In-Home Care vs. Home Health Care

As a Geriatric Care Manager, I have had the privilege of having first-hand conversations with many seniors and their family members. I know the issues that are top of mind for seniors and I know the recurring questions about options available to them as they age and experience health issues. One question in particular that I am asked on a regular basis is “what is the difference between “home care” “in-home care” and “home healthcare”?  It’s important to understand the difference because unless medical care is provided, the service may not be covered in part by Medicare.


In-Home Care aka Home Care

In-home care is non-medical companion and ‘help around the house’ care. When an aging adult isn’t able to keep up with cleaning, shopping, cooking, paying bills, or their own transportation, that is the situation that calls for In-home care. Professional caregivers provide a variety of care that ranges from helping with activities of daily life to companionship.


For example, Carol is a 76-year-old who just recently came home from the hospital after being treated for an infection. She owns her own home, has her own vehicle, but is sent home with oxygen, multiple medications to be taken throughout the day, and orders to not drive or do anything strenuous for the next 30 days. A home care aide is hired to visit Carol’s home every day for 4 hours between 10 am and 2 pm. During this time the aide takes care of the housekeeping by vacuuming, washing dishes, dusting, and wiping down surfaces in the kitchen and bath. The aide will check Carol’s medication list and daily pill dispenser to make sure she’s taken the medication that day. Also, the aide will drive Carol to her appointments and to the store, helping her with her shopping needs. If needed, the aide will prepare nutritious meals and store them in the refrigerator for Carol to microwave or cook on the stove. These non-medical, non-clinical services ensure that household needs are covered and offer Carol a friendly social connection while she is recuperating at home.


These same services are offered to aging seniors who aren’t ready to leave their homes but aren’t able to handle all of the daily living tasks themselves. Another positive aspect is that the aide will often spend a bit of social time with the senior, playing games and watching movies.


Home healthcare

Home healthcare providers, also known as home health aides, have some level of formal medical training and will have passed competency tests. Many will have credentials like a Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN), Physical Therapist (PT) or Occupational Therapist (OT).


Home healthcare includes a wide range of services that can be done in the home, some of which include IVs and injections, monitoring of a health condition, wound care, and patient education. The objective is to treat the illness or injury and helping the patient get better so they can return to independent living and self-sufficiency.


For example, Mike is 82 years old and quite active in his community and physically with a running club and a bicycle club. During a running race, he tripped and twisted his knee, aggravating an existing condition and hastening the need for knee replacement surgery. After surgery, he spent a week at the rehab center and was released to be home as long as he hired a home healthcare service to tend to his knee, provide physical therapy, and help wean him off pain medications.


In order for Medicare or Medicaid to cover the costs of a home healthcare service provider, a doctor must certify that the service is needed and the home healthcare agency must be Medicare-certified and be the coordinator of care.  This type of care is perfect for the aging senior (or anyone for that matter) who needs intermittent nursing care.


Care Costs Add Up

Whether the aging senior needs help with day-to-day tasks or actual nursing care at home, these costs add up. And they add up quickly. It’s important that you understand the differences in care and what services are actually needed so you can do a bit of research and prepare the budget for the costs.