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A Brief History of the Home Care Industry

By the year 2050, the U.S. population of people over the age of 65 is expected to surge to 88 million. There are more than 2 million home health care workers providing personal care and medical services for clients across the country, and the demand for these services is expected to continue to grow as the population ages.

Origins of Home Health

Our ancestors most likely never saw a doctor, and rarely went to a hospital until it was a last resort. Some communities had someone who was–or claimed to be–knowledgeable about the medicinal qualities of plants and other natural substances, and created tonics to treat common illnesses and maladies of the day. Others depended upon their family members or neighbors for treatment.

These caretakers performed treatments of broken bones, cuts, and other injuries based upon techniques handed down from generation to generation. Early-day health practitioners came to the patient in most cases, visiting them in their homes and bringing with them the tools and treatments of their trade. The origins of the word “patient” stems from the English word meaning “one who suffers,” and there is little doubt that those who performed care of the sick and infirm did so in an attempt to relieve suffering.

But even though patient care in the home was often a necessity due to a lack of healthcare facilities and professionals in earlier times, many patients and their families lacked the financial means to pay for services and sometimes bartered with the caregiver. Still, there was a significant demand for these home health services, just as there is today.

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Organized Home Health Care

The demand for in-home health care led to the creation of nursing organizations toward the end of the 19th century, most of which were supported through donors. But even then, there was a struggle over having enough nurses to meet the demand for services, and systems were put into place to determine which patients warranted home health care, and for how long the organization would be able to care for chronically ill patients and remain financially viable.

In 1909, the first home health insurance policy was offered by Metropolitan Life, and within the next 15 years, more than 1 million home health nursing visits were covered under the provisions of insurance policies, indicating the high demand for home health services. As healthcare improved, so did life spans. The danger of communicable diseases was no longer the major threat that it was at the beginning of the decade.

When the Old Age Assistance Act, later known as Social Security, was passed, more families turned to private nursing homes to care for their chronically ill family members. Then in the 1930s and 40s, health care professionals sought a more cost-effective way to care for the chronically ill—those whose conditions were not likely to improve, but did not require the full care provided by a hospital. The problem was that there was no option to help families pay for the services of home care, and it remained an issue revolving around the ability to pay until the 1960s.

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Federal Involvement in Home Health Care

It wasn’t until the 1960s that home health care was included in the Medicare, Medicaid, and Old Age Assistance Act. But because those creating the guidelines assumed there were family members who would be subsidizing home health care needs, coverage for home health care was mandated only for medically necessary, intermittent care for those acutely ill patients who has been released from the hospital. By the 1990s, however, changes within varying levels of government allowed for expansion of home health services, but it didn’t last. The Balanced Budget Act of 1997 drastically slashed Medicare home benefits, and as a result, the number of patient visits were reduced and 3000 home care agencies shut down.

Today, home health care often falls upon family members, and continues to be a major issue for policymakers, especially during election years.

Modern Options

Home health agencies like 24 Hour Home Care offer a variety of services to meet the needs of those who are unable to care for themselves, or who just need some assistance with daily routines, housekeeping chores, meals, or getting to doctors’ appointments. Professional home health agencies can adjust a level of care that meets the needs of their clients and their families, and generally have counselors available to explain the payment and insurance process. If you are seeking high quality companion care around the clock, for the overnight hours, or for a few hours each day, we can help. To make an appointment for a consult or just to get more information on our services, fill out our handy online contact form, and a member of our team will get in touch with you as soon as possible.

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