Home Health Care Explained

In contrast to home care that provides non-medical services, home health care consists of medical services that are provided in the home by licensed professionals, such as nurses, physicians or therapists. Examples of home health care services include skilled nursing care, physical therapy or occupational therapy.

When exploring senior care options, the terminology can be confusing as multiple terms can often be used to describe the same services or types of care. The terms “home care” and “home health care” are often used interchangeably to describe care provided in a senior’s home. However, the definitions of these terms are very different and the word ‘health’ entirely changes the scope of services provided through home health care.

Home Health CareHome care services, also sometimes referred to as “companion care,” are non-medical in nature, and typically provide an individual with services know as  “activities of daily living” (ADLs), such as bathing, dressing and hygiene, as well as provide assistance with home functions like cleaning, shopping for and preparing meals or managing medications.

Home Health Care Defined

Home health care services are provided by licensed and trained medical personnel and ordered by a physician. In many cases, home health care services are required for seniors who have recently been discharged from the hospital or a skilled nursing facility yet still need skilled medical care in their home.

As the average length of stay in hospitals and skilled nursing facilities has decreased over time, home health care services ensure that a senior’s medical needs are met in a less costly and more comfortable home environment.

Home health care services include the following types of care:

  • Intermittent skilled nursing care
  • Physical therapy
  • Occupational therapy
  • Speech pathology

Types of Home Health Care

Skilled nursing care consists of services that must be provided or supervised by a licensed nurse, typically a Registered Nurse (RN). These services may include the management of feeding tubes, in-dwelling catheters or the administration of intravenous medications.

Other services might include providing or supervising oxygen treatments (especially for seniors with conditions such as chronic bronchitis or emphysema) or the injections of medications, such as insulin, particularly when blood sugar levels must be monitored regularly. Wound care must also be provided by a skilled nurse to ensure sterilization and reduce the risk of infection.

Physical therapy consists of rehabilitation services to restore and/or maintain independence when a senior’s physical strength has become compromised. This might be caused by a fall which may lead to a fractured hip, requiring surgery or joint replacement.

While the initial portion of the physical therapy may be provided during a short-term stay in a skilled nursing facility, services can be continued at home once a senior has gained a suitable amount of strength. In such cases, a licensed physical therapist may provide continuing therapy by visiting a senior in their home to provide treatment until they have maximized their level of independence.

Occupational therapy consists of skilled treatment needed for a senior to maintain independence in their ADLs. This type of care is often provided after a certain level of strength has been achieved through physical therapy and allows a senior to regain and/or learn new skills needed to remain independent.

An occupational therapist will typically visit a senior’s home prior to their return from a skilled nursing facility to suggest home modifications and equipment to ensure their safety. Therapy provided in the home may consist of proper use of a walker, assistance with safely transferring, preparing meals and daily grooming/hygiene.

Speech pathology or therapy allows seniors to regain speech, language and/or swallowing abilities that may have been compromised by a stroke or disorder that affects the brain. A speech pathologist will create a plan of care to increase the effectiveness of a senior’s communication and/or gain strength in muscles that support swallowing.

Home health agencies provide these licensed services according to a care plan that has been determined with the coordination of a senior’s physician. The written plan of care determines what services are provided and the length of time each is required in order to regain maximum independence and functioning in the home. As home health care services are medically necessary, they are covered by Medicare, Medicaid and private insurance companies under specific conditions. You can get more information about Medicare coverage and home health care services from the Medicare publication “Medicare and Home Health Care.”

Written by gerontologist Sara Shelton.

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