Quote from DoGoodThenGo
You've never seen those old films were someone became very ill and you knew things were critical when a physican was summoned and then came the whole schabang of equipment. Oxygen tents, O2 canisters, etc.. and a nurse in starched whites with cap who was "engaged" to provide care.
Have long since chucked them away, but when I was younger older relatives who were nurses and or others gave one tons of old nursing text books from the 1940's through 1960's. In most there were sections about providing what would be called "home care" today. Then it was more commonly known as "private duty" and could involve anything from new mother and infant to end of life (COPD, cancer, etc..) care. One book had a chapter on what to do once a patient expired (sorry, appears to no longer to be breathing), up to and including preparing the body for the undertakers to take away. Got as far as plugging up various orifices and quickly moved on.
When you think about it modern hospitals exsist mainly to provide skilled professional nursing care. If one has the funds equip one's home and hire the staff there is much that could be done in that setting.
Saw a French program a few months back where local hospitals in France are sending out nurses to provide care for patients in their homes, rather than have them go to hospital. One patient covered in the show was a young boy with cancer who receives his chemo and other treatments at home via nurse visits. His mother stated her son was much more comfortable with the arrangement then when they had to go to hospital. IIRC the government is trying this out as a cost cutting move but also to see if it provides better patient care.
It is the past and the future; and a lot of us who may not have experienced this or talk to relatives who saw physicians and nursing in the home, and ONLY went to the hospital if you "were going to DIE, or don't want to DIE" (my late grandmother's words), I can see this happening.
I was a HH nurse for 5 years, and the collaboration, advocation and education of the pt and family gives you great tools when working with the complex pt in the home. There are tons of people who do choose to stay at home and in their communities while receiving complex care.
IMO, I can see more multidisciplinary involvement in the community seething and nursing teams similar to acute care occurring in the home. With infusion nursing, wound care nursing, pt's wearing remote home monitoring and wound vacs in the community (I had one during a significant health event and it was portable-able to go out and get air, and move around per nursing orders to help me in recovery, and run errands); this is possible that our pts birth to older adult are able to be a part of the community and stay active.
When I tell nurses that are ambivalent about home health at my current job how I wasn't just "in the home" with pts; I would go to Drs appointments, out to the park, or at least outside so they could get sun and air, engage in games, activities, to keep my pts active and involved in their own way. This model is coming back; we will still need acute care nursing; yet we will need highly skilled nurses of all disciplines to help complex healthcare pts in the best way possible, even in the home.