Mapping the History of Home Nursing Care

 With the inception of the human population, came the need for in-home care. Though there are no stock markers of those in need of these services, the newborns, sickly, and the elderly comprise most individuals who opt for such care.

The concept of home care agencies is comparatively old. But, only recently has it emerged as an independent discipline. The reason being that for decades, home health care nursing was thought to be a part of community health nursing.

How it all started

In the mid-1800s in England, the strains of home care were first visible with the start of the practice of visiting nursing. 

An organized movement of district nursing began when William Rathbone (1819 to 1902), the wealthy Liverpool merchant and philanthropist, took the in-home care services of Mary Robinson for nursing his wife in her last moments of illness.

Inspired by Robinson’s services, Rathbone recognized the need for establishing a district nursing system that the economically backward classes could access. 

On the advice of Florence Nightingale in 1860, he set up the Liverpool Training School and Home for Nurses in 1862. 

Due to the widespread ease of access & convenience in the form of care, this health care system gained popularity among the masses through the 19th century. And not only in the United Kingdom but also in 

the United States.

Coming up of the term ‘district nurses’

Nightingale coined the term district nurses for those visiting nurses who took care of the diseased in America. They also spread awareness about the importance of in-home care in the community. 

Rule of home nursing care

At the beginning of the 20th century, nursing divisions of governmental health agencies & visiting nurse associations largely provided nursing services in the United States. 

But after the mid-1960s, the Medicare legislation was passed. This was the main reason behind home nursing care services becoming widespread from the late 1960s. 

That’s because the legislation allowed the affected individuals to avail these services frequently at the most affordable rates. A bonus was the reduced lengths of in-hospital stay.

Trends across home care agencies 

Today, these trained & specialized nurses use technology that was earlier used only in Intensive Care Units. Now, nurses even educate their patients on managing ventilators, infusing medications, & ambulatory dialysis. 

Innovative in-home programs like crisis intervention for psychiatric patients & post-treatment care for Coronary Artery Bypass Graft surgery are also offered by these caregivers. 

New nursing competencies

Thus, home health nursing has become a novel specialized practice in the present times, having its own set of specific competencies.

The caregivers can now combine their general practice with specialized skills in areas including but not limited to in-home enterostomal therapy, chemotherapy, mental health, lactation consultation, continence management, care of children with long-term health needs, and palliative care.