What is home care?

Everybody needs a little help eventually — but that doesn’t necessarily mean you need to leave the house to get it. After all, home is where the heart is (and your favorite chair). Why leave? 

If you’re looking for assistance as you age, but don’t feel the need for assisted living or a nursing center, home care, including home health care — in which a health aide or trained clinician visits you at your house — might be the best option for you.  

There are two primary home care options, depending on your specific needs, so pull up your favorite chair and we’ll go through them both together. 

Home care is a broad term for services delivered in a person's home to help them remain safe, independent, and comfortable. Depending on an individual's needs, home care can include assistance with everyday activities such as bathing, dressing, meal preparation, and transportation, as well as skilled medical services provided by licensed healthcare professionals. 

Many people choose home care because it allows them to receive support in a familiar environment while maintaining their routines, relationships, and sense of independence. Home care may be temporary, such as during recovery from an illness or surgery, or it may provide ongoing support for age-related changes, disabilities, or chronic health conditions. 

Home care services generally fall into two categories: non-medical home care and medical home care, also known as home health care. 

Just what it sounds like. Non-medical home care can help you with activities of daily living (ADLs) — things like bathing, dressing, eating, toileting, and transferring. This option is best if you have no serious ailments and are instead looking for some general assistance around the house.

“Home care also includes support with independent activities of daily living (IADLS) like home making, meal preparation, laundry, and transportation," says Sean Hordes, a licensed social worker and Care Advocate at CareScout. “Home care is also a great option for those who need supervision and companionship due to a cognitive impairment.”

Non-medical home care services focus on helping people manage everyday life at home. While services vary by provider, they often include personal care, household assistance, companionship, transportation, meal preparation, and help with routine tasks that may become more difficult with age. 

For example, someone recovering strength after a hospitalization may need assistance with bathing and dressing for a few weeks. Another person may benefit from ongoing help with grocery shopping, housekeeping, or getting to medical appointments. These services can help older adults remain at home longer while reducing some of the responsibilities often taken on by family caregivers. 

Home health care is a type of home care that provides medical services in the home. Unlike non-medical home care, home health care must be delivered by licensed or certified healthcare professionals, such as nurses, physical therapists, occupational therapists, or speech-language pathologists. 

Home health care is often recommended after a hospitalization, illness, injury, or surgery, but it can also help people manage certain ongoing health conditions. The goal is to provide skilled care at home while supporting recovery, improving function, or helping individuals manage their health more effectively. 

Home health care can include services such as skilled nursing, wound care, injections, physical therapy, occupational therapy, speech therapy, and health monitoring provided by trained clinicians. 

Medical home care is best if you need help administering injections, or monitoring conditions like diabetes, blood pressure, heart disease, or dialysis.

Non-medical home care can be paid for privately, with eligible long-term care insurance policies, or with certain Medicaid waiver programs.   

Medicare and private health insurance may cover some of the cost for short-term medical home care. If, however, you need medical home care assistance on a more permanent basis, such as for chronic conditions, you may be required to pay privately or use an eligible long-term care insurance policy.

Eligibility for home health care services depends on an individual's medical needs and the requirements of the program or insurance coverage being used. 

In many cases, home health care is appropriate for people who: 

• Are recovering from surgery, illness, or injury 

• Need skilled nursing care at home 

• Require physical, occupational, or speech therapy 

• Need ongoing monitoring for certain medical conditions 

• Have difficulty leaving home without assistance 

Coverage requirements can vary. Medicare, Medicaid, private health insurance, and long-term care insurance may each have their own eligibility rules and coverage limits. Speaking with a healthcare provider or insurance representative can help determine which services may be available and whether a referral or physician's order is needed.

The choice ultimately comes down to the level of care you require, and the best way to determine what’s right for you is to honestly assess what you need. Perhaps an ADL assessment might be a good next step, says Kristin Bragg, a licensed clinical social worker and a board-certified case manager at CareScout. “It provides a review of the person's level of functioning, identifies specific potential care needs and gives recommendations for the duration, level of care, frequency and total weekly hours,” she says.

The assessment can also include a review of the person's ability to safely function in their home environment, which may include recommendations for fall prevention and safety modifications. 

As care needs change over time, the type of support that works best may change as well. Understanding the differences between home care and home health care can help you make a more informed decision about the kind of assistance that will support your goals, health, and independence.