Elderly woman with female caregiver in living room.

Last month, we helped explain the different levels of continuing care available through independent and assisted living, as well as in memory care, adult foster homes and retirement communities.

This month, we help explain the differences between in-home care and home health care.

Whether due to illness, injury or aging, in-home care helps people live independently, often in their own homes or in independent living communities, for as long as possible. In-home caregivers help with activities of daily living, such as bathing and getting dressed, grocery shopping and meal preparation, transportation to doctor appointments and errands, light housekeeping and laundry, and medication reminders.

Home health care differs in that it focuses on medical services done in the home, such as wound care, injections, catheter care, IV infusions and physical therapy.

It is not uncommon for people to use both home care and home health at the same time. In fact, the services often complement each other, says John Hughes, owner/administrator of ComForCare Home Care.

“There are many people who don’t know the difference between home health care and in-home care,” he says. “There are many differences, but at a high level home health care is ‘clinical care’ and in-home care is ‘non clinical.’”

Home health allows patients to discharge from the hospital to their home, assists with faster recovery and reduces future hospital admissions. Home health agencies have a physician overseeing all aspects of care. Home health visits are typically scheduled a few times per week with different members of a team. It is billed to Medicare or other medical insurance.

In-home care is provided by caregivers who are trained to understand the nuances of senior care. “Home care aides can help older adults with activities of daily living, or just offer some friendly companionship,” Hughes says.

Unlike home health, in-home care is classified as personal care or companion care and is considered “unskilled” or “non-clinical” in nature. This type of care allows a person who needs help with bathing, grooming, dressing and general help around the home to age in place without the need to move to a higher level of care.

“This type of service helps people by reducing the likelihood of falls, medication errors, malnutrition and it also helps reduce isolation with older adults, too,” Hughes says.

In-home care visits are one-to-one care that can range from a couple of hours per week up to 24 hours per day depending on client needs/requests. The care is usually private pay, but some people qualify for Medicaid Waiver programs, VA benefits or use long term care insurance to cover the costs.

Hughes says that in Oregon there are four levels of in-home care licensing with “comprehensive” being the highest level. At this level, an agency can do medication management for the client and also do RN delegated tasks, like an insulin shot.

“A delegated task is when the RN will teach a caregiver one-on-one how to do a task for a specific client and then observe them completing the task to ensure they are capable of doing it unsupervised,” he says.

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