Seniors with significant health challenges may be considering additional medical assistance. Both home health care and hospice care can be provided in the home, but each is for a very different purpose. Understanding the differences can help you decide what type of care is right for you or your loved one. 

Home health care is designed to help people recovering from illness or injury. It provides rehabilitation and recovery care in the home, allowing you to save money and recuperate in a comfortable setting. Hospice care, on the other hand, is for people with terminal illnesses. It focuses on the person rather than the disease and aims to make a person’s last months as comfortable as possible. 

This guide goes into greater depth about the care provided by home health care and hospice care. It details what services are provided, the costs involved, and who should consider each type of care.



Home Health Care

Hospice Care

Setting

In-home

In-home or residential

Care Provided

Skilled nursing and medical services

Social and spiritual support, palliative care, bereavement counseling for families

Average monthly cost

$5,148

$4,560 in-home, $19,770 residential

Who Should Consider It

Seniors who need medical care but don’t wish to move into a residential setting; those recovering from illness or injury

People with a terminal illness

Home Health Care

Home health care provides skilled nursing and medical services in the home. The care is usually part of a doctor’s treatment plan and can include wound care, medication management, occupational therapy and physical therapy. Home health care providers also monitor recipients’ health and recovery. Some home health care agencies offer personal care, such as assistance with grooming, hygiene and housekeeping. However, this is technically in-home care and not counted as home health care. 

These services allow people to continue rehabilitation in their homes. Often, home health care is provided after hospitalization or when a person is recovering from a severe illness or injury. The care can be temporary until seniors can manage on their own again. In some cases, home health care lasts indefinitely. Either way, the care is always based on a doctor’s plan. 

The average cost of home health care in the United States is $5,148 per month. This calculation is based on 44 hours of care per week. The hourly average is $27, and your exact costs will vary greatly depending on how much care you need. If your services are part of a treatment plan, they will likely be covered by health insurance, such as Medicare and Medicaid. Home health care costs may also be paid for through veterans benefits, Medigap and long-term care insurance.

Hospice Care

Hospice care is a specialized form of care for people who have a terminal illness. To qualify for hospice care, a doctor must state that the patient isn’t expected to live for more than 6 months. A hospice care team provides a range of services designed to make a person’s final months as comfortable as possible. 

Hospice care is provided where the patient feels the most comfortable. This means the care team can come to their home or an assisted living facility. Also, inpatient hospice facilities are available for people who need more complex medical assistance to be comfortable. 

Services provided through hospice focus on the person rather than the disease. Social services and spiritual support help people come to terms with their condition. Bereavement support is also offered to families after their loved one passes away. Hospice care doesn’t include any medical treatment designed to cure the disease but does provide palliative care to help ease pain and symptoms.  

Hospice care costs vary by location. For more general figures, a typical hospice care facility reports a range of roughly $150 a day when provided in the home and $650 per day in an inpatient facility. Medicare and Medicaid both cover hospice costs. Once enrolled with a hospice agency, services for the cure or treatment of the terminal condition are no longer covered. Hospice agencies may also offer free care or a sliding scale of costs for low-income people. 

Frequently Asked Questions


How does home health care work?


After you choose a home health care provider, the agency assesses your needs and develops a plan of care. This is reviewed and approved by your doctor. The plan details what services you will receive and when caregivers will attend your home. You can request visits at certain times to fit your schedule, and the care plan can be adjusted as needed. The home care agency may request an extension of services if you continue to need care, though you should check to make sure your insurance covers any extended care. 


How does hospice care work?


After you and your doctor decide hospice care is the right choice for you, you choose a hospice care agency. The agency finalizes paperwork to formally enroll you in the service and develops a care plan and schedule to take care of your needs. This plan can change as your needs change. You have a lot of control over the way care is provided and can request a change in caregivers or hospice agencies if you’re not satisfied.


How long do people receive home health care?


According to the CDC, 4.5 million people received home health care in 2015. For most people, this care is temporary until their medical needs are taken care of. However, exact statistics on length of care aren’t available. The Administration for Community Living states that the average person receives 2 years of care at home. However, this includes both in-home care and home health care. Some people stop receiving home health care because it’s no longer needed, while others move into residential communities, such as assisted living facilities or skilled nursing homes. 


How long do people stay in hospice care?


Hospice care is only available when a doctor certifies you have a life expectancy of 6 months or less. As most people don’t enroll in hospice care until their condition has progressed, around half die within 3 weeks of beginning treatment. However, 12-15% of hospice patients are alive after 6 months. If a doctor certifies that you still have a terminal illness, your hospice care can continue. You can leave hospice care if your condition improves or you go into remission.