Spring 2002 Vol. 16
lSSN 1049-2259
No PLACE LIKE HOME: A HISTORY OF NURING AND HOME CARE IN THE US By KAREN BUHLER-WILKERSON,RN
PHD, FAAN
For nearly two centuries. variou organizations have struggled to care for the sick at home. The history of organized home care in the United States reflects many of our fundamental ocial relationships and values. The intriguing question about this history is why, despite the fact that home care is a preferred choice by many palien and familic ,and perhaps a cost-effective alternative to in tituuonai care. it nevertheless remain. a marginalized experiment in caregiving.
Center for The Study of The History of Nursing UNIVERsm' U . PEN 'SY VANIA
The earlie t eff&rt to care for the ic" at home in the United States were mo A HI. TORY tivated by a tradition of religiou benevolence Of NUR INC among wealthy ladie of AND Charleston. Sc. By the end HOMI ARE of Ule 19th cent ury, urban ization. indu trializalion, IN THF immigration, and the con UNIT 0 stant threat of infectiou disease were transfonning TAH most large urban cities into increasingly unhealthy place to live. The relation ship between poverty and illness was indisputable aDd popuJarization of lhe germ theory of disease pro vided furlh r motivation to protect society from Ullcon trolled disease. The grow ing avai lability of trained nur. es provided a pra tical s lullon to thi urban thr at of disease and disor der. Acr s the country, wealthy ladies began to hire nurses to care for the sick poor in their homes. By 1909, nearly 600 organizations across the country were spon oring tbe work of the e v i ~ i Ling nur . Thal same year, public health nw·sing
Sc IIOUL OF N URSINO This artie/e is based on the lecture which Dr. Buhler-Wilkerson presented to The New York Academy of Medicine ill November 2001.
(Collt il/lled Oil page 8)