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Navigating Care Choices: Home Health Care vs Hospice Care

By Shelley Cartwright

Table of Contents

    If you or a loved one is facing serious illness or injury, choosing the right care path can be overwhelming. Two common options are home health care and hospice care. While both offer support and care within the comfort of the home, they serve distinct purposes and cater to different stages of health.

    In this article, our team at APEX Health Services aims to shed light on the key differences between home health care and hospice care, empowering you to make informed decisions for yourself or your loved ones.

    What Is Hospice?

    Hospice care is a compassionate and holistic approach to care that focuses on enhancing the quality of life for individuals facing life-limiting illnesses. Rather than focusing on curing the illness, hospice care shifts the emphasis towards managing pain and symptoms, providing emotional and spiritual support, and ensuring comfort and dignity in the final stages of life.

    Hospice Care Eligibility

    Generally, individuals are eligible for hospice care when their life expectancy is estimated to be six months or less if the disease runs its natural course. Physicians typically make this estimation. However, it's important to note that hospice care isn’t solely about the timeframe; it's about prioritizing comfort and quality of life when curative treatments are no longer effective or desired.

    What to Expect During Hospice Home Care

    During hospice home care, hospice patients can expect a comprehensive and compassionate approach to care that prioritizes comfort, dignity, and quality of life for your loved one. Here's what you can generally expect:

    • Regular visits from the hospice team:
      • Nurses: Will visit regularly to assess your loved one's condition, manage pain and symptoms, and provide education and support to both the patient and family caregivers.
      • Home health aides: Will assist with personal care needs like bathing, dressing, and grooming, as well as provide companionship and emotional support.
      • Social workers: Will offer counseling and emotional support, help with practical matters like financial concerns and advance care planning, and connect you with community resources.
      • Chaplains/spiritual counselors: Will provide spiritual and emotional support to both the patient and family, regardless of religious affiliation.
      • Volunteers: Will offer companionship, run errands, provide respite care for caregivers, and help with other tasks to alleviate stress and provide support.
    • Delivery of medical supplies and medications: The hospice team will ensure that all necessary medical supplies and medications related to the life-limiting illness are delivered directly to your home, so you don't have to worry about getting them.
    • 24/7 availability and support: You'll have access to the hospice team 24 hours a day, 7 days a week. If you have questions, concerns, or need urgent assistance, you can reach out to them at any time.
    • Emotional and spiritual support: Hospice care recognizes the emotional and spiritual challenges that accompany the end of life. The team will provide resources and support to help you and your loved one cope with these difficult emotions.
    • Bereavement support: Hospice care doesn't end with the passing of your loved one. The hospice team will continue to offer bereavement support to the family for up to a year after the loss.

    What Is Home Health?

    Home health care refers to a wide range of medical services provided in the comfort of your own home to help individuals recover, manage chronic conditions, or maintain their independence. Unlike hospice, home health care focuses on improving or stabilizing a patient's condition rather than providing comfort care at the end of life.

    Eligibility for Home Health Care

    To qualify for home health care, individuals must meet certain criteria:

    1. Homebound: The person must be considered homebound, meaning it's difficult for them to leave home without significant effort or assistance.
    2. Need for skilled care: The person must need skilled nursing care, physical therapy, occupational therapy, speech therapy, or medical social services.
    3. Plan of care: A doctor must certify that the person needs home health care and create a plan of care.

    What to Expect During Home Health Services?

    During home health services, you can expect a personalized and comprehensive approach to care aimed at improving your health and well-being in the familiar environment of your home. Here's what you can generally expect:

    • Initial assessment: A skilled nurse or therapist will conduct a thorough assessment to understand your medical history, current condition, needs, and goals. This assessment will help create a personalized care plan tailored to your needs.
    • Development of a care plan: Based on the assessment, we’ll develop a comprehensive care plan in collaboration with your doctor. This plan will outline the types of services you'll receive, the frequency of visits, and the goals of your care.
    • Skilled care services:
      • Physical therapists: Will help you improve mobility, strength, balance, and function.
      • Nurses: Will provide skilled nursing care like wound care, medication management, injections, catheter care, and monitoring vital signs.
      • Occupational therapists: Will help you regain the ability to perform daily tasks and activities.
      • Speech therapists: Will help you improve communication and swallowing difficulties.
      • Medical social workers: Will provide counseling, emotional support, and help with accessing community resources.
    • Education and support: Home health care professionals will educate you and your caregivers about your condition, medications, and treatments. They’ll also provide support and guidance to help you manage your health and achieve your goals.
    • Monitoring and evaluation: Your progress will be regularly monitored and evaluated to ensure that the care plan is effective and meets your needs. As progress is made, the care plan may be adjusted as necessary.
    • Discharge planning: When your needs are met, the home health care team will work with you and your doctor to create a discharge plan. This plan may include transitioning to other services or providing resources to help you maintain your health and independence.

    How Are Home Health Care and Hospice Similar?

    Home health care and hospice care, while serving different patient populations and goals, share several key similarities:

    • Care setting: Both home health and hospice care are primarily provided in the comfort and familiarity of the patient's own home. This allows individuals to receive care in a preferred environment, surrounded by loved ones, and maintain a sense of normalcy and independence.
    • Patient-centered approach: Both types of care prioritize the individual's needs, preferences, and goals. Care plans are developed collaboratively with the patient and their family so that the care provided aligns with their values and wishes.
    • Interdisciplinary team: Both home health and hospice care involve a team of healthcare professionals working together to provide comprehensive care. This team typically includes doctors, nurses, therapists (physical, occupational, speech), social workers, and home health aides or hospice aides who collaborate to address the patient's physical, emotional, and social needs.
    • Holistic care: Both approaches recognize that care goes beyond addressing physical symptoms alone. They consider the patient's emotional, spiritual, and social well-being as integral components of overall health and quality of life.
    • Support for family caregivers: Both home health and hospice care offer support and resources for family caregivers. This can include education about the patient's condition, training on how to provide care, and emotional support to help them cope with the challenges of caregiving.
    • Covered by medicare and other insurances: Both home health care and hospice care are often covered by Medicare, Medicaid, and many private insurance plans. This can help alleviate the financial burden for individuals and families seeking care.
    • Goal of enhancing quality of life: Although their specific goals differ, both home health and hospice care have a goal to enhance the patient's quality of life. Home health care focuses on improving or maintaining health and function, while hospice care prioritizes comfort, dignity, and emotional well-being in the face of a life-limiting illness.

    Differences Between Hospice and Home Health Care

    While home health care and hospice care share similarities, they are fundamentally different in their goals, focus, and patient eligibility:

    Feature Home Health Care Hospice Care
    Goal of Care Improve, maintain, or slow decline of health; rehabilitate and maximize independence Provide comfort, manage symptoms, and enhance quality of life for those with a terminal illness
    Patient Eligibility Homebound individuals needing skilled medical care due to illness, injury, or surgery Individuals with a life expectancy of 6 months or less if the disease runs its natural course
    Focus of Care Curative or maintenance treatments, rehabilitation, and skilled medical services Pain and symptom management, emotional and spiritual support, and family support
    Types of Services Skilled nursing, physical therapy, occupational therapy, speech therapy, medical social work Nursing care, pain management, symptom control, personal care, emotional and spiritual support
    Length of Care Time-limited, determined by the patient's progress and needs Provided until the end of life
    Coverage Usually covered by Medicare, Medicaid, and private insurance for eligible services Covered by Medicare, Medicaid, and most private insurance plans

    When to Consider Hospice or Home Health Care

    Choosing between home health care and hospice care depends on the individual's health condition, goals of care, and personal preferences. Here's a guide to help you determine which option might be best:

    When to Consider Home Health Care

    • Recovery and rehabilitation: The primary goal is to recover from an illness, injury, or surgery, and regain independence with skilled medical care and therapies.
    • Managing chronic conditions: The focus is on managing chronic illnesses and preventing complications to maintain or improve quality of life.
    • Homebound: The individual has difficulty leaving home without assistance and requires skilled medical services in their home.
    • Short-term needs: The need for care is temporary and expected to improve with treatment and therapy.

    Examples of conditions where home health care may be ideal:

    • Post-surgical recovery
    • Stroke rehabilitation
    • Wound care
    • Chronic obstructive pulmonary disease (COPD) management
    • Congestive heart failure management
    • Diabetes management

    When to Consider Hospice Care

    • Life-limiting illness: A doctor has diagnosed a life-limiting illness with a prognosis of six months or less if the disease runs its natural course.
    • Focus on comfort: The goal is to prioritize comfort, quality of life, and pain and symptom management instead of pursuing curative treatments.
    • Emotional and spiritual support: The individual and their family need support to cope with the emotional and spiritual challenges of the end of life.
    • Family caregiver support: Family caregivers need help and resources to provide care and manage stress.

    Examples of conditions where hospice care may be appropriate:

    • Advanced cancer
    • End-stage heart disease
    • End-stage lung disease
    • Advanced dementia
    • Neurological disorders (e.g., ALS, Parkinson's disease)

    Making the Right Decision for Your Care Journey

    Choosing between home health care and hospice care is a deeply personal decision that depends on individual needs, preferences, and health conditions. While both offer valuable support within the comfort of home, understanding their distinct purposes and services is crucial.

    At APEX Health Services, we're committed to guiding you through this important decision. Our compassionate team can assess your unique situation and help you determine the most appropriate care path for you or your loved one. Regardless of what you’re going through, we’re here for you every step of the way.

    Don't hesitate to reach out to us today. Contact us today to schedule a consultation and discuss your care options.


    Is home health care only for seniors?

    No, home health care is available to individuals of all ages, including children, adults, and seniors. The determining factor is whether the individual requires skilled medical care at home due to an illness, injury, or surgery, and meets the homebound criteria.

    Can I receive both hospice and home health care at the same time?

    Generally, no. Hospice care and home health care serve different purposes and have different eligibility requirements. However, in some rare situations, a patient might receive short-term home health services while on hospice to manage specific symptoms or needs that fall outside the scope of hospice care.

    Shelley Cartwright

    Mrs. Cartwright was hired in 2014 as a Business Development Consultant and named Hospice Administrator in 2015. In January 2023 Mrs. Cartwright was promoted to the company’s Chief Executive Officer position. During her tenure as the Hospice Administrator, APEX experienced remarkable growth and success in the hospice and palliative care industry, leading the company to the first accredited in Palliative care in the state of Illinois. With more than 30 years in leading healthcare organizations, Shelley is a proven leader in healthcare operations, organization, leadership, business development and market expansion.

    Read Full Bio

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