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Aging Resources WNC

Exploring Home Care and Home Health Care

You or a loved one may need assistance with daily living tasks such as bathing, getting dressed or running errands. Or perhaps you or your family member needs medical care such as skilled nursing, physical therapy or prescription management.

Home care and home health care services are available to address all of these needs and to help you maintain your independence and quality of life in your own home. By understanding the differences between these two options, you can craft a care plan that best suits you or your loved one both in terms of the help you need and how you will pay for the care you receive.

Home Care

Home care services require no doctor’s orders, can be contracted for 24 hours a day and can continue as long as someone wishes. Home care involves custodial care and is sometimes also referred to as personal care, attendant care, non-medical care or companion care.

Determining the Care You Need for Various Life Situations

Home care services can include meal preparation, personal care, light housekeeping, shopping and other errands, and companionship. Some home care agencies offer geriatric care management, a service that oversees and coordinates all the outside services in a client’s home — from hiring a lawn service to coordinating medical-related home health care visits and more.

Although often crucial to being able to stay independent at home, home care typically is not covered by health insurance, but it may be covered by a long-term care policy if you or your loved one happens to have one.

When looking for a home care agency, ask if the home care agency:

• Can provide services within 24 hours of a request;

• Offers services any hour of the day and every day of the week;

• Sends a substitute home care aide if the assigned aide is unable to come;

• Is bonded and insured for up to $1 million; and

• Conducts criminal background checks and does other pre-employment screening of their employees.

Because the cost of home care is typically out of pocket, some people consider hiring an individual themselves instead of using an agency. If you are exploring that option, consider running criminal and other background checks on the caregiver and get client references. If you go the non-agency route, you also will need to make a plan for:

• What happens when the individual caregiver is ill or unavailable

• Withholding taxes, Social Security and Workers’ Compensation Insurance

• Homeowner’s insurance that would cover if a caregiver is hurt on the job

• Hiring an individual caregiver with the flexibility to change with your needs

• What actions to take should the caregiver harm your family member

Home Health Care

Home health care is in-home medical care ordered by a doctor. The cost is often covered by private health insurance or Medicare. Home health care procedures are performed by medical professionals and include services such as skilled nursing care, medication management, wound care, physical therapy and disease management training. Home health care professionals are in a patient’s home only long enough to carry out treatment.

Home health care is typically prescribed after a hospital stay. A home health care prescription can be taken to any licensed agency covered by your insurance. To be proactive with your planning, research agencies before a hospitalization occurs.

When choosing a home health provider, be sure the agency:

• Is licensed

• Accepts your loved one’s insurance

• Can begin providing services within 48 hours

• Is on call 24 hours a day

• Has a policy for you or your loved one to be able to reject particular care providers if you or your loved one don’t like them or feel they are not a good fit

• Gives you references from a current patient, a patient’s family member and a business that refers to them

As we and our loved ones age, there may be times when home care and home health care will be needed. By understanding what these different services offer, the most appropriate in-home help can be found. 

Home Care Resources

North Carolina home care agency licenses can be checked at the N.C. Division of Health Service Regulation at:

A comparison of home health care agencies, a checklist for interviewing and more tips for finding the right agency can be found at Medicare’s page at

Aging Resources Magazine 2023-2024