I was recently at a home health conference. Why was I there? Talking about end of life with home health workers? Yes, absolutely. Patients die while having home health services just like people die in hospitals, nursing and residential care facilities.
End of life knowledge is beneficial to the patient and family no matter what services are being provided. People don’t die like they do in the movies, yet most people don’t know that. Unfortunately, many medical professionals don’t know the progression of end of life either. They don’t know the signs and even what to do as death approaches — because they are not taught. (Perhaps this is a soapbox for me to get on in another blog.)
Back to home healthcare. What are the differences between hospice and home health services? The biggest difference between the two is the prognosis. Medicare requires that through home health treatment and medical assistance, the patient is expected to improve. Hospice, on the other hand, is required to show a non-fixable prognosis, to show that the patient is not getting better and is in fact approaching death.
Here are some more differences between the two.
Visit length:
Home Health –They assess the patient and administer treatment. The length of the treatment is determined by the amount of time it takes to provide the necessary treatment.
Hospice –In addition to assessing and treating, hospice workers support and guide the caregiver and family, address emotional and spiritual concerns, and educate as to signs of approaching death.
Reasons for the visits:
Home Health –The visits are medically ordered.
Hospice – The hospice professional determines the reasons for visits. The reason does not have to be medical.
Additional services provided:
Home Health –A range of therapies are offered with the intention of getting the person back to leading their normal life. These can include physical, speech, and occupational therapies.
Hospice – The above therapies are offered, but generally referrals are too late to provide assistance. If a patient is on the medicare hospice benefit, the medical equipment, supplies, and medicines related to the life-threatening illness are paid for. Bereavement follow-up after the death is also provided.
Reimbursement:
Home Health – Coverage is determined on a per-visit basis. Medicare can determine it is not a valid visit and decline to pay. Some insurance policies offer home health services, often with a co-pay.
Hospice – Coverage is on a daily basis, no matter how many visits there are in a day…
On call system:
Home Health – Visits are for medical necessity.
Hospice – Visits are made no matter the hour or reason the caregiver has. The reasons for a visit can include approaching death, fear, or to pronounce death.
Medical team’s interaction with the patient & family:
Home Health – While there is some instruction for families as it relates to the disease, they are primarily there for the patient.
Hospice – Both the patient and the family are considered integral parts of the care. Sometimes the staff is more involved with the family than the patient.
In our medical system of services both home health and hospice have their place. Both are necessary. And end of life instruction is crucial.
Something More… about Yes, Death Happens in Home Health, Too
My Exclusive End-of-Life Care Course with Activated Insights is a program of online courses designed to train, educate, and guide caregivers in end of life care, whether you’re a home healthcare professional, a family member, or a patient. These courses provide insights and knowledge that caregivers can use to compassionately serve their patients during their final days. Care professionals can also earn CE hours through the end-of-life care series. Each learner will earn a certificate of completion, and 5 CE hours will be awarded to participating healthcare professionals.
