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Bedside Manners: Home Health Nurses Become First Line of Care

Perhaps not since the ushering in of U.S. public health policies, have visiting or home health nurses played such a vital role in the well-being of Americans.  In fact, statistics provided by Johns Hopkins Medicine note more than 12 million people in the United States currently require some form of home health care. And within the ranks of professional home care givers, 87 percent are women, 60 percent are people of color, and 29 percent are immigrants.  

The nation’s strained health-care system is trying to keep sick seniors out of hospitals, assisted-living facilities and nursing homes and instead have them cared for in their homes.

When a person already feels vulnerable by illness – they heal at better rates and with more positive outcomes in familiar and comfortable surroundings, home health nurse, Tarita Bumbraytold the Informer.  She said that in addition to patients feeling intimidated by clinical surroundings, many develop conditions like “white coat hypertension” — wherein a person’s blood pressure is elevated by being in a hospital.

“When a person loses mobility or cannot manage basic tasks like going to the restroom without assistance, they often feel anxious, fearful – even angry that someone has to help them.  My job is to show them the highest level of respect, while administering the care they need, Bumbray said.  “Because I am also a guest in their homes, I have to be certain that the boundaries of professionalism are never blurred, but that they also feel comfortable having me there for extended periods of time.

With the closure of a record number of D.C.-metropolitan area hospitals, healthcare services have extended into private homes for everything from acute and chronic health conditions to the managed care of a drastically increasing Baby Boom generation, who are now elders. A startling 75 percent of Americans over 65 live with multiple chronic health conditions, ranging from diabetes to dementia.

The duties of home health workers can include medical care, condition monitoring, and dispensing medication, but may also comprise cooking and cleaning for the patient, accompanying them to physicians’ appointments, and doing grocery shopping,” Bumbray said.  “In some instances, we serve as extended family and missionaries to people who may feel isolated by their conditions.

Gladys Pulliam, co-signed Bumbray’s assertion.  As a vibrant and active senior, Pulliam said she quickly became depressed and obstinate when a skiing accident caused her a rip in her knee’s lateral collateral ligament.  

“I hate hospitals but saw rehabilitation centers as a depressing last-stop to the cemetery, so I fought tooth and nail for home health care services,” Pulliam told the Informer.  “It took a few weeks to get comfortable with my nurse, Fatima, but she often went above and beyond her duties, and I had her as company when my kids and grandkids didn’t bother to come by.  Fatima was a godsend and she even played whist with me.”

Pulliam said her emotional health helped speed the recovery of her physical health.

The Centers for Medicare & Medicaid Services reported the U.S. spent an estimated $103 billion on home health care last year, with a projected increase that will see an overall increase in home health care employment by 41 percent from 2016 to 2026.  This translates into 7.8 million job openings.

“Home health care nurses do a lot of the work that used to be handled by midwives and the ladies’ circles at churches, when family members were unable to tend to the needs of the elderly or infirmed,” Pulliam said.  “While hospital closures may be responsible for this move back to home care, I think it is a good thing – especially since so many caregivers are Black women.  It signals a return to community care, and I think that has always served Black bodies best.”

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