As 10,000 Americans turn 65 years old each day, a growing number are asking ‘what is home health care?’  That’s because home health care is something people generally don’t think about, until they need it.

Put broadly, home health care is the myriad of services provided by doctors, nurses and caregivers in the home.  It involves elder care, or the care of younger people who’ve been injured, struggling with illness or born with developmental issues. The words home health care are often interchanged with similar phrases such as homecare, at home nursing care, hospice care, palliative care, etc.  Regardless of the words used, the goal is always the same; improve the quality of life of someone facing illness, injury, physical or cognitive decline where they feel most comfortable, in their own home.  Keeping the client safe from injury or exploitation is a top priority of a quality home care agency, as well as preventing return visits to the emergency room. 

There are different kinds of services that a person may need if they face a loss of independence to due age or physical/mental decline.  

Certified Home Health is usually paid for by Medicare or a person’s traditional health insurance.  This type of care is provided by a home health care agency and is most common when someone returns to home from the hospital or skilled nursing facility.  This care involves visits of roughly 45 minutes from an RN, PT, OT, or home health aid, typically for a period of 30 to 60 days, only as long as the patient is considered ‘homebound’, or unable to leave the home without taxing effort.  Medicare typically does not pay for long term care or shift care, either in a facility or at home. 

Private Duty Nursing is a service that is not covered by traditional health insurance or Medicare.  This includes shift nursing, such as an LVN to help administer mediations or monitor a client for several hours a day.  It’s paid for out of pocket or by using long term care insurance. 

Homecare commonly refers to the type of services provided by a caregiver or personal care attending, including help with activities of daily living.  A person may hire a homecare company to provide help with dressing, bathing, meal preparation, transfers, ambulation and assistance with toileting.  Homecare is funded by private pay, long term care insurance and also Medi-Cal for those who qualify with lower income. 

In California, quality homecare is provided by licensed agencies, and they may be licensed by the CA Dept. of Public Health or the CA Dept. of Social Services.  The agencies should be the full W2 employer, have appropriate insurance, pay payroll taxes and worker’s compensation insurance and supervise their homecare staff. 

Some clients may need homecare just a few times a week for several hours each shift, up to 24 hour homecare.  There are frail clients who can’t be safely left at home alone. They may need caregivers who rotate with 12 hour shifts, or some agencies such as At Home Nursing Care, Inc. have caregivers who will work with clients for 24 hours a day, a few days a week, to avoid rotating faces. 

Any homecare or home health care that a person receives should be patient centered care, meaning that the goals, values and desires of the patient are the foundation for the plan of care.  A home care or home health client should feel they can help create a daily or weekly plan that captures how he/she wants to spend each day, what foods they enjoy, which activities they value, and those wishes should be respected. 

Safety is always a top priority, so anyone who receives elder care or home health care should be screened for safety issues such as mental illness, potential for violent outbursts or guns in the home.  Most home health care agencies have policies and assessments that provide guidance on these difficult issues. 

Whichever type of home health care you need, you should feel that your goals and values are respected and your opinions are heard.  At the same time, the best outcomes are found when the client, client’s family and the home health care agency work together as a team to improve the client’s quality of life at home. 

If you need assistance with finding an in home caregiver, check out the three tips to finding the right in home caregiver here.