Understanding and choosing the right care option for your loved one

If you or a loved one is coping with a serious illness, or recovering from surgery or injury, it's helpful to know what the differences are among various types of care as you consider your options for the best source of help.

Posted 12:46 p.m. Apr 30, 2018 — Updated 7:28 p.m. May 9, 2018

This story was written for our sponsor, Transitions LifeCare.

Terms used to describe healthcare services provided at a patient’s home can be confusingly similar. Yet, there are significant differences between the types of care and their intended purpose.

"Deciding what care is right for you or your loved one at home depends greatly on what the care is intended to do and how long the care is needed," said Jackie Ring, PhD, RN, FACHE, NEA-BC, vice president of clinical services at Transitions LifeCare.

Descriptions and criteria for care can vary by state; below is information that is specific to North Carolina.

Home care is typically more companionship care than true health care. It’s intended for people who need some help at home or someone around in case of emergency. This type of care is often long-term, provided by a trained aide and is paid by the individual instead of covered by insurance.

"A helping hand for the long term points to home care," Ring explained.

Alternatively, home health is designed for patients in need of skilled medical care for a relatively short length of time, typically 60 to 90 days. To qualify, patients need to be classified as home-bound, meaning they are able to leave home only for short periods, such as attending church, going to doctors’ appointments or getting their hair done.

The intent of home health is for the patient to recover from the illness or injury through medical care and/or therapy.

Ring pointed out, "Skilled medical care for up to two or three months with a goal of recovery calls for home health."

Medicare, Medicaid and certain private insurance contracts cover the cost of services, including skilled nursing, physical therapy, speech-language pathology, and services from a home health aide and social worker.

Home health also is used for a short term to train patients about home care for a new disease or stage of illness; administering a new medication; or introducing a process new to the patient, such as catheterization.

Finally, hospice care at home is for patients who have been diagnosed with a terminal illness and whom physicians estimate have about six months or less to live if the illness runs its natural course. In addition, patients must agree they no longer are seeking to cure their condition, but instead want care to keep them comfortable and maintain the highest quality of life possible.

"Expert care to provide comfort and quality of life, without seeking a cure during life's final months, indicates the need for hospice services," Ring said.

Hospice staff are specially trained in end-of-life care and are experts in specialties, such as managing pain and other symptoms.

The hospice team can include physicians, nurses, certified nursing assistants, social workers, licensed therapists, home health aides, chaplains, and grief counselors. Hospice care offers a holistic approach of caring for the patient and their family physically, emotionally and spiritually.

In addition, hospice services include having prescriptions related to the terminal illness and necessary medical equipment, such as a hospital bed and wheelchair, delivered to the patient's home.

Hospice care typically is covered in full by Medicare, Medicaid and private insurance companies.

This story was written for our sponsor, Transitions LifeCare.

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