Home health care and hospice care both bring medical support into your loved one’s home, but they serve different goals. Home health helps someone recover, rehabilitate, or manage a chronic condition, typically for a limited period after surgery, a hospitalization, or a new diagnosis. Hospice focuses on comfort and quality of life for someone with a life-limiting illness, for as long as that care is needed. Neither one requires giving anything up permanently, and it’s possible to move from one to the other as conditions change.
If you’ve been told your loved one needs “home health” or “hospice” and aren’t sure which applies, or why the two get confused so often, you’re not alone. Both bring a care team into the home. Both can include nursing visits, therapy, and support from a social worker. The difference comes down to what the care is working toward.
What Is Home Health Care?
Home health care is short-term, goal-directed medical care delivered at home, aimed at recovery, rehabilitation, or managing a chronic condition so someone can stay independent. It’s ordered by a physician for patients who are homebound (meaning leaving home takes considerable effort, help from another person, or a mobility aid) and who need intermittent skilled care.
A home health team can include:
- Skilled nursing for wound care, medication management, and monitoring conditions like heart failure, COPD, or diabetes
- Physical therapy to rebuild strength and mobility after surgery or a hospital stay
- Occupational therapy to regain independence with daily activities
- Speech-language pathology for communication or swallowing difficulties
- Medical social work and home health aide support
Home health is often used after a hospital discharge, a surgery, or a new diagnosis that requires skilled care at home. Duration depends on the person’s diagnosis, functional goals, and rate of progress, with the care team reassessing along the way, and services typically end once those goals are met. For a full breakdown of these services, see Home Health Care Services in Virginia and our Home Health FAQs for more on eligibility and getting started.
What Is Hospice Care?
Hospice care is medical, emotional, and spiritual support for someone with a life-limiting illness, focused on comfort rather than curing the underlying condition. It’s available to patients whose physician certifies a prognosis of six months or less if the illness runs its expected course, and it continues for as long as the patient continues to meet those criteria, not on a fixed timeline.
A hospice team can include:
- Nursing and hospice aide visits for symptom and pain management
- Medical equipment and medications related to the terminal diagnosis
- Medical social work, chaplain support, and volunteer visits
- 24/7 on-call support and bereavement support for the family after death
Unlike home health, hospice isn’t working toward discharge. The goal is comfort, dignity, and support for the patient and the family for as long as it’s needed. To see how hospice adapts as needs change, read The Four Levels of Hospice Care Explained, and for a look at where this care actually happens, see Hospice at Home vs. Hospice in a Facility.
Key Differences at a Glance
| Home Health Care | Hospice Care | |
| Goal | Recovery, rehabilitation, or chronic disease management | Comfort and quality of life |
| Who qualifies | Homebound patients needing intermittent skilled care, ordered by a physician | Patients with a physician-certified prognosis of six months or less |
| Duration | Time-limited, based on progress toward specific goals | Ongoing, for as long as hospice criteria are met |
| Focus of treatment | Treating and improving the condition | Managing symptoms; not intended to cure the illness |
| Team | Nurses, PT/OT/speech therapists, social workers, aides | Nurses, aides, social workers, chaplains, volunteers |
| Typical cost | Usually no cost for services; 20% coinsurance applies to durable medical equipment | Covered with little out-of-pocket cost; small copay on some medications |
Can Someone Move From Home Health to Hospice?
Yes, and it happens often. If a patient receiving home health for a chronic condition reaches a point where their physician determines the illness is progressing and curative treatment is no longer the goal, the care team can help transition them to hospice. The reverse can also happen: if a hospice patient’s condition improves and they no longer meet hospice criteria, they can be discharged and, if appropriate, return to home health or another level of care.
Neither path is permanent, and your care team can walk you through what a transition would look like when the time comes. Our What to Expect From Hospice Care page covers what that transition looks like in practice.
Frequently Asked Questions
- Do I need a hospital stay to qualify for home health care? No. While home health often follows a hospitalization or surgery, it can begin whenever a physician determines it’s medically necessary and the homebound and skilled-care requirements are met.
- Is hospice only for the final days of life? No. Hospice is available to anyone with a physician-certified prognosis of six months or less, and many families find that starting earlier gives more time to benefit from the full range of support hospice offers.
- Who decides which type of care is right for my loved one? Your loved one’s physician, together with the home health or hospice team, evaluates their diagnosis, prognosis, and goals of care to recommend the right fit. You don’t have to figure this out alone.
Not Sure Which Type of Care Fits Your Situation?
Every family’s situation looks different, and the right starting point depends on your loved one’s diagnosis, prognosis, and goals. A member of the James River Home Health & Hospice team can talk through your specific situation and help you understand which service fits now.
Learn more about Home Health Care in Virginia, and review our hospice eligibility guidelines. Call us anytime at (855) 415-5744 or contact us online with questions.