September 18, 2020
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Home Health Care vs. In-Home Care: What you need to know

By: Julie Ann Soukoulis
August 30, 2019

To an untrained ear, the terms “home health care” and “in-home care” can sound awfully similar. It is easy to mistake one for the other, you may need help understanding the differences. 

In the U.S. as the healthcare system continues to migrate from a fee-for-service-based system to a value-based payment model, the utilization of in-home care will likely increase as the care services provide can help mitigate the risk of hospital readmissions for elderly high-risk patients.

What is home health care?

Home health care refers to care provided in the home by a licensed medical professional, such as a nurse or physical therapist. Generally, home health professionals are only authorized to perform the tasks prescribed by the senior’s physician.


When home health care is needed

Medical home health care consists of a home health aide, supervised by a nurse or other medical professional, who has certified training to provide medical care. This care is done in the senior’s home for about one hour per day.

Care provided can include:

Post-op Rehab

Skilled assessments

Occupational, physical or speech therapy

Wound care

Mobility training

 Pain management

 IV Therapy/injections


How In-Home care differs from home health care

In-home care focuses on helping seniors with the daily activities they need to engage in life and remain safe and healthy. These activities can make up the remaining 23 hours of a day when a home health aide is not providing medical care.


When In-Home care is needed

In-home care focuses on four key factors: Cognitive, Functional, Social, Wellness. Each factor supports various elements that impact a senior’s daily life including physical activity, social interaction, emotional well-being, and brain health to name a few.

 Home care aides and caregivers can help reinforce prescribed care instructions and act as the eyes and ear within a senior’s home. Many professional caregivers, including those from Home Instead Senior Care, are specially trained to meet the needs of older adults.

Providing assistance with the following care tasks are examples of in-home care services:

Safety assessments

Reinforce plan of care compliance



Continence care

Medication management/reminders


Meal preparation/hydration

Light housekeeping


Alzheimer’s and dementia care

Having someone to help senior clients with these care tasks and ADLs may help the senior avoid a preventable hospitalization.


Where to find personal in-home care

There are three options for finding the right in-home care.


Private caregiver.

This can be a family member or friend and is a relationship, including payment for care provided, is managed by the senior and/or senior’s family. The caregiver may or may not have caregiving training.



This model connects caregivers with clients, placing a caregiver in the home as an independent contractor. The senior and/or senior’s family is usually responsible for payment, scheduling, payroll taxes and possible work-related injuries of the caregiver. The caregiver may or may not have caregiving training.



This model minimizes client/provider risks as background checks, training, bonds and insurance are taken care of by the employer or caregiving agency. Professional office staff provide local support including care team approach, skills assessments and certifications, legal support, ongoing training.

Seniors and their families should evaluate their options to find the best fit based on the senior’s needs, level of comfort and cost.


A combination of care services

Often seniors and their families find a team approach of using in-home care services to supplement home health care services provides the best solution. Also, seniors and their families should be aware that there might be some overlap between services provided by the two types of care. Both may involve assistance with activities of daily living (ADLs) such as meal preparation for specialty diets. Before hiring an agency to provide services, seniors and their families should know exactly what types of care the agency’s professionals can provide, along with how they are trained.


Additional cost and care considerations

Needs. The type of care services a senior patient should obtain depends on his or her needs. There could be issues related to medication, activities of daily living (ADLs), medical equipment, dietary or activity restrictions, along with other recommendations that should be considered. Families also must consider how much help they’re able to provide, especially if they don’t live close by or have other obligations. In addition to consulting with a senior loved one’s medical providers



What may be covered by insurance and what a doctor and family believe a patient need may not be the same thing. The family should review the coverage of any supplemental, Medicare Advantage or long-term care insurance the patient holds. If unable to locate a policy, contacting the insurance provider(s) directly is a good place to try. They can also find information about Medicare coverage at

Seniors and their families should especially take note of what isn’t covered by Medicare. According to the Centers for Medicare & Medicaid Services (CMS), Medicare doesn’t cover 24-hour-a-day care, meal delivery, homemaker services like shopping and laundry if that’s all the patient needs, or personal care like bathing and dressing if there is not a skilled component already in the home. A skilled component requires a therapy completed by a clinician such as a nurse or therapist.



Be aware of copayments. Even if the senior has insurance, there may be some out of pocket expense for whatever care is provided. For instance, patients could have to make a 20 percent copayment for approved medical equipment.


Julie Ann Soukoulis is the owner of Home Instead Senior care office in Rohnert Park, mother of two and passionate about healthy living at all ages. Having cared for her own two parents, she understands your struggles and aims, through her website, to educate and encourage seniors & caregivers. Have a caregiving or aging concern?  She’d love to hear from you at 586-1516 anytime.