A century of home healthcare, from P-Town to Plymouth
A century ago, Cape Cod did not have a hospital. But it did have a devoted nurse, Elizabeth A. Eliot-Smith, who rode a bicycle through the Upper Cape to visit the sick, the infirm and the elderly. Undaunted by the area’s twisting, unpaved roads, Eliot-Smith provided bedside nursing, prenatal and infant care, aided tubercular patients, and offered school programs for children.
“Even then at the beginning, we were comprehensive in our services,” said Jeanne Sarnosky, director of marketing for the organization that eventually accepted the home healthcare baton from Eliot-Smith and her successors, the Visiting Nurse Association of Cape Cod. (VNA)
One of the earliest not-for profit organizations on Cape Cod, the VNA of Cape Cod was founded during the summer of 1916 by the Woods Hole Woman’s Club during a Falmouth town meeting. After hiring Eliot-Smith as its first nurse, the town was so grateful for the services she provided, it soon bought her a used Model T so she could reach residents in the more hard-to-reach areas.
Today the VNA of Cape Cod has 800 employees -250 of them RNs – and provides more than 380,000 home visits annually to residents of the Cape and most of Plymouth Country.
“We’re a mix of nurses, social workers, home health aides, homemakers, physical and speech therapists, dieticians, psychologists, educators and more,” said Sarnosky.
In honor of the 100th anniversary, this year’s CCHC Summer Gala will celebrate the VNA and proceeds from the event will support the organization and the services it provides. The Gala will be held on Saturday, July 30, from 6 to 11 p.m. at The Ridge Club in Sandwich.
Care for Newborns to the Elderly
Nearly all of the VNA’s offerings, which include comprehensive home health and hospice services for individuals ranging from newborns to the elderly, are available 24 hours a day, seven days a week. To serve those needs and coordinate staff for the 25 towns it serves, the VNA of Cape Cod has a 125-member administrative staff. The organization also runs adult day care centers in Sandwich and Harwich and maintains a full hospice staff.
Despite its current prominence, the VNA of Cape Cod evolved gradually. By 1946 patients were paying nurses a dollar per visit.
“Today that’s obviously changed along with changes in medicine and payments dictated by insurance plans,” said Sarnosky. “It used to be that every town had its own budget and employed a public health nurse, but as those budgets grew smaller, the towns contracted with the VNA for their public health and wellness programs. We seem to pick up another town every year.”
One reason for the surging demand for home health services relates to shorter hospital stays.
“Most of our cases come from referrals when patients are discharged from the hospital or from a skilled nursing facility. We pick it up from there,” Sarnosky said. As a result, patients often require more acute nursing services in the home than they did in the past. Typically these include a nurse’s supervision of things like intravenous equipment, medications and wound care.
The changing demographics of Cape Cod and the surrounding region are another factor. Although 10 percent of those using home health services from the VNA are under 45 years of age, 59 percent of them are over 75 and a remarkable 9 percent are over 90.
Regardless of his or her age, patients find home care with a visiting nurse has advantages. Not only is that care less costly than a hospital stay, but patients seem to heal better at home. In addition, the home setting provides the nurse with an opportunity to educate the patient and care giver more intimately. That often results in close personal bonds which are often more difficult to establish in the hospital.
“When I visit a patient regularly, I get to know his family, remember the dog’s name and recognize furniture of pictures in the house, all of which enhances the personal aspects of care,” said Sarnosky. “When the patient you’ve been seeing and his family tell you you’ve made a difference, it reminds you about why you’re in it, why you’re a visiting nurse.”
[Featured Image: VNA nurses – Bottom Row from L to R: Gina Kupski, RN; Kathy Ganey, RN; Diann Cardillo, RN; Patti Zilewicz, RN | Middle Row from L to R: Alyce Celona, RN; Teresa McGuire, RN; Mary Devlin, RN; Marti Baker, RN; Meg Payne, RN | Top Row from L to R: Amy Chipman, RN; Lisa Bushy, RN; Amy Philo, RN; Dee Yeater, RN; Marion Santos, RN; Betty Blackham, RN]