Difference between Hospice & Home Health

Transcript of Interview: ” Difference between Hospice & Home Health”

Mike Barnes:

Yeah, it seems like there’s so many things that there is so much confusion about when you’re talking about your aging parents in so many different ways. I think hospice and home health is, to me, so confusing because I don’t really understand the difference in some ways. When do I call in one? When do I call on the other? Could I actually have both?

Kim Barnes:

Absolutely. So today we’re bringing in Jessica Davis from Generations Hospice because we want to try to sort of cut through that confusion. I think that way we can be better advocates for our aging parents. Jessica, thanks so much for being with us.

Jessica Davis:

Good morning and thank you for having me. I think this is a huge topic that even I get confused about a lot, so I think it’s good to kind of lay it out, at least in some form, the differences between home health and hospice and how they can work together in some cases.

Kim Barnes:

Yeah, absolutely. Because I think that when you see your aging parent has a problem, it’s hard sometimes to know who can help them and what they can be helped with. So let’s just start with, you know, both hospice and home health come to you. Generally, just in case people have heard, there are some hospice locations where you actually go to hospice, and I think that’s really how it started. But the current model is, most of the time, they’re going to be coming to you. Correct me if I’m wrong.

Jessica Davis:

That’s correct. Most individuals, we don’t have a location they can go to, so instead, we go wherever they are, whether that’s the memory care, the assisted living, or their homes. Wherever they are, we go straight to them.

Kim Barnes:

So both home health and hospice will come to you, but they serve very different purposes in many cases, correct?

Jessica Davis:

Yes, and my team, Generations Hospice of Austin, does the hospice piece of that. But I think you’re right, it’s so confusing. It’s good to note that both of those entities, home health and hospice, can come to you where you are and serve whatever role you’re looking to achieve.

Mike Barnes:

Let’s start with hospice. There’s a misconception that when someone goes on hospice, it means that this is the very end, like we’ve got 10 days or two weeks. I think often people don’t bring in hospice until then because they think that’s its purpose, but it’s really much bigger than that.

Jessica Davis:

It’s really a huge misconception. Even in the senior living community, we try to educate people, but I still talk to people daily who think this needs to be the last three weeks of our family member’s life. For example, in my own family, there were six children, and my grandmother was in the last three weeks of her life before they brought in hospice care. It was sad to see that she could have been helped for a lot longer. She had spinal cancer, so it was really sad even for me to watch that happen to my own family. On the other hand, I have individuals who have been on hospice for three years and are thriving. They still qualify and need us, but they’re not on their last three weeks of life. They have a lot of life left and a lot of quality time to spend with their loved ones.

Mike Barnes:

I think it still confuses a lot of people, especially when you bring home care into the mix. Home care, home health, and hospice can all be confusing. My dad is 85, and today is his birthday. He’s doing well, but if things were going bad for him, I’m not exactly sure whom I should call first. Besides going through the whole diagram of home care, home health, or hospice, who do we call first? Do we rely on the doctor, someone like you? How do we find out whom to talk to?

Jessica Davis:

One hundred percent, reach out to one of the agencies. If that’s me, great. I probably only take in about 20% of the patients and families I talk to because many just need resources in other places. Even though I don’t do home health, there are many home health and home care agencies I refer to and trust. I think calling someone who has more knowledge is crucial. It changes every day, and I can’t even keep up, so I don’t expect others to. At least I know where to start. If you have a good agency or person to talk to, they’re not going to push you into something that isn’t right for your loved one. The goal is to get them to the right place, not just put them in a program to put them in a program.

Kim Barnes:

Thinking about the fact that you don’t have to be actively dying to be on hospice is essential. Can you give us some examples of when you would need hospice versus home health?

Jessica Davis:

Sure. Alzheimer’s is a common issue. Home health’s goal is to restore some type of function or bring you back to some baseline. If they think physical therapy, skilled nursing, and occupational therapy will get them back to a baseline where they can thrive, then home health is a great option. You’re going to get a skilled nurse, physical therapist, occupational therapist, speech therapist, and an aide to help with bathing in limited cases. They’re going to bring them back to a level they were before.
For example, if someone comes out of the hospital after surgery or a stroke, home health may be a good first step to get them back to where they can be. Once they progress to a point where they’re not showing improvement, that’s when hospice can take over to focus on quality of life. This doesn’t have to be the last few weeks; it can be longer. Individuals on hospice often get better because they have a team surrounding them. Home health provides limited people coming into your home, while hospice offers a whole team, including a skilled nurse, someone to help bathe, a social worker, a chaplain, medical equipment, medications, and incontinence supplies.

Kim Barnes:

That’s an example for someone with advanced Alzheimer’s. They might start with home health until they reach a point where they aren’t gaining anything more and then transition to hospice, which is more encompassing and available 24 hours a day, even if they’re living in a memory care community.

Jessica Davis:

Absolutely. We have nurses available 24 hours a day. If the memory care calls needing an assessment, a nurse goes out no matter the time. Hospice aims to keep them where they are. If we can do an x-ray or provide medications for a UTI there, we will. Home health would refer you to your doctor for medications, but hospice has a medical director and can order medications directly.

Mike Barnes:

Am I oversimplifying things by saying home health tries to make things better, like with a broken bone, and hospice helps you feel okay?

Jessica Davis:

We’re trying to create a different quality of life, focusing on comfort and care rather than restoring to a previous level. It’s about feeling good and spending time with loved ones.

Mike Barnes:

So, if I look at my mom’s or dad’s condition, whether it’s Alzheimer’s or a broken bone, I can determine if it’s home health or hospice and then call an expert like you.

Jessica Davis:

Yes, absolutely. It’s a good way to think about it. I see many individuals in your Facebook group struggling with decline and not seeing improvement with home health. Please reach out for more help. It’s not giving up on a loved one; we still treat infections and other issues but focus on comfort rather than aggressive treatments like chemo or radiation.

Kim Barnes:

Can you give us other examples of conditions that are a good fit for hospice?

Jessica Davis:

COPD, lung disease, heart failure, congestive heart failure, and Alzheimer’s are good examples. Signs to look for include falls, inability to do daily activities, weight loss, and confusion. If you see these signs, it’s time to have a conversation with someone.

Kim Barnes:

Home health might be more for orthopedic issues, strokes, or heart attacks. It’s often about managing or improving from an event or diagnosis. Is that fair to say?

Jessica Davis:

Yes, absolutely. After a heart attack, home health helps you regain strength and function. If it doesn’t work, hospice is a good option. Hospice can provide some physical therapy, but not as much as home health. They usually serve different purposes.

Kim Barnes:

What questions should we ask if we think our parent might be eligible for hospice?

Jessica Davis:

Ask how they’ll serve your loved one and your family. Staffing levels are crucial. For example, at Generations, our nurses see only two to three patients a day. If a nurse sees ten patients a day, what does that look like for your loved one? Ask about staffing, how often they bring supplies, how quickly you can access them, and how they coordinate care. Communication and coordination are key.

Mike Barnes:

Jessica, you’ve helped clear up a lot of confusion. Thank you so much for all of your expert advice.

Jessica Davis:

Thank you for having me. Your group brings attention to important topics.

Kim Barnes:

What it all comes down to is knowing who the experts are and not being afraid to ask them what they think you should do. The more you know, the more questions you have.

If you have any other topics you’d like us to discuss, please let us know. Parenting Aging Parents.

*This transcript is auto-generated. Please excuse any typos or mistakes.