Home Health vs. Hospice

by Amedisys

Home health and hospice are two options for healthcare at home that provide very different types of care. Comparing home health vs. hospice will help you understand which type of care matches your needs. So, what is the difference between hospice and home health?

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What's the Difference Between Home Health and Hospice?

Home health and hospice are two options for healthcare at home that provide very different types of care. Comparing home health vs. hospice will help you understand which type of care matches your needs. So, what is the difference between hospice and home health?

The Differences: Home Health vs. Hospice

Some of the key differences between hospice and home health care are:

Purpose

  • Home health care helps people recover from illness, injury or surgery. It also helps people learn to manage chronic health conditions.
  • Hospice care provides pain and symptom management for people with a terminal illness who aren’t expected to live longer than six months.

Services

  • Home health services address intermittent, or periodic needs, and may include:
    • Skilled nursing
    • Physical therapy
    • Occupational therapy
    • Speech therapy
    • Medical social work
    • Wound care
    • Medication assistance
    • Help with personal care from a home health aide, as needed
  • Hospice services include:
    • Skilled nursing
    • Help with personal care from a home health aide
    • Medical social work to help with planning, insurance, advance directives and other concerns
    • Bereavement counseling for loved ones
    • Spiritual counseling with a chaplain
    • Trained volunteers to assist with household tasks, errands, preparing meals and providing companionship

Eligibility

  • To qualify for home health care coverage, patients have to meet certain eligibility criteria. For example, they must be considered homebound, which means they have limited ability to leave their home without help.
  • Hospice has different eligibility criteria. A doctor must determine that the patient has less than six months to live if their illness follows its usual course. Hospice patients do not have to be homebound.

Insurance Coverage

  • Home health is typically covered by Medicare, Medicaid and some private insurance plans for eligible patients. Medications are not covered under Medicare, and medical equipment and supplies may be covered at 80% under Medicare Part B.
  • Hospice is also covered by Medicare, Medicaid and most private insurance plans for eligible patients. Medicare covers medications, medical equipment and supplies related to the terminal diagnosis.

Care Team

  • The home health team is made up of:
    • Nurses
    • Therapists
    • Medical social workers
    • Home health aides
  • The hospice care team is made up of:
    • Nurses
    • Social workers
    • Home health aides
    • Therapists
    • Chaplains
    • Bereavement counselors
    • Trained volunteers

Frequency & Length of Care

  • Home health care visits are based on the needs of the patient and caregiver. They typically decrease over time as the patient’s health improves and their needs decrease. The patient receives visits on an intermittent basis for as long as they meet eligibility criteria and their doctor deems care medically necessary.
  • Hospice care visits are also based on the needs of the patient and caregiver. They typically increase over time, as the patient’s health declines and their needs increase. The patient can receive visits for six months or longer if a doctor certifies they continue to have a limited life expectancy.

Goals

  • The primary goal of home health care is to help the patient recover or maintain their current level of functionality.
  • The primary goal of hospice care is to promote quality of life and manage pain and other symptoms.

Location

  • Patients can receive home health care in their home. This can include a private residence, assisted living and group homes. It cannot be provided in most inpatient settings, like a hospital or nursing home.
  • Patients may receive hospice care wherever they call home. This includes a private residence, a facility, an inpatient hospice center and short stays in an inpatient hospital setting. There are four different levels of hospice care:
    • Routine care is provided wherever the patient calls home.
    • Respite care places the patient in a care facility for five days and five nights to provide relief to the caregiver.
    • Continuous care is provided in the home during a period of crisis. Continuous care includes nursing and home health aide services.
    • General inpatient care is provided when the patient’s symptoms cannot be managed at home. The patient is admitted to the hospital and hospice works with the hospital to manage their symptoms.

The Similarities: Home Health vs. Hospice

To understand the difference between home health and hospice, it helps to know the similarities. Both types of care:

  • Can be provided in the comfort and safety of home
  • Are covered by Medicare, Medicaid, the Veterans Administration and many private insurance companies
  • Require a doctor’s order, based on eligibility criteria
  • Help older adults stay as independent as possible
  • Provide help with tasks like bathing, dressing and grooming, depending on the patient’s needs
  • Are less expensive than hospital or facility care
  • Continue as long as your doctor certifies, and you continue to meet eligibility requirements
  • Are provided by interdisciplinary teams
  • Typically involve visits a few hours per week, depending on the patient’s needs and doctor’s orders, with most day-to-day care provided by a family member or caregiver

When you’re comparing home health care vs. hospice care, you should know that both are part of a continuum of care. People receiving home health care might transition to hospice if their condition worsens. Patients receiving hospice may transition to home health if their condition improves enough that they are no longer eligible for hospice.

In some situations, patients can receive home health and hospice at the same time. This may be an option if the patient meets the criteria for both services and needs care for a terminal illness as well as a condition that isn’t related to the terminal illness.

Although there are many differences between hospice care and home health care, both types of care can help older adults “age in place” in their homes. Ask your health care provider if home health or hospice care is an option for you. To learn more, call an Amedisys at-home care agency near you.

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