Access to different types of skilled nursing and therapy services, as well as other services like meal preparation and housekeeping, enables patients to heal more effectively in their own homes. (Visiting Nurse & Hospice Care photo)

The term “home care” may bring to mind hospice care for the elderly or evoke a classic image of a physician toting a doctor’s bag and stethoscope while making a house call in the countryside.

Today, home care is both of these things and more.

“A primary goal of home care is to keep patients out of the hospital,” Lynda Tanner, president and CEO of Santa Barbara’s Visiting Nurse & Hospice Care, told Noozhawk.

With the health-care system in a state of constant change, medical professionals are always on the lookout for ways to make patient care not only more accessible, but of higher quality — treating people for their present health issues as well as using preventative care measures to ensure that they can spend more time at home and less time in the waiting room.

With the direction that home health care is going, this is becoming easier than ever before.

Access to different types of skilled services — such as nurses, physical therapists, occupational therapists, speech therapists and social workers, as well as nonskilled services like meal preparation and help with housekeeping — provide patients with the opportunity to heal more effectively in their own homes.

“Home health care is an essential component to our health-care continuum,” Tanner said.

And while home care, she said, “reduces the overall cost of health care” by limiting the need to go into the hospital for check-ups, “it also improves the quality of life of the patients and their families” by giving them more of an active role in their own health and healing.

This is true not only for those who are receiving adult or hospice care, but for those who need assistance due to an injury, disability or chronic illness. The continued development of home care services is making this all the more possible.

“The overall goal of home health is to assist individuals to return to their ‘normal’ level of functioning” by connecting them with the skilled professionals who can “meet face-to-face with (them) and work as an interdisciplinary team to provide (care),” explained Agnes Padernal, VNHC’s director of Home Health.

The growing popularity of home care plays well with the concept of “population health” and for the community’s ability to provide for the diverse needs of its residents.

Lynda Tanner, president and CEO of Visiting Nurse & Hospice Care, maintains that home health care gives patients and their families a more active role in their own health and healing — which is a good thing. “A primary goal of home care is to keep patients out of the hospital,” she says.

Lynda Tanner, president and CEO of Visiting Nurse & Hospice Care, maintains that home health care gives patients and their families a more active role in their own health and healing — which is a good thing. “A primary goal of home care is to keep patients out of the hospital,” she says. (J.C. Corliss / Noozhawk photo)

“The power of population health is knowing and understanding who we serve, where our people fall in the health-care continuum, identifying their needs and risks, and engaging them in education and intervention,” Tanner said.

“We need to listen (to) and understand our communities — where they work, live and play.”

With the objectives of population health and home health care converging, the focus shifts away from the short term and on to long-term care — and more important — preventative care.

Angeli Mancuso, a Registered Nurse and manager of Employee Health & Safety at Cottage Health, points to a disconnect in the health-care system.

We are often “willing to pay for a leg amputation due to a nonhealing ulcer when we won’t pay for a pair of boots to prevent the wound in the first place,” she said, identifying it as one of the challenges she faces in her work with the nonprofit Doctors Without Walls.

The need for greater preventative care rings true for numerous health-care issues the community faces.

“Home care is just one avenue to provide better access to care,” Mancuso said. “What if we offered care at someone’s place of employment? At their church? In their neighborhood? On the streets? After regular business hours?

“As you remove the barriers, you can more clearly see the root of the problem.”

While the nation’s health-care system continues to expand to meet the needs of an aging population, so, too, will home care programs. And, as Tanner pointed out, “for patients at end of life, home care includes hospice care.”

Angeli Mancuso, a Registered Nurse and manager of Employee Health & Safety at Cottage Health, welcomes the focus on greater preventative care. “Home care is just one avenue to provide better access to care,” she says. “As you remove the barriers, you can more clearly see the root of the problem.”

Angeli Mancuso, a Registered Nurse and manager of Employee Health & Safety at Cottage Health, welcomes the focus on greater preventative care. “Home care is just one avenue to provide better access to care,” she says. “As you remove the barriers, you can more clearly see the root of the problem.” (Henry Ventura photo via Cottage Health)

In a recent Noozhawk interview, Tanner said the U.S. Census Bureau projects that, by 2030, more than 70 million Americans are expected to reach the age of 65 — a phenomenon often referred to as the “Silver Tsunami.”

“Forecasting the state of health of the Baby Boomers is not as easy as looking at census reports,” Tanner continued, “and (neither is) identifying a peak for when we will need a strong hospice care workforce.

“Rather, we need to build up our home health-care providers because the future of health care is in the home … healing and aging in our homes safely and independently.”

And as Americans live longer, healthier lives, home care programs must adapt to provide for these needs.

A 2014 health workforce analysis for The Future of the Nursing Workforce by the Health Resources and Services Administration of the Health and Human Services Department provides some sobering projections.

By 2025, California alone is expected to have a minimum shortage of 3,700 registered nurses at current estimates — not taking into account the comparable shortages expected to occur in neighboring Western states that are expected to reach a shortage of at least 64,200 registered nurses combined.

So, despite an estimated excess of 340,000 registered nurses nationally, many states — particularly those in the West — will surely be hurting.

And, as Tanner pointed out in a previous article, nearly “50 percent of the active nurses across the country are over 50 years old … they’re aging out faster than they’re coming in.”

If Santa Barbara County hopes to keep pace with this demand for nurses over the next decade and more, a huge emphasis must be placed on the value of and necessity for nurses.

It sometimes can be easier for patients in need of physical therapy to have the therapist make a house call.

It sometimes can be easier for patients in need of physical therapy to have the therapist make a house call. (Visiting Nurse & Hospice Care photo)

“We need to build up our home health-care providers because the future of health care is in the home,” Tanner said. “This poses a challenge for our health-care system as older patients with more complex health needs outpace the number of health-care providers with the appropriate knowledge and skill to provide care.”

As the home health-care environment evolves, the community’s attitude, awareness and understanding must adapt, too.

Padernal noted that the aging “community can be better served when patients, appropriate for hospice, are referred for hospice care early in their disease process. When patients receive hospice care much later, they do not get the full benefits.”

“While hospice care is not about curing a patient, it is 100 percent about caring for the patient,” she said.

Tanner agreed.

“Our next challenge is educating and changing behavior about how we consume health care,” she said. “It’s no longer about ‘going to the doctor when you get sick,’ rather it’s about empowering people to take control of their health.”

A key objective of the new emphasis on home health care is to ensure a more tailored and efficient delivery of patient care. That means continuing to develop more advanced home care technology, as well as a larger nursing workforce as a whole.

“By empowering patients and offering the right access for the appropriate type of care, each health-care entity can do what they do best,” Mancuso said. “Our Emergency Department can provide emergency care instead of trying to be the primary-care providers.

“The goal is to engage people in their total health and give them the tools to achieve physical, mental and social well-being.”

— Noozhawk contributing writer Kellie Kreiss can be reached at news@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkSociety, @NoozhawkNews and @NoozhawkBiz. Become a fan of Noozhawk on Facebook.