Nurse with patient in home

Home Health VS Hospice



Home health agencies bring their services to the private homes of patients in need of skilled care related to their diagnosis, including, but not limited to, registered nurses, certified nursing assistants, speech/language pathologists, physical therapists, and occupational therapists.


Most patients receive hospice services from a Medicare-certified hospice organization, which provides each patient with an interdisciplinary team—physician, nurse, hospice aide, social worker, chaplain, volunteer, and bereavement specialist—who come to the patient’s home, wherever they call home: private residence, assisted living community, nursing home.



The length of service is determined by the goals of care. The amount, frequency, and time period of the services need to be reasonable and the condition must improve or be maintained through therapy.


The patient receives unlimited visits for six months or longer, as long as the patient continues to have a limited life expectancy, as determined by a physician.



Home health care patients are recertified after each 60-day episode of care. Medicare does not limit the number of continuous episode recertification for patients who continue to be eligible for the home health benefit.


A physician must recertify a patient if they outlive their initial six-month prognosis. The first two recertification periods are 90 days; after that, the patient must be recertified every 60 days. There is no limit to the number of times a patient can be recertified, as long as the physician’s prognosis is six months or less from the time of recertification.



Home health care patients must be certified by a doctor that they are homebound except for short durations.


Hospice patients do not have to be homebound. That is, they can leave home, take a walk, do errands, and even take a trip if they feel well enough



The Medicare home health care benefit does not cover 24-hour care.


Hospice can provide up to 24 hours/day of skilled nursing and hospice aide services for patients who need acute symptom management and want to remain at home.



Home health agencies do not follow patients when they need inpatient care in a hospital


Hospice care can be provided in an inpatient setting for short stays until symptoms are under control and the patient can return home.



Home health care is provided in the patient’s private residence and cannot be given to patients in a long-term care facility.


Hospice services are brought to patients anywhere they call home, including assisted living communities or nursing homes.



Medications are not covered for home health care patients under the Medicare home health benefit.


The Medicare hospice benefit covers all prescription and over-the-counter drugs related to a hospice patient’s terminal diagnosis.



For home health care patients, medical equipment and supplies must be ordered by their physician and are covered 80 percent when approved under Medicare Part B qualification guidelines.


Under the Medicare hospice benefit, all equipment and supplies related to the terminal diagnosis are provided and covered 100 percent. The need for equipment, oxygen, and other products is determined by the patient’s palliative plan of care.



Medicare does not cover personal care services for home health care patients


A hospice aide who provides personal care, such as bathing and mouth care, is a member of the hospice patient’s interdisciplinary team and is covered 100% by the Medicare hospice benefit.



For Medicare patients who have met the home health criteria, home health care is covered while the patient is on hospice for conditions not related to their terminal diagnosis.


For Medicare patients who have met the home health criteria, home health care is covered while the patient is on hospice for conditions not related to their terminal diagnosis.

Doctor with Patient

Our Hospice Philosophy

Alpha Home Health and Hospice believes that choice always exists. Excellent quality of life is always attainable — people with illness can live fully and die well.

When death is accepted as a natural part of life, hope changes but does not disappear. A person faced with serious, life-limiting, or terminal illness need not stop reaching for wishes and dreams. Alpha Home Health & Hospice has a bias toward saying yes, and we focus on enhancing and maintaining the quality of life as defined by each patient and family.

Hospice is a philosophy aimed at providing palliative (comfort) care to patients in their end-of-life stages. To carry out these services, Alpha Home Health and Hospice utilizes a medically-directed Interdisciplinary Group that involves patients, their families, professionals, and volunteers. We believe that a “family” includes anyone significant to the patient, regardless of blood relation.

The goals of palliation are comfort, dignity, and quality of life. The difference between this and other treatments designed to cure or control a disease is that palliative care focuses on the person living with the disease rather than on the disease itself. People may choose palliation before “all else has failed” if, in their experience, the burdens of continued curative treatment outweigh its benefits. While Interdisciplinary Team members have expertise in hospice and palliative care, they are not experts in any individual situation. The only experts are the patient and family. They are in charge of determining how their care is planned.

Every effort is made by the hospice team to provide maximum physical comfort for the patient. Hospice then focuses on the heads and hearts of those experiencing the disease process–preparing emotionally and spiritually for death. Alpha Home Health and Hospice considers it just as important to provide these services to family members as we do to our patients. This is one reason why we provide bereavement counseling for all those grieving the loss of a loved one.

Palliative care does not automatically include nor exclude any specific treatment or approach.  Hospice looks at each difficult symptom–from physical pain to anxiety and isolation–and outlines options for addressing that symptom. Multiple choices are always available. The benefits and burdens of each option are considered, and the patient and family select the option that feels most comfortable.

Alpha Home Health and Hospice was created by seasoned hospice professionals who are committed to providing care that exceeds all expectations. We do this without prejudice in an environment that supports the integrity and dignity of all people, 24 hours a day, seven days a week.

The Caregivers Role

You may not think of yourself as a caregiver, but anyone who helps someone else because that person is no longer able to manage some or all of the activities of daily life is considered a caregiver. Whether the caregiver is a relative, spouse, friend, neighbor, volunteer, or medical professional, it is important to identify the caregiver role.

Your journey in the caregiving role may include a wide variety of experiences. While there are often many intrinsic benefits to caregiving – spending time with a cherished loved one, feeling needed, the opportunity to serve – there may also be challenges and special considerations you must take.

Your role as a caregiver is very important, as another individual depends on you. If your well-being suffers, you may become unable to care for another. So, if you’ve accepted the caregiver role, you also have a special responsibility to take care of yourself. That means assessing and taking care of your own physical, emotional, mental, spiritual, interpersonal, and financial needs. When you have attended to your own needs, you will have so much more to give to the person you’re caring for.

Your Physical Health

Woman holding weight in hand

Physical health is a key caregiver concern. This begins with adequate rest every night. If this is not always possible, then try to fit in naps or break periods during the day. A regular bedtime and a light snack or warm milk may help you fall asleep. Beyond daily rest, you may need periodic breaks from caregiving, and you can plan for a period of respite, such as a long weekend. Discuss this option with a member of your hospice team.

Physical exercise is also important. Regular exercise, for instance, will strengthen you for the rigors of caring for another who needs assistance with their own movement. Generally, physical exercise will help you rest better. It is recommended that you aim for a minimum of 20 minutes of exercise four times a week. Fresh air and sunshine can also lift your spirits, and nature is a great healer.

Good nutrition will facilitate your own health and vigor and support a healthy immune system. If you receive offers of help from others during this time, request a nutritious meal – it is a simple way for others to support you. Any physical illness or healthcare needs should be attended to promptly in order to shorten your recovery time.

Emotional needs

Woman Thinking

Emotional health is closely related to overall health, but may be overlooked. Caregivers experience the full range of human emotions – including anger, guilt, impatience, depression, helplessness, love, loneliness, and isolation – sometimes all at the same time.

At times you may tell yourself that some of these feelings are “good” and others “bad.” Rather than label them, it is important to know that all these feelings are normal. Acknowledge your feelings. Accept them. Realize that your situation is not unique and many other caregivers share these feelings.

It may help to have a close friend or confidant you can call daily. It helps to talk to another person so you don’t become overwhelmed. You might choose to create a list of people you can call. Remember, your Alpha team is also available to listen and act as a resource for emotional support – we are here not only for the patient but for family and caregivers as well.

Due to the number of tasks that need to be completed, stress is almost inevitable in caregiving, and it is often compounded by inadequate rest. While there is often little to be done to change the circumstances creating stress, there are many ways to cope with it.

The following are some suggestions to help alleviate some of your stress:

  • Keep a journal or diary. Writing about your feelings can reduce stress.
  • Read a book or listen to music. These activities provide a pleasurable diversion.
  • Take a long, relaxing bath with bath salts or aromatic oils.
  • Consider getting a therapeutic massage; even a back rub from a friend can help.
  • Listen to relaxation tapes – you can find them at a public library.
  • Exercise. Physical activity naturally produces chemicals in the body that help reduce tension, anxiety, and depression.
  • Stay focused in the present moment. Don’t fret about work when you are caregiving or worry about your loved one when you are away.
  • Take a few moments in nature to lift your spirits.
  • Stroke or brush a pet – this is a therapeutic activity for you and the patient.
  • Laughter is healing –watch a funny movie or read a humorous book.
  • Pursue a creative outlet or enjoy a hobby, such as playing a musical instrument, singing, sketching or painting, or writing a short poem. These activities can do much to relieve stress and express emotions.
  • Perform spiritual practices such as prayer, meditation or inspirational reading.
  • Join a support group.
  • When offered time off, take it without guilt or worry. The break will refresh you and help you be a better caregiver.

Spiritual Needs

Woman Meditating

Spirituality is highly personal, widely defined, and important to many individuals. Some find their time as a caregiver reinforces and strengthens their spirituality. Others may be challenged to find the time to participate in their previous spiritual or religious practices while busy with the demands of caregiving. If your personal spirituality is important to you, you may need to temporarily adjust your caregiving. You might add a regular quiet time to your day for prayer, contemplation, or meditation. Time spent in nature can be rejuvenating. Inspirational reading or music may help you stay connected to your spiritual source. Your Alpha Hospice chaplain is available to talk to you and direct you toward helpful resources.

Making It Happen

Who has time for all of this? Keep in mind that one activity may help to achieve balance in your life. For example, a walk with a friend provides physical exercise and social interaction and is emotionally and spiritually uplifting. Hobby groups may relieve stress and allow you to discuss current events. Singing in a choir provides a change of scenery, a creative outlet, and social contact.

The most important thing is to begin. It may be difficult to make many changes all at once, so select at least one or two areas to work on right away. Set a realistic goal for yourself to maintain your own well-being and regain a sense of control and balance. Alpha Hospice team members know all about the caregiver role and can help you through any challenges you may encounter during this journey. Don’t hesitate to use them as your own resource.

Two people holding hands

Respite Care

How Respite Care Helps

Respite care services provide temporary in-home care for elderly or disabled individuals, allowing family caregivers to take some time off from their caregiving role while ensuring that their loved one is well cared for. At Alpha, our in-home care program matches your loved one with one of our friendly and compassionate caregivers. Our professional staff can visit for a few hours a day or several times a week to provide family caregivers with the opportunity to run errands, go to work, take a vacation, or simply rest and recharge.

How We Help

You can feel exhausted while caring for an older adult loved one who needs help 24-hours a day. During these situations, Alpha Home Health and Hospice can provide well-deserved respite services for family caregivers and offer necessary assistance to their loved ones. Our professional respite care services will restore your peace of mind and you can rest assured that you or your older adult loved one is in the caring hands of skilled professionals, 24-hours a day, 7-days a week.

When our caregivers visit, they will quickly put your loved one at ease. While engaging in friendly conversation, caregivers can also provide assistance with a wide variety of home care needs. Our caregivers can help your loved one with dressing and bathing, transferring assistance, and other personal care needs. They can also help around the house performing simple chores and preparing healthy meals. The valuable care we provide makes it easy for your loved one to look forward to these visits and can help relieve the anxiety or guilt you may feel by stepping away for a few hours.

Labor of Love 

Caring for an elderly or disabled loved one is a labor of love that can prove stressful over time. Respite care can help prevent the troubling symptoms of caregiver burnout, including:

  • Stress
  • Depression
  • Fatigue
  • Anxiety
  • Anger
  • Decline in overall health
  • Disinterest in once-loved activities
Nurse with patient at bedside

What is Hospice: Myths About Hospice Care

‘Hospice’ is a term that describes a specific type of symptom management care for people who will eventually die as a result of a progressive disease. In order to make informed decisions and take advantage of the personalized level of care and services that hospice offers, we can correct our misconceptions.



Myth: People cannot be referred to hospice until death is imminent.

Correction: While it is true that some hospice referrals are made “after all else has failed”, it is also true that consumers are demanding more choice and control regarding their health care. In response to wishes for comfort, dignity, and quality of life, a new trend toward earlier hospice access is emerging.

Myth: Hospice means “giving up”.

Correction: Hospice means changing focus. The focus of hospice care is on aggressive management of the patient and family’s experience of the illness, as distinct from an aggressive focus on treatment to cure the illness itself. Hospice care is dedicated to enhancing and maintaining comfort, dignity, and quality of life as defined by a patient and his or her family. In fact, if a palliative approach to illness meets their goals, asking for and receiving hospice care “after all else has failed” is often the greatest regret patients and their families have.

Myth: Hospice care takes place in a hospice facility where the patient must move in order to become a hospice patient.

Correction: While a small percentage of hospice care occurs in hospice facilities, the vast majority (over 90%) of hospice care occurs in patients’ homes (including nursing homes). We realize that most people prefer to live their remaining days at home; it is not necessary to relocate to a hospice facility to become a hospice patient.

Myth: Hospice patients receive large quantities of narcotic medication to control their pain. That makes them drowsy or unresponsive and sometimes leads to addiction.

Correction: Hospice professionals are experts in comfort care. Many different methods of pain and symptom control, including relaxation techniques and massage are available today. In the event that medication is a preferred treatment, there has been no evidence supporting the idea that prolonged drowsiness occurs when narcotic medication is used to control real physical pain. In fact, as long as real physical pain is present, addiction is never an issue.

Myth: Once a person enrolls in a hospice program they decline very quickly.

Correction: Rapid decline is always possible when a serious illness is present. It is more common, however, for hospice patients to rally in response to the personalized care for mind, body, and spirit they receive. The goal of hospice is to provide care for all the problems that interfere with the quality of life.

Myth: Patients can only receive hospice benefits for six months or less.

Correction: There is, indeed, language in Medicare, Medicaid, and most private insurance policies speaking to a requirement for the life expectancy of six months or less. There is recognition, however, that every person progresses through the stages of illness differently; thus, it is exceptionally uncommon for a policy to limit the number of days or months for hospice care. The stability of the disease process is never a cause for discharge. If the underlying terminal disease process continues to be present and the patient and family continue to desire a palliative approach to treatment, they can keep their hospice benefit for as long as they need it. Hospices are not required to discharge a patient because of failure to die.

Myth: Once somebody chooses hospice care they can never change their minds.

Correction: Freedom of choice is always a right of patients and families. At each point of symptom change along the way, hospices should encourage patients and families to continually assess their goals and options.

Care team diagram

Overview of Services: The “People” Part of Hospice

The Inter-Disciplinary Group (IDG) is composed of individuals who provide the complete spectrum of care to the patient and his/her loved ones. The team members are a community of care providers with the patient and family at its center. Alpha Home Health and Hospice team members contribute expertise in managing physical, emotional, and spiritual symptoms – but the patient and family are the experts when it comes to determining how their care is planned. Each patient’s IDG members include the patient’s primary care physician, the Alpha Hospice Medical Director, the patient’s Hospice Nurse, Certified Nurse’s Assistant, Social Worker, and Chaplain, and sometimes a volunteer. With the patient’s and family’s goals, and our knowledge, we will collaboratively develop a Plan of Care that is individualized and carried out by hospice professionals and volunteers. IDG members are in constant contact with one another regarding each patient and family.

Every two weeks, the IDG and the Medical Director will meet to review and update each patient’s Plan of Care. The patient and family’s participation in the Plan of Care helps us meet their needs, thus achieving comfort, dignity, and quality of life. Hospice services are provided in the place the patient calls home on a scheduled basis or as needed 24 hours a day.


All hospice care is provided under the guidance of the patient’s primary doctor and Alpha Hospice’s Medical Director. The medical director oversees physician services within our organization. He/She will act as a medical resource to IDG (Inter-Disciplinary Group) members and is available to supplement primary physician services. He/She is present at IDG meetings, routinely directing and approving the Plan of Care. If the IDG identifies the need for physical, occupational, or speech therapy, these services are recorded in the Plan of Care and ordered by a physician.


Each Alpha Hospice nurse is a licensed and skilled professional with expertise in end-of-life care. He/She is there to minimize any distressing symptoms and serve as a teacher and supporter. The nurse maintains ongoing communication with the patient, his/her family, caregivers, and other members of the IDG. Each patient’s primary nurse is notified of any contact that patient has with other nurses (for example, during on-call hours).

Nursing responsibilities include:

  • Completing initial assessments to determine hospice needs
  • Evaluating and re-evaluating patient and family/caregiver needs
  • Administering medications and treatments as prescribed by the physician
  • Counseling the patient and family in meeting the nursing and related needs
  • Providing healthcare instructions to patients and family
  • Working in cooperation with the family/caregiver and hospice Interdisciplinary Group to meet the emotional needs of the patient and family/caregiver


Our CNAs have training and expertise in end-of-life caregiving and provide personal care in a manner that meets each patient’s specific needs. CNAs assist patients with activities of daily living such as bathing, shaving, shampooing, and changing bed linens. They also provide support and teach a patient’s other caregivers about Hospice and safety. The CNA often becomes a source of emotional support to the patient and family.

CNA responsibilities include:

  • Providing patients and families with positive communication techniques
  • Planning and preparing nutritious meals, including shopping, as assigned
  • Providing proper care and observation of patient’s skin to prevent the breakdown of tissue
  • Assessing and reporting on patient’s condition and significant changes


Alpha Hospice Social Workers are skilled professionals who have training and expertise in end-of-life planning, as well as, individual and family counseling. They connect patients and families with helpful community resources. A patient or family member may rely on his/her social worker as a companion or confidante. The social worker is there to support, validate and advocate for the emotional well-being of the patient and family.

A Social Worker’s responsibilities include:

  • Assessing the psychosocial status of patients and families/caregivers related to the patient’s terminal illness and environment – communicates these findings to team members
  • Carrying out social evaluations, including family dynamics, caregiver abilities, communication patterns
  • Counseling patient and family/caregivers as needed in relationship to stress, and other identified coping difficulties
  • Educating patients and families on, and assists in, preparation of advanced directives
  • Serving as a liaison between patients and families/caregivers and community agencies


Alpha Hospice recognizes and respects all faith traditions. All our chaplains have an interfaith perspective and are there to support the spiritual and religious beliefs of the patient and family. Soon after a patient and family’s admission to Alpha Hospice, a chaplain will meet with them to discuss and assess their spiritual needs. Alpha Hospice recognizes dying as not only a physical event but also an emotional and spiritual journey that requires special attention. Spiritual care may be provided by one of our hospice chaplains, or we can coordinate with other community clergies.

Chaplin responsibilities include:

  • Performing spiritual assessment of patients and families
  • Serving as a liaison and support to community chaplains and spiritual counselors
  • Providing consultation, education, and support to the interdisciplinary group on spiritual care
  • Providing for funeral or memorial services for patients as requested


Volunteers are valued members of the Alpha Hospice team. All volunteers receive extensive training and are supervised and supported by the Volunteer Coordinator. Alpha Hospice volunteers can provide support, companionship, and respite for caregivers and other practical non-medical services. Our volunteers also provide therapies to complement hospice treatment, which may include massage, pet therapy, and other healing arts.


Alpha Hospice is committed to providing support to loved ones for a minimum of 13 months after a death. Contact is maintained by the staff members and volunteers who practice through our bereavement program. We are here to support people through their healing journey and help honor those who have lived fully and died well.

Bereavement Coordinator responsibilities include:

  • Coordinating the assessment and delivery of grief counseling
  • Planning for Bereavement Program development
  • Providing bereavement support to hospice personnel coping with work-related grief
  • Providing bereavement information and referral services to callers from the community
Physical therapist with patient

Therapy At Home

Measurable Results at Home

No matter your health needs, the Alpha Rehabilitation Team is ready to help you. Our therapy team is passionate about bringing the latest techniques and programs to our patients. Through continuing education, our physical and occupational therapists apply the latest research to improve balance and reduce fall risk. They also utilize therapeutic modalities combined with a full-service therapy program for strengthening, balance training, pain reduction, wound care, urinary incontinence, and increasing patients’ range of motion.

Our Holistic Approach

Our therapists work together with your physician, nursing, social services, the business office, families, caregivers, and local communities to assess functional potential, and collaborate on the unique goals for every patient.

  • Physical Therapists (PT) & Physical Therapy Assistants (PTA)
  • Occupational Therapists (OT) & Certified Occupational Therapy Assistants (COTA)
  • Speech and Language Pathologists

Our team works holistically with one goal in mind: to maximize your comfort and health.


Physical Therapy

The physical therapist’s role is to evaluate the patient’s condition, determine barriers and develop a plan of care to work towards goals.

  • Strengthening
  • Conditioning Exercise
  • Mobility Training
  • Home Exercise Programs
  • Joint Replacement Rehabilitation
  • Orthotic / Prosthetic Training
  • Gait training/ Ambulation
  • Transfer Training
  • BIG Therapy for Parkinson’s

Occupational Therapy

The focus of Occupational Therapy is to improve your quality of life by maximizing function, safety, and independence in activities of daily living.

  • Improve activities of daily living including dressing, bathing, grooming.
  • Use of special equipment training
  • Orthotic / prosthetic training
  • Muscle re-education
  • Home modifications and equipment
  • Therapy for Parkinson’s

Speech Therapy

Speech-Language Pathologists work to improve communication and cognitive skills. Speech Therapists also work with patients to improve their ability to safely eat and swallow.

  • Language and word-finding
  • Communication Therapy
  • Treatment for cognition and memory
  • Swallowing Therapy
  • LOUD Therapy for Parkinson’s

Levels of Care

Specialized Care

Alpha Home Health and Hospice provides high-quality care through individualized, compassionate service. At the heart of hospice care, you will find a deep appreciation and understanding of the special needs of our patients. We believe strongly in the dignity and value of the human soul. Hospice care focuses on comfort and quality of life, rather than cure. Our palliative care focuses on providing comfort to people of all ages experiencing chronic, serious illnesses. Through symptom management, the goal of hospice & palliative care is to enable you to have an alert, pain-free life, to live each day as fully as possible.

Levels of Care

Routine Home Care – Care in the home or care facility is provided by the hospice team through regularly scheduled visits which can be once a week to daily depending on the needs of the patient and family. (Most of our patients fall into this category)

Continuous Care – An intensive or crisis level of care can be provided to hospice patients when their symptoms cannot be managed at the routine level of care. Continuous Care is provided on a short-term basis (1-5 days) to maintain the patient in their home or care facility. Nursing care is usually provided for 8-24 hours a day and some of the hours may be provided by a home health aide.

Inpatient Care – Inpatient care is provided for pain and symptom management at a participating hospital, long-term care facility, or specialized hospice inpatient unit. Short-term inpatient care is provided for the patient for pain control and symptom management.

Respite Care – Respite Care is short-term inpatient care provided to relieve those caring for the patient in their home. Care is normally provided in a contracted nursing home and, up to five consecutive days at a time.

Bereavement – Alpha Home Health and Hospice is equipped with a bereavement team ready to help you with grief and the mourning of a lost loved one.

Professional Home Care

We bring the care to you! Our experienced and specially trained professionals will create a carefully crafted plan with a focus on comfort and quality of life. Care is provided in the home as well as inpatient facilities such as Assisted Living Facilities, Personal Care Homes, and Skilled Nursing Homes. Our wish is for all our patients to live the remainder of their lives wherever they reside.

Hospice Services Included:

  • Offer specialized pain and symptom management.
  • Provide needed medications, medical supplies and medical equipment.
  • Regular nursing visits to maintain the patient’s comfort, including regular assessments and support for the family.
  • Assist patients with personal care and activities of daily living.
  • Instruct families and caregivers on how to properly care for the patients.
  • Chaplains to provide support and help patients and families with spiritual or religious questions or concerns at the end of life.
  • Social workers to provide emotional support, supportive counseling, information and referral services, assistance with advanced directives, out-of-home placements, etc.
  • Volunteers to provide companionship, emotional support, and life-enhancing activities.
  • Bereavement services and counseling to help families deal with grief.
  • Access to Hospice Nurses 24-hours a day, 7-days a week.