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Will Home Care Come Full Circle?

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Elizabeth
 
(877) 871-4062
ElizabethHogue@ElizabethHogue.net 
"My view, you know, is that the ultimate destination of all nursing is the nursing of the sick in their own homes...I look to the abolition of all hospitals...
 
But no use to talk about the year 2000."
 
- Florence Nightingale; June, 1867
 
 
The roots of healthcare in the United States are clearly in the care of patients at home. Perhaps the definitive book on home care nursing in this country is No Place Like Home: A History of Nursing and Home Care in the United States authored by Karin Buhler-Wilkerson in 2001. As Ms. Buhler-Wilkerson points out in her book, care for the sick was part of domestic life in early 19th century America. Physicians and nurses delivered care in patients' homes, most often with the help of female family members, neighbors, and perhaps servants. For those who had no one to care for them, the options for care were scarce.
 
Enter The Ladies Benevolent Society (LBS) of Charleston, South Carolina! The LBS was founded in 1813 during the British blockade of Charleston harbor to address the needs of patients for whom there were few other options. The Society was founded by 125 women who were the wives, sisters, and daughters of Charleston's wealthiest families. The Society was a philanthropic organization only. Members raised needed funds for care of the sick and distributed them, including hiring nurses to care for patients in their homes. A visiting committee conducted the daily work of the Society.
 
Patient load varied with the seasons and the occurrence of epidemics. In the early years, the Society cared for an average of 290 patients annually. Ms. Buhler-Wilkerson says in her book, "Most important, the LBS supplied the sick poor with nurses, for 'of what avail are medicines or proper nourishment, unless there be some kind hand to administer them in due season?'"
 
Home care has once again become the "fashion." An increasing number of treatments are provided at home. An article by Shantanu Nundy and Kavita K. Patel entitled "Hospital-at-Home to Support COVID-19 Surge-Time to Bring Down the Walls" that appeared on the JAMA Health Form, JAMA Network on May 2, 2020, makes the point that both COVID-19 patients and patients with other diagnoses should be cared for at home. The authors state that "the concept of a hospital stay in the home has been tested and proven to be effective in a wide variety of settings and clinical conditions..."
 
The article goes on to say that:
 
A 2016 Cochrane review evaluating the effectiveness and cost of hospital care at home found no difference in 6-month mortality..., no difference in being transferred or readmitted to a hospital..., and lower costs...
 
It is clear, contrary to Florence Nightingale's prediction above, that hospitals will always have a role to play in the delivery of healthcare. It is also clear, however, that home care of all types provides an important answer to many dilemmas currently encountered in the healthcare industry and must, therefore, be ascendant! Will healthcare now come full circle to its roots of caring for patients in their homes? 
 
©2020 Elizabeth E. Hogue, Esq.  All rights reserved.
 
No portion of this material may be reproduced in any form without the advance written permission of the author.

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VALA is proud to offer upcoming webinars for assisted living administrators, regional staff members, caregivers, nurses, and other staff members. The webinars will offer a variety of continuing education credits dependent upon the topics (i.e. NAB, Nursing, Social Work). Many of the webinars are held live with the ability of participants to interact with the presenter during the webinar. 

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Per 18VAC95-30-70(A)(1) and 18VAC95-20-175(A)(1), Up to 10 of the 20 hours may be obtained through Internet or self-study courses and up to 10 continuing education hours in excess of the number required may be transferred or credited to the next renewal year. 

03/19/2020 CE guidance: During the six month extension of continuing competency requirements that must be obtained for the licensure period between April 1, 2019 - March 31, 2020, programs delivered via teleconference or webcast where there is an opportunity to interact wtih the speakers in real time ("interactive course") will count toward the 10 hours of continuing competency requirements that must be taken in addition to the 10 hours of internet or self-study hours.