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Every year, November is celebrated as the month to celebrate and honor those practicing in home care and hospice. There is no question about the difference that home healthcare and hospice workers make in people's lives every day.

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In fact, the term "home" is getting some additional use and acquiring different connotations in our healthcare lexicon. More and more (pursuant to healthcare reform [HCR]), the terms "medical home" and "primary-care home" are heard. Interestingly, this is almost, from my perspective, very confusing. As a neighbor of mine said so well, "Why would the doctor's office be my home now?" And that is just the start of the discussion. And one might add-if you are going to use these terms-why "medical" home? Wouldn't it be your "healthcare" home? Especially in light of HCR, where the emphasis (we hope!!) is being reframed to wellness and health as opposed to medical care and illness. And-it is not one's home!! Is this making the case for valuing the patient's choice, whenever possible, for healthcare to be provided in his or her own home? Is this choice of venue being changed through the use of emerging terms and their possible implications? If the goal of all of these related terms is to provide patients with one place/organization and primary care providers who know them and their unique healthcare needs, then shouldn't the place be called what it is-perhaps a "Patients' Center for Health"?


There is no place like home. In fact, The MetLife Report on Aging in Place 2.0: Rethinking Solutions to the Home Care Challenge (MetLife Mature Market Institute, 2010a) is a new, 31-page report that addresses how "adjustments will need to include homes in which residential design, health care services and new monitoring technologies . . . are combined with comprehensive community care services to form a dynamic and efficient home health management system. Referred to as AiP2.0, this new Aging in Place blueprint envisions a more efficient use of available resources and an enhanced and better coordinated service delivery mechanism, while also leading to the creation of business opportunities for the private sector" (MetLife Mature Market Institute, 2010b). Readers may want to review this for a different look, as demographics and healthcare needs for the aging support aging in place with thoughtfully constructed supports for care in communities. To see the entire Aging in Place 2.0 report, visit


Because the holidays are almost here, consider three reading recommendations. The first two are books, and the last one is an article. The first book, The Immortal Life of Henrietta Lacks, is hard to put down (Skloot, 2010). A nonfiction book, it is based on a true story of the person and happenings behind what we all learned to call "HeLa" cells in biology class. The author takes this story and runs with it, covering aspects of privacy (pre-HIPPA and so, nonexistent), consent (ditto), and the intersection of people and science. It is a fascinating read for anyone interested in science generally. The other book recommendation is authored by Atul Gawande (2009) and is entitled The Checklist Manifesto: How to Get Things Right and is of value to those both within and outside healthcare. Another nonfiction work, this book speaks eloquently to the basic assumptions that if we are smart (enough) and an expert in what we do, that does not mean we do not need checklists to ensure a standardized and detailed process-every time-no matter how many times we have done something (think surgery, take offs and landings, buildings, etc.). This is another great read and makes the case for improving quality through some fundamental ways. You may recognize Dr. Gawande's name from his other books or from his writings in The New Yorker. In fact, the August 2nd issue of that magazine published his article entitled "Letting Go: What Should Medicine Do When It Can't Save Your Life?" (Gawande, 2010). Skillfully weaving patient examples with science and technology and honoring wishes (some to remain at home), this 16-page article should be a must-read for clinicians, healthcare consumers, and policy makers to help reframe and better understand the complexity of modern health and medical care. In fact, the author talks about how we used to die, what has changed, and about hospice. If there is something great you read, please e-mail me at


Inquiries for an update on the International Home Care Nurses Organization (IHCNO) have been arriving. Readers with an interest in this organization are referred to the Web site, There is some news listed on the Web site and an update about the institutional home we have found. The organization is moving forward with a team of committed leaders, and at this time we are seeking funds for the organization for specific activities.


Thank you, and I wish you and yours a great holiday season!!


Tina M. Marrelli

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Gawande, A. (2009). The checklist manifesto: how to get things right. New York: Macmillan. [Context Link]


Gawande, A. (2010). "Letting go: What should medicine do when it can't save your life?" The New Yorker, August 2, 2010. Retrieved from[Context Link]


MetLife Mature Market Institute, in conjunction with Tenenbaum, Louis. (2010a). The MetLife Report on Aging in Place 2.0: rethinking solutions to the home care challenge. Retrieved from[Context Link]


MetLife Mature Market Institute. (2010b). AiP2.0, the future of aging in place unveiled in MetLife Report: Improved caregiving through enhanced communities supported by high-tech systems. Retrieved from[Context Link]


Skloot, R. (2010). The immortal life of Henrietta Lacks. New York: Crown Publishing Group. [Context Link]