
• Ends when the patient reaches their goals or stops improving.

Home care (what we do)

• Non-medical help with daily life: bathing, dressing, meals, mobility, medication reminders, transportation, housekeeping, companionship, supervision.
• Arranged by the family directly; no physician order required.
• Scheduled for as many hours as needed, from a few per week to 24 hours a day.
• Paid privately or through long-term care insurance or veterans benefits. Not covered by Medicare.
• Continues as long as the family wants it to.

When you need both

After a hospitalization, the most common right answer is both at once. Home health handles the wound, the therapy exercises and the medication changes. Home care handles everything else: getting safely to the bathroom, meals that follow the diet order, rides to the follow-up appointments, and someone present when the nurse is not. The two agencies should talk to each other. We do, with the family's permission, and we share our visit notes with the home health nurse when it helps.

How to tell which one someone is offering

Ask two questions. Is this ordered by a doctor and billed to Medicare? That is home health. Will someone be in the home for the hours I choose to help with daily activities? That is home care. If the answer to the second question is what you need and the discharge planner has only arranged the first, call us before your parent comes home.