Home Health Care vs. Skilled Nursing: Which is Most Appropriate?

The trend is unmistakable – a significant number of older Americans now prefer to receive their health care at home rather than in a clinical or medical setting.

While this desire may have always been there, it’s undoubtedly grown stronger, almost by necessity, as the healthcare industry attempted to navigate the pandemic.

According to the Home Care Association of America, U.S. home care spending reached an all-time high in 2020. In 2021, there were about 9,000 more home care agencies than there were five years ago. These trends are expected to continue this year and beyond.

While it may be preferential for some, there are many variables to consider when determining whether home care is more appropriate than another health care option like skilled nursing.

How severe is the injury or illness? How mobile is the patient? Do they require constant supervision? Do they need help with basic living tasks like feeding, going to the bathroom, getting dressed, or taking medication?

Answers to these questions will help dictate which setting would best provide the care and attention you or your family member requires to recover as quickly and completely as possible.

In some cases, a patient’s condition isn’t the most significant deciding factor in whether they will receive treatment at home or in a skilled nursing community. Many times, it’s just the patient or caregiver’s preference. That’s why it’s helpful to understand the main differences between the two options, so you can discuss with your doctor the best choice for you.

 

SKILLED NURSING

Skilled nursing facilities, sometimes referred to as rehab facilities, are commonly used as a short-term transition from a hospital stay to home or assisted living. The goal is to help the patient resume the lifestyle they had prior to the illness or injury that triggered their hospital stay.

The specific services provided at a skilled nursing facility are usually nursing care and physical, occupational, and/or speech therapy. Clinical staff is available 24/7, and the facility works with the patient’s following physician to manage their care.

The length of stay is determined by the medical condition, recovery progress, and insurance criteria for coverage. Once the patient has stabilized or stops making progress, they are discharged. If the patient has not recovered enough to return home safely, long-term care in skilled nursing could be recommended.

Pros of skilled nursing

Skilled nursing facilities are experienced in handling complex needs. Here are some advantages of treatment received at a skilled nursing facility.

Quick access to healthcare services.

With a skilled care provider onsite, patients receive immediate attention. This is especially important for fall risk patients.

Guidance on diet and nutrition.

Skilled nursing facility staff can work with the dietitian and their team to ensure that patients get the nourishment they need for recovery and energy.

Physical activity opportunities.

A trained caregiver or physical therapist gives input on and coordinates physical activities that are best for each patient, based upon medical history and health status.

Assistance with daily living tasks.

Skilled nursing facility caregivers can assist patients with activities of daily living that may be difficult because of injury, illness, or age.

Sense of security.

It can reassure the patient and their family to know that a care provider is available when needed. Having someone available to monitor health and recovery brings some peace of mind.

Therapy opportunities. 

There are many more therapy opportunities at a skilled nursing facility than at home. It’s not unusual for a patient to receive physical therapy (PT) and/or occupational therapy (OT) twice a day in a skilled nursing facility. Speech and respiratory therapy are sometimes available, too.

Coordination of medical services.

An excellent skilled nursing facility will coordinate and manage patients’ medical services. These may include X-rays, follow-up surgeon appointments, and communication with the primary care physician.

 

HOME CARE

Suppose you or your loved one are homebound or prefer the comfort and familiarity of home during recovery. In that case, it’s still possible to receive a similar level of care at home as you would in a skilled nursing facility.

Along with recovery care, home health is also a convenient way to receive some routine medical care. You could hire a registered nurse or therapist directly, or work with a trusted home health provider like At Home with Shepherd to provide a nurse, therapist, or aide to visit as often as necessary for your specific needs.

When they visit your home, skilled nursing care providers will help with:

• Health monitoring
• Medication management
• Education on disease processes
• IV therapy
• Physical, Occupational and Speech therapy
• Wound management
• Catheter care
• Dressing changes
• Feeding tubes and other forms of nutrition
• Dietary guidance
• Blood draws and injections

At Home with Shepherd works closely with your physician to achieve the goals that are established when care is started and updates your physician throughout your home care plan.

Besides feeling more at home during recovery or rehabilitation, there are other benefits to choosing home care instead of skilled nursing care.

Family members are involved in the care

When a health professional treats you at home, you may be able to arrange for a family member or friend to be present. This allows them to be involved in your care, ask questions, and better monitor the care you’re receiving.

One-on-one care is provided

Person-centered and customized care is vital to recovery. Patients receiving home health care know that the professional is focused entirely on them during each session, and there won’t be any outside interruptions.

Allows customized therapy

Exercising in a wide-open space is one thing, but using actual permanent surroundings is something else. If the physical therapy session is done in a patient’s home, the therapist can demonstrate exactly what patients can do in the house for themselves and safe ways to complete these tasks.

Choosing which health care option is appropriate can sometimes be a difficult decision. And it’s an important one. So, when the time comes, seek out the advice of family and friends, and research several options to make sure that the care provided will help you or your loved one recover in a healthy and timely manner.