By far, one of the most confusing concepts related to home care in general is understanding the difference between home health care vs home care. Prior to deciding what is best for a loved one, however, it is important to assess their needs first.
Home Health Care Vs Home Care
No matter the type of home care, everything starts with an initial consultation. This is where anyone can determine the type of care a dependent truly requires.
The consultation is often referred to as a “needs assessment.” A home care worker will visit your loved one’s residence to understand exactly the type of home care they need. There are several things you can do to prepare, however, so you don’t waste your time with a home care worker if a loved one actually needs a home health worker instead.
The first responsibility should be to gather all of the paperwork and information necessary for the assessment. This can include background information, insurance information, medical records, etc. The following is a list of a few things that should be gathered prior to the assessment:
- All contact information
- Height, weight, and age
- Prescription information including the type, dosage, and frequency
- Everyone’s daily schedule
- Medical history and any diagnoses
- Psychological and physical impairments
- All emergency contacts
- Information on all primary care physicians
- Pharmacy information
- Legal instructions and power of attorney
Once all of this information has been gathered, all family members should have a better understanding of how to meet the needs of a loved one. Home care is more about companionship, and may not be able to offer the level of medical care an individual needs.
Home Care Vs. Home Health Care
Although the terms are used interchangeably, home care and home health care are two separate concepts. Any non-medical care is typically referred to as in home care, whereas services that involve medical procedures are referred to as in home health care.
In home care refers to assistance with the daily activities of life. This can include a variety of the following types of care:
- Meal prep
- Personal hygiene
- Medication management
- Mobility and exercise
- Social activities
In home health care requires a caretaker that is more trained. Generally, home health care is prescribed by a doctor and in addition to assistance with daily activities, can also include some of the following medical services:
- Wound care
- IV care
- Pain management
- Medication education
- Medical and psychological assessments
- Catheter management
- Physical therapy
- Speech therapy
- Occupational therapy
In addition to having a separation of services offered, in home care and in home health care also have two different types of skilled caretakers: a Personal Care Assistant (PCA) or a Home Health Aide (HHA).
Home Health Aide (HHA)
HHAs are also generally skilled Certified Nursing Assistants (CNAs) and are trained to perform the various medical duties required. HHAs are assigned by a doctor and usually, work for either a nursing facility or a hospice agency.
PCA’s are not certified to care for an individual in most medical respects. If your loved one requires a lot of medical care, then you are most likely going to need to hire an HHA. Other job titles related to the medical capacity of an HHA include Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Physical Therapists (PTs), and Occupational Therapists (OTs)—to name a few.
PCA (Personal Care Assistant)
If a loved one requires more companionship than medical care, decision-makers may want to consider a more affordable caregiver like a Personal Care Assistant. Unlike HHAs, PCAs do not have medical experience, but still require certifications.
There are only a few “medically-related” tasks that a PCA is able to perform: medication reminders and toileting. Mostly, the job of the PCA is to provide company and conversation for your loved one. They must also ensure daily needs are being met, like grooming and meal prep.
Certifications and Coverage
For every state, the department of health is what dictates the certifications and coverage. Check here for your state information. Medicare pays for the majority of in home health services, but not every state will compensate for companionship (i.e. PCAs). Thus it is imperative that prior to assigning a caretaker, a decision-maker does the research to see what services may or may not be covered.
For instance, California does not have licensure for non-medical or custodial care services, whereas Florida compensates depending on the level of care. Although home care may not be covered by Medicare in your state, there are many Medicaid Waiver Programs that can help to financially assist you in this process.
Although home health care can be covered by private aide, it is almost always covered by Medicare. Additionally, long-term care insurance will usually cover home care but not home health care. There is a lot involved in financing home care, so it is important to understand all of the details prior to making a decision.
Although the two types of home care can be quite different, they’re not exactly mutually exclusive. In many instances, a loved one may require a combination of services. Many families often find that utilizing these in tandem will best meet the needs of their loved one.
One example of when services may cross is in a period of rehabilitation. After an injury or illness, a loved one may require a higher level of care that can later be demoted. While the home health staff can address rehabilitative and clinical needs during the transition, home care can be assisting with activities of daily living and household chores.
Overall, the goal is the same regardless of the caretaker and their certifications—and that’s to aide in the comfort and care of your loved one. An in home healthcare worker can change an individual’s prescriptions, and a PCA can remind them when to take them.
Who Needs What?
If you are still slightly confused about what exactly you may need for your loved one’s care, the following are some prime examples of people who may need home health care vs. home care in general:
Who Uses Home Health Care?
The prime example of an individual that needs home health care is not age, but rather rehabilitation. However, it is still the most popular in the 65+ age group. Here are a few examples of situations that would require this level of care:
- Discharge from a hospital or nursing home, but may require additional care
- Those with short-term health needs
- Anyone that requires assistance to remain in their own home
- The terminally ill that may want to live out their days at home
So in general, unless the loved one is coming straight from the hospital, home health aid usually isn’t prescribed.
Who Uses Home Care?
Anyone that wants to remain in their home with no pressing medical issues (but still has problems caring for themselves) are eligible for home care. The following are a few simple examples of when an individual may require home care (and not the full extent of in home health care):
- Need assistance with bathing and dressing
- Requires help with running errands and meal prep
- May need transportation assistance
- Longs for companionship and company
- Needs help maintaining household chores
Home care is a decision that takes more time. As doctors may arrange for home health care, home care requires more introspect and cooperation from your loved one. It’s a big decision to ask for help in life and for a full grown adult to admit they need care with simple activities like using their stove or going to the bathroom.
No matter what form of care your loved one needs, it’s important to make it a family conversation and involve them as much as possible. It is their home—and their opinion matters (if they are able to give it).
Once a loved one has their initial assessment, the next step is to research finances. If simple home care is required, it may take some more maneuvering within each state to get it covered. It is also important to remember that home health aides don’t generally perform too many ADL’s (like meal prep and housekeeping) so it may be that a loved one needs a combination of both agencies to assist.
Medicare and Medicaid will both cover a variety of services depending on your state. A PCA is always more affordable than a skilled nurse, and they usually start at minimum wage. Whether a loved one requires in home health care, home care, or a combination of both, understanding the difference between the two is the first step in meeting their needs. Contact Caring Hands Matter for more information.