Home health and hospice have something important in common: both can bring professional care to a patient where they live.
That similarity can also make the two easy to confuse.
The simplest distinction is this:
Home health is generally focused on helping someone recover, maintain function or manage a health condition. Hospice is focused on comfort and quality of life when someone is living with a terminal illness.
Both can be valuable. They are simply designed for different stages and different goals of care.
Home health brings skilled medical and therapy services into the home for someone who needs care because of an illness, injury, surgery or change in condition.
A patient receiving home health may be working toward goals such as:
Depending on the patient’s needs, home health services may include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services and certain home health aide services.
For Medicare-covered home health, patients generally must need part-time or intermittent skilled services and meet Medicare’s homebound requirements. A healthcare provider must also order the care.
The important idea is that home health is active skilled care with a clinical goal.
Hospice serves patients with a terminal illness when the focus of care has shifted away from treatment intended to cure that illness and toward comfort.
Under the Medicare hospice benefit, eligibility generally includes certification that the patient has a life expectancy of six months or less if the illness follows its normal course, along with the patient choosing comfort-focused hospice care for the terminal illness and related conditions.
Hospice care can include support such as:
Hospice is often provided in the patient’s own home, but it can also be provided in places such as assisted living communities or nursing facilities.
The goal is not recovery from the terminal illness.
The goal is comfort, dignity and helping the patient and family make the most of the time they have together.
Imagine two people who both need care at home.
One has recently returned home after hip surgery. Walking is difficult, leaving home takes considerable effort and the patient needs nursing and physical therapy to recover safely.
That person may be appropriate for home health.
Another person has an advanced illness that is continuing to progress despite treatment. Symptoms are becoming harder to manage, hospital visits are becoming more frequent and the patient and family want to focus on comfort at home.
That person may be appropriate for hospice.
Both are receiving care at home.
But the reason for the care, and the goal of that care, is different.
This is another area where the terminology gets confusing.
Home health is not the same thing as hiring someone to stay with a person throughout the day, prepare meals, clean the house or provide ongoing custodial assistance.
Medicare home health is primarily skilled, intermittent care. Medicare does not cover 24-hour care at home, meal delivery or homemaker services unrelated to the patient's care plan through the home health benefit.
That distinction matters when families are trying to understand what kind of help they actually need.
Hospice also has misconceptions around it.
A patient does not need to be completely bedridden or in the final days of life before a family can begin asking about hospice.
Hospice eligibility is based on the person’s illness, prognosis and goals of care, not whether someone fits a particular image of what the end of life is supposed to look like. Medicare allows hospice care to continue beyond six months as long as the patient continues to meet eligibility requirements and is appropriately recertified.
That is one reason families often benefit from asking questions earlier.
Yes.
For some patients, home health may be appropriate during an earlier stage of illness when the goal is rehabilitation, recovery or maintaining function.
As an illness progresses, the patient’s needs and goals may change.
If treatment is no longer helping in the way the patient hoped, symptoms become more difficult to manage or the focus shifts toward comfort, it may become appropriate to have a hospice conversation.
That transition is not a failure of home health.
It simply means the patient is entering a different stage of care.
You do not have to know the answer before making the call.
Home health may be worth asking about when someone is experiencing things like:
Hospice may be worth asking about when someone has:
These are reasons to start a conversation, not a diagnosis of eligibility.
Families sometimes approach this decision as though home health and hospice are competing choices.
Usually, they are not.
They are different tools designed for different needs.
The better question is:
What does this person need right now, and what are we trying to accomplish with their care?
If the goal is recovery, rehabilitation or skilled management of a condition at home, home health may be the right conversation.
If the goal has shifted toward comfort and support during a terminal illness, hospice may be the right conversation.
At Benchmark Home Health & Hospice, we provide both, which allows our team to help families understand those differences and begin the conversation about which type of care may fit their situation.
The care you deserve.
Call Benchmark at 936-274-3787. Our team can help you understand the difference and talk through the next step.
Whether you're exploring care options for a loved one or need assistance with any questions, we're here to help.
