Navigating the Options: Home Care and Home Health

"Home care" and "Home health" are often used interchangeably, leading to confusion among families seeking the most appropriate support for their loved ones. While both services aim to enhance the well-being and independence of individuals in their homes, they differ significantly in their scope, focus, and requirements. Understanding these distinctions is crucial for making informed decisions that align with the specific needs of the individual.

Approximately 80% of people with Alzheimer's disease and related dementias are receiving care in their homes.

Most older adults, including those with dementia and their care partners, prefer to receive care at home rather than in nursing facilities, and many families choosing to provide care themselves.

Home Care: Assistance for Daily Living

Home care, also known as non-medical care, provides assistance with activities of daily living (ADLs), enabling individuals to maintain their independence and routines within the comfort of their own homes. These services encompass a range of non-medical tasks, such as:

• Personal care: Bathing, dressing, grooming, and toileting
• Meal preparation: Planning, shopping, cooking, and cleaning up after meals
• Light housekeeping: Maintaining a clean and organized living environment
• Medication reminders: Ensuring timely and proper medication intake
• Companionship: Providing social interaction and emotional support

Home care services are typically provided by trained caregivers who may not have formal medical training. They are not intended to treat or manage medical conditions but rather focus on enhancing the overall well-being and quality of life for individuals who need assistance with daily tasks.

Home Health: Medical Care in the Home

Home health care, on the other hand, is a skilled medical service provided by licensed healthcare professionals, such as nurses, therapists, and social workers. It is ordered by a physician to treat or manage a specific medical condition, illness, or injury. Home health services may include:

• Wound care: Managing and treating wounds, including diabetic foot ulcers
• Medication administration: Administering injectable medications and monitoring their effects
• Disease management: Providing education and support for managing chronic conditions like diabetes or heart failure
• Therapy services: Occupational, physical or speech therapy to improve function and mobility
• Post-operative care: Providing assistance with recovery following surgery or hospitalization

Home health services are typically covered by Medicare Part A, Medicaid, and private insurance plans.

The process for home health services typically starts with a:
>referral
>MD order(example: Home Health services for OT/PT/SLP to evaluate and treat related to _________)
>home health clinician will reach out to schedule initial visit(start of care) reviewing medications, scope of function needs, concerns>additional therapists necessary will contact patient for therapy specific evaluations, which will include creating plan of care(goals/interventions) and frequency of visits(example: once per week for eight weeks)
>progress visits and recertification completed to monitor, modify, update goals and adjust visit frequency as needed>home health discharge(some therapies or nursing may end at different times--you may meet your nursing goals, so you are discharged from nursing but may continue with OT and PT for several weeks longer as appropriate)
>possible referral for outpatient therapy services as appropriate

Benefits for Older Adults and Persons with Dementia

Both home care and home health services offer significant benefi ts for older adults and individuals with dementia. Home care can assist individuals with maintaining their independence and autonomy, reducing the risk of falls and institutionalization. It can also provide much-needed respite for caregivers, allowing them to take breaks and attend to their own needs.
For persons with dementia, home care can provide a sense of familiarity and comfort in their own environment, reducing anxiety and promoting emotional well-being. Home health services can address specific medical needs, such as managing medications, monitoring disease progression, and providing wound care.
 

Benefits for Caregivers

Home care and home health services also provide invaluable support to caregivers. Home care can alleviate the burden of daily tasks, allowing caregivers to focus on emotional support and spending quality time with their loved ones. Home health services can provide caregivers with education and training on managing specific medical conditions, reducing their stress and anxiety.

Health Outcomes

Studies have shown that individuals receiving home care and/or home health services experience improved health outcomes, including:

• Reduced risk of hospitalizations and readmissions
• Improved functional mobility and ability to perform ADLs
• Enhanced quality of life and satisfaction with care

Home care and home health are distinct yet complementary services that can significantly enhance the well-being and independence of older adults and individuals with dementia.

Out-of-pocket costs averaged $62,000 for people with dementia, more than 80% higher than for someone with cancer or heart disease.

Families of older adults with dementia also spent a larger amount of family assets for care in the last five years of life than families of those with other conditions.

Caring for adults with dementia living at home is the most time-intensive type of elder care.

Older adults with dementia receive on average 92 hours per month versus 68 for those without dementia.

Many people with dementia rely on family members even when they have paid care. Family caregiving does not end when older adults with dementia move into residential care settings such as assisted living; about 80% of older adults with dementia living in residential care had at least one family or unpaid caregiver assisting with self-care or household activities.

Understanding the differences between these services is essential for making informed decisions that align with the specific needs of the individual and their family. Both home care and home health services have been shown to improve health outcomes, reduce caregiver burden, and promote overall quality of life.

Author

Shunaka White, OTR/L, CAPS, ECHM, is the founder of For Safety’s Sake, LLC and an Aging in Place Occupational Therapist. More than just an occupational therapist, Shunaka wants to be your helpful, knowledgeable, guide to aging with dignity and safety – wherever you choose. Shunaka's entire 15-year career in occupational therapy has focused on older adults. Working in both skilled nursing facilities and home health care, with the mission to learn skills and knowledge to ensure older adults thrive.

Learn more about For Safety's Sake, LLC by reaching out via email at info@forsafetyot.com or phone at 202-696-0634.