A home health nurse assists an elderly patient.

Article

Home Health Nursing: What It Is and Why It Matters

Nursing

by Norwich University Online

April 19th, 2023

The older adult population is on the rise, thanks to advancements in medicine and health care helping to extend lifespans and quality of life. In response to this demographic shift, there is growing demand for home health nursing, a type of care where individuals receive health services at home from a qualified nursing professional.

The magnitude of this population trend is illustrated by statistics such as the following:

The World Health Organization (WHO) estimates a near doubling of the older adult population (individuals age 60 and older) throughout the world—from 12% in 2015 to 22% in 2050.
The American Psychological Association projects the number of Americans age 65 and older to more than double from 46 million in 2021 to over 98 million by 2060.
According to U.S. Census Bureau projections, the older adult population will exceed the number of children in the country in 2034.

Against the background of these historic shifts, nursing professionals can make an impact by preparing for a career in the home health field. Advanced education can help individuals acquire skills to specialize in home health or advance in the field of home health nursing. For example, a master’s degree or post-master’s certificate can provide multiple routes into home health nursing and help prepare professionals to address the healthcare challenges coming over the next several decades.

What Is Home Health Nursing?

Home health nurses address the needs of patients who are unable to travel outside the home for medical care. In the older adult patient population, mobility issues, cognitive issues, or an acute condition, such as an injury or sickness like pneumonia or flu—or most recently, COVID-19—can make it hard for them to leave home.

To treat chronic disease, such as diabetes or hypertension, medical professionals often prescribe medications and treatments that patients can take at home. Chronic diseases affect 80% of adults age 65 and older, according to the National Council on Aging, but for those with cognitive and mobility issues, self-medication can be a struggle.

Home Health Nurses’ Responsibilities

Rather than leaving older patients to their own devices, home health nursing helps individuals manage their care without having to travel to a medical facility. This can help improve the quality of life for older adults.

As part of an overview of what home health nursing is, the most common responsibilities are listed below:

Administering medications and treatments
Giving injections, providing wound care, or other procedures requiring a skilled nurse
Educating patients about their medical conditions
Providing guidance to patients on how to monitor their conditions at home to avoid complications
Helping patients with bathing, dressing, and meal preparation
Providing care and emotional support in the final stages of a terminal disease

Home Health Nursing: Key Data and Statistics

Many older adult populations rely on the health care system for the treatment and management of chronic and acute health conditions associated with aging. These include hypertension, arthritis, heart disease, cancer, diabetes, and stroke. The prevalence of these conditions in the U.S. is a key factor defining the field of home health nursing today.

Chronic and Acute Conditions Associated With Aging

Home health nurses often deal with conditions such as high blood pressure, arthritis, heart disease, cancer, diabetes, and the after-effects of stroke, which affect significant proportions of older adults in the U.S.:

The prevalence of high blood pressure among adults between the ages of 65 and 74 is 70.8% for men and 77.8% for women, according to the American Heart Association. The prevalence of high blood pressure increases to more than 80% for individuals 75 and older.
The most recent data from the Centers for Disease Control and Prevention (CDC) indicates that nearly 50% of individuals 65 years of age and older have been diagnosed with arthritis.
According to the CDC, 17% of older adults (age 65 and older) report having coronary heart disease.
People age 66 and older account for more than 50% of all cancer diagnoses, according to WebMD, with breast cancer, prostate cancer, colon cancer, and lung cancer among the most prevalent.
About 33% of adults age 65 and older have diabetes, according to the Endocrine Society, putting these individuals at high risk of developing kidney failure and heart disease.
Stroke can affect anyone, but it can become more of a risk as people age. It is a leading cause of serious long-term disability for people age 65 and older, according to the CDC.

Chronic diseases can impact the physical and functional ability of older adults, increasing risk of injury when attempting to visit a health care provider. For many, staying home to self-medicate can lead to inadequate care or ineffective care delivery, which makes home health nursing an especially important resource for them.

Benefits of Home Health Nursing

Primary care providers can work with a growing number of home health agencies to help ensure proper coordination and integration of health care services. There were 10,591 Medicare-certified home health agencies in the U.S. and 5,266,931 beneficiaries in 2019, according to the Centers for Medicare & Medicaid Services.

Within this integrated approach to care, the benefits of home health nursing include the following:

Empowering individuals to stay compliant with care regimens. Clinical nurses can administer medicines and treatments and also guide and educate patients on healthy habits.
Ensuring better health outcomes. Home health nursing can ensure a continuum of care, particularly for frail older adults who risk injury with too much movement.
Lowering the overall cost of care. As health care costs rise, strategies to counteract this trend become important for providers. Keeping patients out of the hospital and reducing readmissions can lower expenses in caring for older adults.
Increasing patient satisfaction. Patients and their families often face less stress in their homes than they would in health care facilities, resulting in higher satisfaction rates. However, home health nursing does not substitute entirely for hospitalization, such as in cases of an acute respiratory condition or bone fracture.

How to Get Home Health Care

When older adults can no longer take care of themselves by themselves, there are many options that can help them make sure they are cared for. These include full-time residence in a nursing home, moving to an assisted living community, or aging in place. For older adults who want to remain in their homes, home health nursing offers the convenience of staying where they are most comfortable and feel more independent as they receive the professional care they need.

Individuals and families looking to learn how to get home health care should make sure they understand basic requirements and processes.

Qualifying, Planning, and Paying for Home Health Care

Individuals who may qualify for home health care include older individuals and people recovering from injuries. The first step in the process of getting home health care is to undergo a doctor’s evaluation. After a physician determines an individual’s need for in-home care, they help develop a plan of care, including the use of home health nursing.

The next steps involve determining how to fund home health care: directly paying for services from a home health care agency, using health insurance, or finding out if Medicare will cover the cost.

For a patient to receive home health nursing services under Medicare Part A or Medicare Part B, a physician must create a plan and regularly review it, certifying that the patient is homebound. Under Medicare Part A and Medicare Part B, older adult patients can take advantage of various home health nursing services, such as:

Part-time skilled nursing care
Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Injectable osteoporosis drugs (for women)

Homebound patients may also qualify for durable medical equipment and medical supplies for use at home, which a home health nurse can help the patient use. Financial assistance for home health nursing services may also be available from the Department of Veterans Affairs (VA) and Medicaid.

Home Health Nursing Skills

Home health nursing skills include clinical and nonclinical competencies. Both relate to the fact that home health professionals provide patient-centered care in a setting that is unique and personal to each individual. As they carry out their medical responsibilities, they can also build lasting and rewarding relationships with patients.

Clinical Skills for Home Nurses

Individuals interested in pursuing the home health nursing path must understand the clinical skills needed to be successful in the role, such as the ability to independently monitor vital signs and deliver emergency care.

Assessing Patient Needs

Home health nurses work with physicians to develop patient care plans, which highlight goals, desired outcomes, and interventions. This process requires an understanding of the patient’s unique circumstances and needs, as well as recording symptoms of an illness, if any. While assessing a patient’s needs and condition, nurses gather subjective and objective data, information about family, and surgical and medical history; take an inventory of medication; and more.

Taking the Patient’s Vitals

Vital signs are an important indicator of a patient’s status and a critical step in recording symptoms in individuals struggling with a chronic or acute disorder. In hospitals and other medical facilities, physicians and nurses make the rounds to check patients’ vital signs, representing the body’s most basic functions. Similarly, home health nurses measure a patient’s body temperature, pulse rate, respiration rate, and blood pressure.

Administering Pain Medication

For older adults taking medications to control chronic diseases, a mistake in dosage can lead to negative side effects such as confusion, memory loss, lightheadedness, unexpected falls, and potentially urgent care at a hospital. To help patients ensure they are taking the right medicine and dosage at the right time interval, based on doctor’s orders, home health nurses administer medications and help organize them for patients. They also perform follow-ups with the patient’s physicians should symptoms worsen, giving vital information to help determine changes in prescriptions.

Completing Medical Treatments

Medical treatments performed by home health nurses can vary, from drawing blood intravenously to inserting and removing catheters. Oftentimes, nurses may have to move or lift their patients to perform medical treatments or common tasks such as changing a patient’s linens.

Nonclinical Skills for Home Health Nurses

Home health nursing activities also involve helping patients with daily living activities, such as bathing and grooming, and advising them about self-care. To fulfill this role, nurses need nonclinical skills such as:

Interpersonal and Communication Skills

Home health nursing helps create a holistic, patient-centered care environment, which means that patients are treated as individuals and that their values are respected. In this type of setting, patients feel empowered and involved in their care. For both nurses and patients, home health nursing helps create lasting, rewarding relationships. This is why nonclinical competencies such as interpersonal and communication skills are needed to become a home health nurse.

Patience and Flexibility

In a home setting, patients may have special requests regarding their health. At times, a patient with disabilities may require more attention than what is typical. Home health nurses also need patience and flexibility to adapt to evolving patient needs as they arise, successfully change course through unexpected scenarios, and make informed choices that will provide patients with maximum benefit.

Critical-Thinking Skills

In nursing, a trial-by-error or one-size-fits-all approach can result in unfavorable outcomes. Critical thinking enables nurses to incorporate evidence-based practice concepts to develop care plans for patients that account for their unique needs. Critical thinking also comes into play when looking for solutions for sudden issues that may arise while caring for a patient.

Self-Motivation

Self-motivation is also important, as home health nurses regularly work independently. Self-motivated nurses who can focus on a goal―ensuring optimal health outcomes for their patients―are less likely to get side-tracked by challenges. Learning new skills or obtaining new knowledge can help nurses stay motivated. One way to do this is to enroll in an advanced nursing program that can create opportunities for growth.

Decisiveness and Initiative

In a hospital, nurses typically have to take directions from a doctor or head nurse. But home health nurses have a great deal of independence in patients’ homes to determine the best course of clinical action. That means that they need to be able to balance requests from patients while ensuring that health decisions maximize outcomes.

Take Your Nursing Career to Where You Want to Be

The U.S. Bureau of Labor Statistics projects nursing roles in general to grow 9% from 2020 to 2030. Other sources offer more detailed predictions for home health nursing in particular. A recent Home Health Care News report, for example, highlights what home care leaders foresee. In the piece, they cited opportunities such as the projected doubling of Medicare Advantage (MA) plans, which will offer home care benefits in the coming years, and the potential for home health care to help address some of the broader issues in the health care industry. These factors may be a driver for the growth of home health nursing roles in the coming decades.

Industry data presents numbers favorable to the home health nursing market too. For example, Risk & Insurance predicts that the home-based health care market will grow in the coming years, from $85 billion in 2020 to nearly $150 billion by 2028. And a Deloitte study projects $265 billion worth of care services moving to the home by 2025.

With this growing demand comes the need to prepare individuals with knowledge and skills to enter the home health nursing workforce. Nurses ready to take on the emerging challenges in the field can explore master’s degree programs such as Norwich University’s Master of Science in Nursing (MSN). With advanced training they can gain the expertise needed to excel in home health nursing roles, engage some of today’s most important health care challenges, and help older adults live a life full of dignity and independence.

Recommended Readings

How Nurse Practitioners Can Start Their Independent Practice

Advocacy in Nursing: Resources for Nurse Practitioners

Acute vs. Chronic Pain: The Role of Family Nurse Practitioners

Sources:

Ageing and Health, World Health Organization

Older Adults, American Psychological Association

Demographic Turning Points for the United States: Population Projections for 2020 to 2060, United States Census Bureau

The Impact of Population Aging and Public Health Support on EU Labor Markets, International Journal of Environmental Research and Public Health

The Top 10 Most Common Chronic Conditions in Older Adults, National Council on Aging

Home Care, HealthinAging.org

Home Health Services, Medicare.gov