Follow
Share

My mother-in-law had 2 strokes over a year ago and is wheelchair bound. She needs assistance with toileting, meals, baths, and other daily activity tasks.

We have her scheduled for Medicare Home Health Care but we also got a referral to the local Hospice group.

The local Hospice group reps came to the house to discuss what they could offer and it seemed to be similar to Home Health Care services.

My mother-in-law is not near death but does need assistance for daily activity care. Since the strokes, my sister-in-law has been taking care of her at my sister-in-law's home.

We were wondering what the difference is between Home Health Care and Hospice services were.

Any insight is appreciated.

This question has been closed for answers. Ask a New Question.
Find Care & Housing
Did you invite the hospice reps to your home? I'm wondering how they got involved.

Hospice is generally available only to those with six month or less to live as determined by a physician. Many people live longer than that, but in order for Medicare to pay for hospice care, the doctor has to feel that the patient is considered terminal. If your mother-in-law is not considered terminal, then Medicare/Medicaid will most likely not pay for hospice, so please be sure what you sign on for.

Is your mother-in-law on Medicaid? Most Medicare help is limited to nursing care.
If Medicare/Medicaid is paying for the care that you mentioned, you are fortunate. Many states don't offer such services through Medicare. A handful have Medicaid's Cash and Counseling - I wish all states did.

Grab on to what is available and then look into hospice when the doctor says the time is right.

Take care,
Carol
Helpful Answer (1)
Report

Primary difference is Hospice is fully covered by Medicare, but reserved for patients who are not expected to live more than six months. It usually is for a patient with a DNR who does not want more treatment.
Home Health Care is usually very temporary, covered for 60 days after a hospital stay, then totally out-of-pocket and pretty expensive.
Helpful Answer (4)
Report

The difference is, or should be considered, huge. Hospice prepares the family for impending death. This can include things like taking her off her regular medicines and aggressively sedating her "for comfort."

If you say she's not near death please reconsider hospice and like Carol said, wait until the time is right.

They might seem radical to some but organizations like hospicepatients/
can be very educational.
Helpful Answer (3)
Report

Hospice assists families too if they are called in more than a few days before death. In Indiana the ones I work with offer assistance with getting affairs in order and offer classes and grief counseling for families for 13 months after death.
Helpful Answer (2)
Report

As mentioned, generally Hospice care is for individuals who are not expected to live more than a year or so. Medicare will pay for these services.

Some home health aide, RN visits, PT and OT will be paid by Medicare for short periods of time but generally limited to visits of 45 minutes to an hour say 3 times a day. They are not going to provide a full day of home health aide coverage. Either way after about 6 to 8 weeks, they will drop the patient either claiming they don't need the service or the person has "plateaued" (can't make any more progress-which is often not true in my experience) but either way they are out the door and you the caregiver are on your own.

If they off some care under Medicare --take it but it will not last long. Long term care by a home health aide to avoid a nursing home placement will not be covered. You need to have a long term care policy to help cover these services. This is why most people have to give up on the home care and place their elder in the nursing home. Then the Medicaid program will pay for even more expensive nursing home coverage--false economy of our government funds but this is our current state of caring for people who need 24/7 coverage or help.
At some point we will figure out it is cheaper and often better to allow the senior to receive full time coverage of home health aides in their home. But we are not there today.

Good luck as you look for home health aides. I hope you can keep your loved one in a home setting.
Helpful Answer (1)
Report

Hospice offers more programs and benefits that home health doesn't offer if you need any of the extra services that they provide. Here in Ky they have a hospital that will give you or your family a break for 5 day vacation every other month. which is a valuable service for once who need the help. They offer more care and longer services. first off this is a service for any one who is at life end stage of life only. Where the other is just general help. Hospice will come when the other wants.
Helpful Answer (0)
Report

Home health care is to manage ADLs (activities of daily living) and will be covered if medically necessary by Medicare. A hospice referral from a doctor tells me that she is closer to death than you realize. It is the end-of-life services to make one comfortable with pain meds, daily care, etc., but is usually free from some non profit agencies. Take advantage of the breaks both provide.
Helpful Answer (0)
Report

I live in Indiana, so am not sure if it is the same in all states, but most of the answers above are pretty much the way it is here too. The main differences between Medicare and Hospice are these:
1-Medicare is intended for temporary in-home skilled care (nurses, aides, therapists) that is expected to be short term (60 days or less), temporary, and expected to make the person better in some way. We can often extend to another 60 day period, and another if documentation can prove the patient continues to slowly improve. Aides can only be provided 2-3 times a week.
2-Hospice, like said above, is only to be used if the doctor will state that he feels that the patient probably has 6 months or less to live. No improvement is expected to be shown as the patient is considered to be dying. Sometimes the patient does live longer than 6 months and can be extended because the doctor cannot know for sure and is sort of "guessing" at the beginning according to his professional experience. When Hospice takes over, they will stop most of the medicines that have been given to 'improve' their condition because they are not expected to improve, and just keep them on ones that will keep the patient comfortable. They will often require that their care be turned over to the doctor for their company - no longer to be seen by their own family physician or any specialists they have been seeing. The one advantage is that they offer much more personal care - around the clock if need be, including nurses, aides, grief counseling for the family, etc, and I think all of the medicines they use for the patient are paid for by Medicare (sedatives, pain meds, etc). As ferris1 states, usually Hospice is not referred to unless the doctor thinks she is terminal.

Some people will take advantage of whatever services are available through Medicare to start out with, just to see if there is any improvement to possibly be made, and then later go to Hospice once they are considered terminal. Sometimes, they will go straight to Hospice if the patient is not expected to live longer than 6 months, as stated. Medicare will not pay for both at the same time.
Helpful Answer (0)
Report

Home heath care's focus is on rehabilitation while hospice care's focus is comfort, safety, and support. A doctor's order is required for both types of care. Medicare has very specific guidelines for both services. If the doctor suggested hospice care, he may want you to listen to a presentation of the services of both hospice and home care before you decide. Caring for someone with a history of strokes can be very demanding and challenging because of constant changes and decline. The hospice staff will walk through the decline and death of a loved one and respect the way you want the care to be directed. Hospice care does not hasten or prolong the dying process. It allows the patient to remain in their home and be cared for by family with hospice support. Most people prefer to be home when they die and hospice services helps families provide a natural setting for a natural process - free of tubes and monitors, tests and painful interventions. Each person in hospice has an individualized plan of care that addresses physical, emotional, spiritual, and social needs for the patient and family.
Helpful Answer (0)
Report

My understanding from experience is that Hospice is a service that provides end of life care in the latest stage. My mother who has suffered from a ruptured brain aneurysm, now needs help with activities of daily living, similar to your mother, but medically, she is well and is certainly not in the end stage of her life...although this is her trajectory at the age of 78 with frequent falls and poor mobility and needing 24/7 care. Medically, she is fine; vital signs are good; and she is alert and oriented and able to advocate for herself to some extent, although she needs me as her POA. My suggestion is that you explore home health aids, which there are many such services available, if she is living at home. (I also understand home health aids will go to assisted living facilities (ALF) to provide similar services to augment what ALF staff provide. At least, this has been my experience.
Helpful Answer (0)
Report

See All Answers
This question has been closed for answers. Ask a New Question.