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Senior Citizen's Guide to Cleveland

Homecare & Homehealth Care
The Difference Between and How We Work Together

Most callers to our office automatically assume that the assistance they need at home, will be covered by Medicare, will be provided by a nurse and therefore think they are in need of 24-hour care. It isn’t, it won’t be and no, you do not.

The title “nurse” is used universally for anyone providing care. And the term “homehealth” is used interchangeably for any and all care provided at home. However, there is a difference:

Homecare: Non-medical care at home that does not consist of a nurse caring for the patient. Also called: private duty care. This is not covered by Medicare. This is an out of pocket expense. These patients only require the assistance of a caregiver. That can be a Certified Nursing Asst (CNA), a State Tested Nursing Asst. (STNA), a Patient Care Asst. (PCA), or any caregiver who has experience from a facility or their own private duty experience, that can be verified. Different States use different titles and each homecare agency has its own requirements.

Homecare services are used when the patient needs help with bathing, dressing, grooming, housekeeping, laundry, errands and shopping, companionship, supervision, meal prep, med reminders and transportation upon discharge from the hospital or other facility. The schedule is what the patient wants and what works best for their situation. This can be a few hours per day up to 24 hour live in. It can be a long-term need or just enough to get the person rehabilitated. You are called the client. If there is an emergency while on duty, 911 is called and EMS is provided with your detailed careplan.

Most times the caregiver accompanies the client to the ER and the office calls the family.
Homehealth care: Medical care at home that is billed to Medicare. These visits are short in nature and are done by medically trained individuals; therapists, wound care nurses, IV specialists, ostomy nurses, and/or nursing assts that are certified to do medical procedures, ie: give medications, or who are IV certified.

Homehealth care services are used when a patient has any procedure deemed medical by the state in which they live. Medical procedures usually consist of “anything the enters the body.” These are tube feeds, colostomies, enemas, injections/IV’s, and wound care. Think: Anything that has the potential to become infected or harm the patient should it not be done correctly.

These trained individuals have more than one visit that day, so the schedule can vary from visit to visit. They usually will not cook a meal, ambulate someone, bathe someone or provide any non-medical type of care during that visit because they don’t have time. They need to do the procedure they came to do and leave. You are called a patient. If there is an emergency, let’s hope it happens during their visit so they can call 911.

Let’s use the example of Hospice and how a non-medical care provider would work with them:

Hospice (healthcare): Nurses who manages pain meds and provides grief counseling to the family of a dying patient. They refer these families to non-medical care, because they understand the need for their patient to have care around the clock from an experienced caregiver and the grieving family to have respite. The non-medical caregiver can bathe, turn, and keep comfortable a dying patient, so the family can spend the time they have left with their family member as a companion, not as caregiver.
Experienced caregivers familiar with death and dying can also provide comfort to the patient as well as to the family by calling hospice with any changes in condition, and for on-going support.

Hospice can also provide an aide who will come in and bathe a patient, but those visits are usually once a week, and sporadic in the time of the day. This is why most families opt to include the use services in addition to the aide visit that hospice provides. In an emergency, hospice is called. The nurse managing that person’s care, comes as fast as she can.

Although people use the term “homehealth” to describe help at home, there is a major difference. We all work together in tandem and respect each other’s limitations to rehab patients or work with hospice to pick up where one leaves off.

Regardless of who does what, we all agree that we all do one thing well, and that’s keep that person in their cherished home, where they do better, recover faster, and feel more comfortable. And now you know the difference between homecare and homehealth care.

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