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This chapter seeks to help both those who are new to home care and those with some experience in home care. In this way, you can either learn or refresh your information and understanding of the holistic nature of home care. Of course, a part of this holistic nature includes the patient’s unique home and the community in which they live. Safety concerns may be impediments to care and achieving goals. This may also mean promoting the health, safety, and well-being of the patients in your care within their homes, and patients can be as unique as the home itself.

For purposes of this chapter, “home” can be an older adult high-rise apartment, a mobile home, a house in a neighborhood, and other locations. It can mean a number of places. I once visited and provided wound care to a homeless man who lived in a large cardboard box behind a convenience store. This was his home.

As home care transitions from the traditional medical model into more integrated, holistic, community-based models, home care nurses and managers can lead the way for this transformation. There has been much discussion about improving community health and creating healthier populations generally. It is generally accepted that socioeconomic factors and indicators impact health and healthcare, and may lead to poor health and lifestyle or other habits.

The first section of this chapter focuses on the community and how to conduct a windshield assessment and gather data about the neighborhood and geographic area that is in your purview or “catchment”/service area for patient care. Later sections address emergency preparedness and management and safety aspects when working in the home, as well as other hazards that nurses and visiting team members may encounter. Home and patient safety is also discussed, particularly in regards to how it may impact team members.


Healthy People initiatives have been creating national health-related objectives for three decades and their current initiative, Healthy People 2020, provides “science-based 10-year national objectives for improving the health of all Americans” (, n.d., para. 1). They establish benchmarks and monitor progress over time with aims to “encourage collaborations across communities and sectors,” “empower individuals toward making informed health decisions,” and “measure the impact of prevention activities” (, n.d., para. 2). The vision of Healthy People 2020, “a society in which all people live long, healthy lives,” is very clear and is aligned with other programs and emerging care models (, n.d., para. 4).

As population health, faith-based initiatives, and other models change to bring people either back home to the community or help them stay in their homes and be cared for there—“age in place”—nurses and others practicing in home care need to understand this wide-ranging policy shift. This shift makes the community and ...

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