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Care Manager Insight: Home Care Vs. Home Health

2858999_f520As a geriatric care manager, I am forever explaining the difference between home care and home health care. There are many misperceptions by health care professionals and the general public alike about what each of these terms means. It starts with the widespread misuse of language. The phrase “home health care” is often used interchangeably with the term “home care.” They couldn’t be more different. Let me sort out this confusion between home care and home health care.

The phrase “home care” refers to the non-medical provision of care in a home and community based setting. Caregivers are non-licensed, non-professionals with minimal training on the basics of caring for the elderly and infirm. They are not allowed to administer medications, do medical treatments or function as liaisons between their patients and their doctors. Caregivers are allowed to assist with ADL’s or “activities of daily living.” These are typically identified as: bathing, grooming, dressing, toileting, ambulation/transferring and eating. Some lists include other activities but these are the usual.

Home health care is medical provision of health care by a licensed home health agency. The staff consists of licensed nurses, therapists and various professionals all acting under the auspices of Medicare regulation and with the goal of providing short-term “skilled nursing or therapy services.”

Home care companies usually provide hourly care for their elder clients and commonly stay for long periods of time such as 4-12 hour shifts. Some even provide 24 hour live-in care as well. Home care is usually private pay or covered by long term care insurance.

Home health companies do not provide hourly or “shift care.” The home health nurse will typically come out to visit the patient/client to accomplish a specific goal directed by a physician. They do not stay for long periods of time and will only do intermittent visits for the most part. Once their goal is achieved they will discharge the case. They are paid for by Medicare and other insurances.

While home care and home health can and often do work together in their respective medical/non-medical roles, in general remember that home care agencies stay to provide care long after home health companies leave.


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