The beginning of the holiday season is just days away and, as we think about gratitude, it is certainly different from years past. No doubt the pandemic has affected each of us and will be etched in our memories forever. There are so many sad and heartbreaking stories - too many. And the full cost is not yet known. But still so much to be grateful for. And as we celebrate National Home Care Month, the one thing that comes to my mind is gratitude. 

I first became a home health nurse in 1975. At 22, I was full of hope and unbridled enthusiasm. I loved this work. I covered public housing in Washington DC. It changed my life. As naïve as I was young, I had no idea people lived this way. I saw the relationship between poverty and disease long before there was talk of the social determinants of health. Patients lying on dirty mattresses with no sheets, roaches, mice and rats. No electricity, no phone, no running water but also the realization that they thought that this was as normal as I thought my life was. 

I felt I could really make a difference. Teaching patients and caregivers basic hygiene and handwashing, diet, and wound care- yes, we really did bake our dressings to sterilize them. Mobilizing scant community resources to help with food, housing issues, infestations. Helping patients understand their medications. Tube feedings, catheter changes, giving injections, drawing blood for lab work, weighing babies, pronouncing deaths. We did it all. 

I will never forget those days and how my experience in home health informed my life. What I remember clearly is the gratitude of the patients and families I worked with. This was and remains important and meaningful work. 

I think that unless you have done this work whether in home health or hospice, you can never understand the deep personal connection you have with your patients seeing them in their own home. How much more you understand their disease, their pain and suffering, their challenges and why their health and well-being is not always a priority. 

This is hard work. Harder today than in my time. Sicker patients, more visits, more calls, more paperwork, more training, more frustrations. It takes a special person today to do this work- independent, highly skilled, confident, resourceful and kind. But it also requires integrity. Perhaps that is the most important quality- to do what is right- day in and day out. 

This month we honor those home health and hospice workers. The aides, the nurses, the chaplains, the physical, speech, and occupational therapists, the social workers, grief counselors, volunteers, administrative staff and all those who contribute to the important work of caring for patients in their homes. 

It is a privilege to have been counted among you.