Families searching for help at home quickly run into a tangle of similar-sounding terms. They describe very different services, and choosing the wrong one can mean paying for help that does not fit the need. Here is a plain-English guide.
Details of coverage and regulation change, so confirm specifics with your insurer, the agency and your loved one's doctor.
Private duty nursing
Private duty nursing is dedicated, one-on-one skilled nursing care at home, provided by a registered nurse or licensed practical nurse. The nurse can administer medications, manage equipment such as ventilators and feeding tubes, assess changes in condition and carry out a care plan, for a few hours a day or around the clock.
It is often arranged privately by the family, and it is common for medically complex children and for adults with significant needs.
Home health aides
A home health aide helps with personal care and daily living: bathing, dressing, toileting, meals and light household help. Aides do not provide skilled nursing care. They are a valuable support for many older adults, and many families use an aide alongside a nurse.
Home health agencies
A Medicare-certified home health agency typically provides skilled nursing and therapy visits. Coverage generally depends on the patient being homebound, needing skilled care on a part-time or intermittent basis and having a doctor who certifies the plan of care. Visits are usually short and scheduled, not continuous.
Care management
Care management is different from all three. It is the coordination: someone who oversees medications, doctors, appointments and supplies, and who knows the whole picture. A care manager who is also a nurse can combine that coordination with clinical judgment.
Which one does your family need?
- Need skilled hands-on care for a longer stretch of time, such as overnight? Consider private duty nursing.
- Need help with bathing, dressing and meals? Consider a home health aide.
- Recovering at home and eligible for short, skilled visits? Ask whether a home health agency fits.
- Overwhelmed by the coordination? Consider care management.
Many families combine two or more. If you are not sure, a consultation can help you sort out what is needed and in what order.
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Reserve Your ConsultationThis article is for general education and is not medical advice. Always follow the guidance of your loved one's own doctors and care team.