Chapter 5: Home Health Nursing in Canada

Home care is defined as an array of services—including nursing, therapy, and personal support—that complement the efforts of family and community networks to help clients manage chronic conditions, recover from illness, or transition to end-of-life care. While home health services are considered an extended health service rather than a publicly insured one under the Canada Health Act, the field has evolved significantly from its early 17th-century roots into a highly professionalized discipline governed by the Community Health Nurses of Canada (CHNC) standards and competencies. Home health nurses (HHNs), comprising registered nurses and practical nurses, operate as guests in the home, requiring high levels of independence, adaptability, and clinical expertise to perform comprehensive assessments, education, and care coordination. The text contrasts traditional expert-driven medical models with person- and family-centered care (PFCC), which prioritizes the expertise and lived experience of the client and their support network. Furthermore, the chapter addresses the systemic shift toward task-based nursing fueled by fee-for-service funding models, which often compromises holistic care and impacts nursing-sensitive outcomes. A significant portion of the discussion is dedicated to health equity, highlighting the unique needs of vulnerable populations such as First Nations and Inuit communities, the homeless, and those in remote regions. Concepts such as Jordan's Principle are examined alongside the First Nations and Inuit Home and Community Care 10-year plan to illustrate the ongoing push for culturally safe and equitable access. Finally, the chapter looks toward the future, where technological advancements, telehealth, and a potential national home care strategy are expected to transform the nursing ecosystem while keeping the human element of advocacy and relationship-building at the forefront of community health.