Hospice and Home Health and Home Care. Oh my!

For seniors and their families, understanding the difference between hospice, home health and home care may not be frightening, but it can be overwhelming.

The below statements are both correct and incorrect:

Mom is going home with home health so she already has a home care service provider.

Dad is on hospice, but hospice isn’t here all day.

The home care company isn’t providing the physical therapy mom needs.

The above statements are not uncommon. Hospice, home health and home care are sometimes used interchangeably. Although sometimes the words can be used to describe the other, it’s important to understand the differences. We will attempt to provide clarity.

Before going into the particulars, please see the below table for a high-level comparison:

Home Care Services

According to Medicare.gov, depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:

  • Doctor services
  • Nursing care
  • Medical equipment (like wheelchairs or walkers)
  • Medical supplies (like bandages and catheters)
  • Prescription drugs for symptom control or pain relief
  • Hospice aide and homemaker services
  • Physical and occupational therapy
  • Speech-language pathology services
  • Social work services
  • Dietary counseling
  • Grief and loss counseling for you and your family
  • Short-term inpatient care (for pain and symptom management)
  • Short term respite care
  • Any other Medicare-covered services needed to manage your pain and other symptoms related to your terminal illness and related conditions, as recommended by your hospice team

Home Health or skilled home health is a Medicare benefit program. Home health is provided during 60-day episodes. According to Medicare, in order to be eligible for home health, the following criteria must be met:

  1. You must be under the care of a doctor, and you must be getting services under a plan of care established and reviewed regularly by a doctor.
  2. You must need, and a doctor must certify that you need, one or more of the following.
    1. Intermittent skilled nursing care
    2. Physical therapy
    3. Speech-language pathology services
    4. Continued occupational therapy
  3. The home health agency caring for you must be approved by Medicare (Medicare-certified).
  4. You must be homebound, and a doctor must certify that you’re homebound. To be homebound means the following:
    1. Leaving your home isn’t recommended because of your condition.
    2. Your condition keeps you from leaving home without help (such as using a wheelchair or walker, needing special transportation, or getting help from another person).
    3. Leaving home takes a considerable and taxing effort.

Home Care Book provides home care services, sometimes referred to as custodial care. Home care is non-medical care that is designed to help an individual with their activities of daily living. This can include:

  • Dressing
  • Bathing
  • Toileting
  • Incontinence care
  • Preparing meals
  • Transferring
  • Exercising
  • Transportation: doctor appointments, errands and shopping
  • Memory care: Alzheimer’s / Dementia
  • Parkinson’s
  • Medication reminders
  • Light housekeeping
  • Sitter service
  • Companionship
  • And more

Unlike hospice and home health, home care services are decided by you. You set the exact time you want home care services. For example, you can request care every day from 8am to 8pm. Unlike hospice, home health or the cable company, we don’t give you a time range when we will show up. We show up on time. Further, you tell us exactly what you need. If your needs change, please feel free to contact our Care Manager.

Home Care Book is unique in that we able to coordinate care with your Home Health agency or Hospice agency. If applicable, we also coordinate care with your primary care physician, hospital social worker, rehab facility social worker and/or other medical settings and case managers.

Still have questions? Please feel free to give us a call and we are happy to explain further. 214-377-0711