Health care is ever evolving, but like many things, the more it changes the more it remains the same. Many who are in greatest need of care today are least able to afford it. Things were no different a century ago. Long before Medicare, Social Security, Medicaid and the Affordable Care Act, many lacked access to affordable care. Those with greater means responded to provide that care regardless of patients' ability to pay.
Retired nurse Peggy Peppler has for months researched historical documents and artifacts to unfold the story of Visiting Nurse in Fort Wayne, which on Thursday is celebrating its 125th anniversary. Current and former staff, board members, volunteers and supporters will gather at Ceruti's Summit Park for dinner and a walk down memory lane, one that winds back to 1888, when the Ladies Relief Union was formed to “help the sick and the poor of Fort Wayne.”
“In 1888 in Fort Wayne, like any area of the country that had become metropolitan, there was a group of rich people and many others who were very poor,” said Peppler, a former nurse with Visiting Nurse. “It did not take long to realize there was a definite link between poverty and disease.” Germans, Russians, Italians, Macedonians and others came to this country to find a better life. Language barriers, lack of skills and too few jobs led to a dramatic rise in Fort Wayne's and other cities' impoverished population.
Sanitation was a problem. Manure and flies covered city streets. Local female physician Dr. Jessie Carruthers Calvin rallied city leaders and community groups to embrace indoor plumbing and clean up the city. Her organizing and fundraising efforts led to formation of the Visiting Nurse League in 1900.
Telephones were available but limited. O. E. Mohler, identified in records only as a Fort Wayne Gazette newspaperman who was “conversant with the poor,” took the calls for medical help, decided which were a priority and passed information on to the League's first employee, nurse Josephine Shatzer.
Paid $10 a week, Shatzer rode a bicycle or took the trolley to homes. Patients were asked to pay 15 cents a visit. Of the 1,127 visits made in 1904, only four people paid. Community groups, churches and businesses donated money, food and medical supplies so the League could carry out its work.
Helping deliver babies, giving baths, teaching nutrition and bandaging wounds incurred in the workplace or during a drunken brawl were part of her everyday work. She even took flowers to patients, thanks to the City Park Board approving her request to pick flowers in Swinney Park. She eventually had an office in City Hall, and additional nurses were hired.
In the next few years, World War I, tuberculosis and the great flu pandemic “taxed both staff and monetary resources for the League,” Peppler said.
Financial records show the League had just $276 in its treasury in early 1919. Later that year, a Peace Centennial fundraiser added $1,000 to the coffers.
Two national life insurance companies, Metropolitan and John Hancock, put in place home health benefits for their policyholders. The companies employed nurses from visiting nurse associations to assess policyholders who were ill. League nurses were paid 75 cents per visit. The home visit program proved to be both cost- and life-saving. After seven years, mortality rates of children and adults declined by 7 percent, on average, and for infants by 19 percent. Demand for services increased so much that the League purchase a car to expedite travel. One problem: none of the nurses could drive, so two took driving lessons. The League's first director, Isabel Devlin, was hired in 1923.
“The Great Depression years in the 1930s were the most difficult years in the League's history making nursing visits all the more necessary,” Peppler said. The polio crisis crippled thousands. Headquarters for the League moved to several downtown locations through the years. In 1954, the name was changed to Visiting Nurse Services. (VNS).
The agency was a leader in public health care delivery and innovative practices, instituting a home-based stroke project to assess therapy needs. VNS also developed an experimental program that focused on serving the chronically ill in their homes rather than in a hospital. This led to the start of VNS' housekeeping aide services and helped ready the agency for the nation's new Medicare program.
The 1970s brought ups and downs due, in part, to competition from other service providers. In the ensuing years, more diversified services were added, then dropped. In 1984, the Medicare hospice benefit became available. Hospice of Fort Wayne merged with VNS. The agency was renamed Visiting Nurse Service and Hospice (VNSH). Hospice Home opened on the eighth floor of the former Lutheran Hospital Fairfield Avenue site.
In 1998, the board moved the focus wholly to Hospice Home and oncology/palliative home care.The latter provides supportive care for patients with advance illness but who may still opt for treatment. The Lutheran Foundation announced plans to demolish the old Lutheran Hospital. VNSH purchased land at 5910 Homestead Road, the agency's current site. The new building opened for business in 2004; that year the name was changed to Visiting Nurse and Hospice Home.
Several additions have been made, and growth of Hospice Home continues. In January, adjacent land was purchased for future expansion. Also this year, the agency's name came full circle. Once again it is Visiting Nurse.
Phyllis Hermann is CEO of Visiting Nurse and has held other positions within the agency. Reflecting on its history, she said, “As we move forward into our next 125 years, we are committed to the same set of principles – providing compassionate nursing care, regardless of the ability to pay. Above all else, we are humbled by the patients and families who allow our staff to assist them at such an important time in their life.”