Hospice Care vs. In-Home Care: What’s the difference?

  • Published: October 21st, 2010
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When I am out in the community talking about hospice care, many people ask “What’s the difference between hospice care and in-home care?” It can be very easy to get the two services mixed up, but the differences are significant.

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Hospice care involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support for patients and their families affected by a serious illness. Hospice care is usually provided in a patient’s home or wherever a patient calls “home” such as a skilled nursing facility or assisted living facility. Care is provided by a team of healthcare professionals all working together with the patient, the patient’s physician, and the patient’s family members. The hospice care team makes intermittent visits to a patient’s home, depending on the medical needs of the patient. And hospice care is very affordable, as it is covered under Medicare, Medi-Cal (Medicaid), most private insurance plans and HMOs. The goal of hospice care is to help the seriously ill patient live the best quality of life possible, for as long as life lasts – whether that’s weeks, months, or years.

hospice care vs in-home care differencesIn-home care services in San Diego are available for patients and individuals in need of assistance with activities of daily living (ADLs), or for family caregivers who may need additional help in caring for their loved one who needs constant supervision. Non-medical home care agencies provide assistance with ADLs, which require no medical intervention. These activities include supervision and assistance with personal care, such as bathing and dressing, feeding, companionship, medication reminders, and light household tasks. It’s important to note that non-medical home care (also known as Companion Care) is not covered by Medicare or other commercial insurance policies (i.e. PacifiCare, Secure Horizons, etc).  Generally, in-home care agencies in the San Diego area can range from $13 to $20 per hour (this is an approximate price range and can vary).  If your loved one needs assistance 24 hours per day, sometimes known as a “live-in” home care, prices may range from $150 to $250 (this is an approximate price range and can vary) per 24-hour period. Some services may be covered by long term care insurance, so review your policy for details, as applicable.

The main difference between hospice care and in-home care is that hospice care team members do not provide “round-the-clock” direct care/supervision. Hospice team members visit patients on an intermittent basis, based on the medical needs of the patient. Hospice team members do not “live-in” with the patient or stay with the patient all day (except in cases where the level of care is determined to be continuous care, based on the medical needs of a patient). And services provided by the hospice care team are usually covered by insurance.

In-home care workers or agencies can provide a variety of non-medical care, can stay as long as needed (depending on the service agreement between the in-home worker and the patient), but patients usually pay for this type of care out-of-pocket as these services (in most cases) are not covered by insurance. Again, based on the services you are inquiring about, check with your insurance provider to see what is or is not covered regarding in-home care.

Online senior resources can provide information on questions to ask or issues to consider in identifying available care options. To determine which type of care is best, talk with your doctor or healthcare provider, or contact a San Diego hospice provider for more information.

Written by mdelacalzada

Communications Executive, Social Media Aficionado, Caregiver Advocate. Currently serves as the Executive Director of Communications and Public Relations at San Diego Hospice and The Institute for Palliative Medicine, a non-profit community-owned healthcare organization since 1977.

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