Home Health Care
Home health care has been in existence for over a century. While home care was initiated in the 1880s to address illness and infectious diseases, it has evolved to include more maintenance type medical care (Nies, 2019)(Karlsson, Ridbäck, Brobeck, & Pejner, 2019). The Visiting Nurses Association sees people of all ages, races, ethnicities and disabilities (Val, 2019). The majority of patients now served and the most vulnerable are the disabled and the eldery (Val, 2019).
Community Setting
Home health care visits in the United States were primarily founded in the New York City area by Lillian Wald (Nies, 2019). Ms. Wald set up the Henry Street Settlement which served immigrants and poor families fulfilling a need for health care services that they might not have had otherwise as well as the Visiting Nurses Services of New York (Nies, 2019). The visiting nurses primarily provided services for people with smallpox and polio (Nies, 2019). These services were provided free of charge (Nies, 2019).
The Visiting Nurses Service of New York continues to serve home care clients today (Nies, 2019). The visiting nurses tend to see more disabled persons, and eldery persons but continue to see clients from prenatal to senior. However, they continue to serve clients in their homes for many services. Clients are typically referred to home care visiting nurses after a hospitalization but may be referred after a doctor visit (Nies, 2019). They may be seen for a variety of services including continued care for chronic illnesses. They may see patients for acute things such as intravenous therapy, wound or skin care, a continuation of physical, occupational or speech therapy services (Nies, 2019).
Health Promotion Nursing Intervention
The community health nurse can promote health in prenatal visits with first time Moms by teaching them about immunizations and promoting well care visits for the infant. The community health nurse can promote such things as breastfeeding as well. Connecting the new Mom with childcare clinics for immunizations, lactation consultants to promote breastfeeding success, and connect the new Mom with pediatricians for continued care (Neelon, Duncan, Burgoine, Mayhew, & Platt, 2014) .
Community health nurses can help teach older clients about maintaining health with chronic illnesses such as diabetes. The community health nurse can connect the client with support groups, and dietitians. As well as provide ongoing education about monitoring glucose levels and eating healthy (Price, 2008). They provide education on other comorbidities that may affect the diabetes or be created by the diabetes.
Professional Nursing Organization
The Visiting Nurses Association of America, also known as VNAA, was founded in 1983 (Val, 2019). According to their website, they advocate for community-based care regardless of the ability to pay. They continue to strive for the principles that Lillian Wald pioneered in home care in NY in the 1890s (Val, 2019).
The VNAA is currently partnered with Elevating Home. Together they are working with Leading Age to reduce regulatory burdens placed on nursing home providers. Currently there are extra taxes levied on providers taking in greater numbers of medicaid patients in many states. However, there are a few states with discounted taxes or even exemptions to these taxes. This places a greater burden on those that do not receive exemptions or reductions (‘Home Page’, 2020).
Summary
Visiting nurses is an important part of nursing history and continues to be important today. They allow clients the ability to remain in their homes while receiving needed care and education. While there are many more agencies that help to provide this care than in the past. Most continue to uphold the ideals and standards set forth by Florence Nightingale and Lillian Wald. They continue to provide care across the age continuum, As healthcare evolves these organizations continue to evolve as well. They continue to educate new Moms about infant health and adults about maintaining or improving their health. Their organizations continue to advocate for better services and care as well.
References
- Home Page. (2020.). Retrieved February 9, 2020, from https://www.leadingage.org/
- Karlsson, S., Ridbäck, A., Brobeck, E., & Pejner, M. N. (2019). Health Promotion Practices in Nursing for Elderly Persons in Municipal Home Care: An Integrative Literature Review. Home Health Care Management & Practice, 32(1), 53–61. doi: 10.1177/1084822319863308
- Neelon, S. E. B., Duncan, D. T., Burgoine, T., Mayhew, M., & Platt, A. (2014). Promoting Breastfeeding in Child Care Through State Regulation. Maternal and Child Health Journal, 19(4), 745–754. doi: 10.1007/s10995-014-1560-6
- Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.
- Price, E. (2008). Public Health Nursing and Diabetes Prevention. The Journal of Chi Eta Phi Sorority.
- Val. (2019, July 23). About us. Retrieved February 8, 2020, from https://www.vnaa.org
