What type of medical support is available at home?
Home health, palliative care, and hospice care offer a range of health care services that can be delivered at home for those with illness or injury. Our experts are here to answer your questions about managing health at home.
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Skilled Care Solutions
Compassus provides a continuum of home-based services, including home health, infusion therapy, palliative care, and hospice care. Founded in 2006, Compassus delivers high-quality care and manages patients’ advanced illnesses in partnership with health systems and long-term care partners in 180 locations across the country. The Compassus brand promise, Care for Who I Am, focuses on each person as an individual and a patient to improve their quality of life in a meaningful way.
CenterWell Home Health puts patients at the center of everything they do – helping them live healthier, happier lives. Their skilled care teams deliver comprehensive, personalized care to help patients recover from the comfort and safety of home. CenterWell’s multi-disciplinary approach teaches patients the tools they need to manage their health with confidence, maintain their independence and get back to doing what they love. For more than 35 years, they have offered skilled nursing; physical, occupational, and speech therapies; social work; and disease management education. CenterWell’s proprietary specialty programs help patients manage medical conditions and enable them to remain in their homes as they receive medical or rehabilitative care. Skilled clinicians, in 38 states, work in their own communities, delivering high-quality healthcare, backed by CenterWell’s extensive resources.
We can help you choose the best solution for you.
What type of medical support is available at home?
It used to be that a medical crisis led to the end of aging at home. But today, many older adults who have chronic conditions, injuries, or illnesses can still remain at home with the support of home health, palliative care, hospice, and home care. Home health care agencies send licensed medical professionals into an older adults’ home offering a wide range of medical and therapeutic services. Palliative care increases overall comfort and quality of life by providing relief from a serious illness, in conjunction with treatment for that illness. Hospice care has a similar goal but doesn’t include treatment for the illness. Home care services provide caregivers—we call them Care Professionals, or Care Pros, for short—who offer companionship and help with activities of daily living. While these services can be very beneficial, it’s important to learn about the qualifications to determine if it’s right for you.
The following list includes common services and scenarios that indicate a need for home health care. A doctor or health care provider needs to order or prescribe home health care to initiate the service.
When home health care is needed
- Post-op rehabilitation
- Skilled assessments and teaching
- Physical/occupational therapy
- Speech therapy
- Wound care
- Mobility training
- Pain management
- IV therapy/injections
A home health agency is likely to employ a range of professionals, including physicians, registered nurses, licensed practical nurses, physical therapists, social workers, speech language pathologists, occupational therapists, and certified aides. These professionals commonly provide task-based services for a limited period of time with the goal of helping you get better, regain independence, maintain current function, or slow decline. The following are common home health services.
Services provided by home health
- Skilled nursing services
- Skilled therapy services
- Physical, speech, and occupational therapy
- Home health aide
- Medical social services
- Medical supplies
- Durable medical equipment (DME)
Medicare, as well as private insurance, may pay for some home health services under specific qualifications. If you’re discharged from a hospital or rehabilitation center, Medicare may pay for a nurse, occupational therapist, or speech therapist at home, but only according to a doctor’s prescribed plan of care. Below are payment options for home health care and the requirements for Medicare coverage.
Payment for home health care
- Covered by Medicare (and Medicare Advantage) under specific circumstances
- Often covered by private insurance
- Covered by Medicaid under specific circumstances
- May be an option to pay out-of-pocket when coverage runs out
- Covered by Veterans Affairs under specific circumstances
Requirements for Medicare coverage
- It must be medically necessary (skilled nursing service or skilled therapy care needed on an intermittent basis)
- You must have trouble leaving your home without help or leaving home is not recommended due to your condition
- You must see the healthcare provider face-to-face to certify the need and receive documentation from the provider confirming homebound status and skilled need
- You must receive care from a Medicare-certified home health agency
- Medicare will reimburse at a lower rate if you have not been admitted to the hospital prior to receiving home health care
Once you determine that you meet qualifications for home health care, and have orders from your healthcare provider, the home health agency will schedule an appointment to assess your needs and ask questions about your health. Services will be provided as often as your doctor orders. And the home health care agency will keep the doctor updated on your progress. You may benefit from having home care along with home health care. That way, when home health services end, home care can continue to support you as you live independently at home.
For more information on home health care and coverage for these types of services, visit Medicare.gov. You can also use the Medicare Home Health Compare search tool to locate a home health care agency near you.
The goal of palliative care is to increase overall comfort and quality of life by providing relief from the pain and stress of a serious illness, regardless of prognosis. Palliative care can be provided at any age and at any stage of a serious illness. An individual on palliative care continues to receive curative and therapeutic care (such as radiation, dialysis, chemotherapy, or surgery).
How and where palliative care is delivered
Palliative care is delivered by a team of specially trained doctors, nurses, and other specialists. This team works with your doctors and is tailored to your needs. An important part of palliative care is ensuring communication between all parties: the palliative care team, your doctor(s), and you and your family or loved ones. Palliative care can be provided in any setting including hospitals, skilled nursing facilities, senior living communities, outpatient clinics (such as an oncology clinic), and at home.
Services provided by palliative care
The services of palliative care are tailored to your needs and can include the following:
- Pain and symptom management
- Care coordination with your current physicians and others on your healthcare team
- Assistance with developing your plan of care
- Practical assistance with documentation and insurance forms
- Guidance on making decisions about options for your care and/or housing
- Help with advance directives and Portable Medical Orders (POLST)
- Spiritual care
Payment for palliative care
Palliative care is typically covered by private insurance plans, and may be covered by Medicare, Medicaid and Veterans Affairs (VA). It’s important to check with your doctor and healthcare plan to see if all or some palliative care services are included in your coverage.
The primary goal of hospice care is to increase comfort and quality of life through physical, emotional, and spiritual support. While the goals of hospice are similar to palliative care, hospice is intended for those at the end of life. Sometimes individuals or families are hesitant to request hospice because they perceive it as giving up. In reality, hospice can honor the individual's wishes and provide comfort to them and their family. After bringing in hospice, many families say that they wish they would have started the service sooner because they had a wonderful experience.
When hospice care is needed
Individuals qualify for hospice when a physician certifies that their life expectancy is six months or less, based on the typical progression of their illness. Hospice is often recommended when a cure is no longer possible or the burdens of treatment outweigh the benefits. If the individual receives care past six months, they can qualify for extended hospice services.
Where is hospice care delivered
The majority of hospice care is delivered at home, which can include independent and assisted living facilities. Hospice can also be provided in long-term care facilities or nursing homes. Some communities have facilities that are solely dedicated to hospice care such as a local Hospice House.
Services provided by hospice care
The hospice team tailors the services to the needs of the individual, with the goal of keeping the person as pain-free as possible. The services can include:
- Management of pain and symptoms
- Emotional support
- Medications, medical supplies, and equipment
- Support and coaching for family members and Care Pros on how to care for their loved one
- Special services if needed, such as speech and physical therapy
- Short-term inpatient care can be provided when pain or symptoms become too difficult to manage at home or when family or Care Pros need respite time
- Grief support, also known as bereavement support, after the individual passes away
Who provides hospice care
The hospice team will work together with the individual, family and/or their Care Pro(s) to manage symptoms, provide comfort, and enable the highest quality of life possible.
- Hospice Physician - An ongoing role of the hospice physician or medical director is generally to manage the individual’s symptoms and pain. They regularly evaluate comfort and modify medication as pain and other symptoms may increase. The individual’s personal physician may also be included in the care.
- Nurses - Nurses generally check in to make sure that the patient is comfortable and their physical needs are being met. Nurses on the core hospice team also educate family members and Care Pros, teaching them techniques for personal care and ways to help keep their loved one comfortable.
- Social Workers - Once a family decides to enlist hospice care, social workers provide information and help coordinate community services such as additional home care or government benefits.
- Chaplain - A chaplain can provide spiritual support to the person on hospice and their family members.
- Speech/Physical Therapist – While not part of the core hospice team, a person on hospice may need the assistance of a speech therapist to show them techniques to communicate with family members and Care Pros. A physical therapist may help them learn to move with a disability or a new device.
- Hospice Volunteers - Volunteers help by providing the patient with support and companionship.
- Hospice Staff – A hospice staff member, such as a home health aide, is available on an intermittent basis—usually once a week—for assistance with tasks such as bathing.
The role of family members and loved ones
While hospice is on call 24/7, the hospice professionals are often not present with the individual and their family around the clock. The family members or loved ones often take an active role in providing care and support. Family caregivers typically provide the daily care that a hospital or a hospice center would provide, such as bathing, toileting, grooming and assistance with eating. However, they also can look to in-home Care Pros for help and support.
Support from Care Professionals
Care Pros from in-home care companies can assist families with a loved one on hospice care by providing some care directly, such as companionship, personal hygiene, meal preparation, and light housekeeping. They can also provide respite help if the family needs time away or has an outside commitment. A Care Pro also can support the family by providing their loved one assistance with laundry, medication reminders, and errands.
Payment for hospice care
The cost of hospice care is covered for those who qualify for Medicare Part A and meet specific criteria. Private insurance, Medicare Advantage plans, and state Medicaid plans will also likely cover it. You can discuss payment coverage with the hospice team.
With all of the options for home health care available, more and more adults are successfully aging and approaching the end of life in the comfort and familiarity of home. And families are feeling confident that their loved ones are safe and cared for, even if they can’t be with them all the time. If you have any more questions about home health care options, reach out to us via phone.