Providing Quality Care in the Comfort of Home

As part of the celebration of November as National Home Care and Hospice month, the staff at Lincoln Medical Home Health and Hospice provided weekly information about home health and hospice care. The series concludes with a story of a home care patient.

Mr. Robert Clark is 68 years old. He has high blood pressure, had a heart attack in the past and takes several medications for those conditions. He also has osteoarthritis in his hips and knees. Recently, he underwent a total knee replacement surgery, and was discharged home to recover. As part of his discharge planning, his orthopedic surgeon ordered physical therapy at home for the first few weeks, until he is well enough to go to an outpatient physical therapy program. The hospital referred him to an agency he selected from a list of local providers.

The day after he arrived home, his home health nurse called him to set up a time to come out and evaluate him for home health care. She arrived later that day. After interviewing and assessing him, talking to his wife, and looking over his medications, the nurse had several concerns. Mr. Clark had been discharged from the hospital with some prescriptions for new medications, and was taking those in addition to several medications that he had been taking before surgery. His blood pressure was very low, and he felt sick to his stomach, so he wasn’t eating or drinking very much. He told the nurse that the medicine he was taking for pain made him feel sick and dizzy, so he was hesitant to take it. He was in a lot of pain and he didn’t think he would be able to do his physical therapy. He was feeling pretty discouraged and wondering if he’d ever be able to do the things he’d done before surgery. His wife was worried too.

The nurse discovered that Mr. Clark was taking his medication on an empty stomach. He was also taking his old blood pressure medication as well as the new prescription for blood pressure medication he had received at the hospital.

The nurse called his heart doctor to clarify which medications Mr. Clark needed to continue and which he should stop. She reviewed the new medications with him, and explained what the medications did, side effects they might cause, and the best time of day to take them. She talked with him about how to take his pain medication with food, and combine it with an anti-nausea medication to help with the side effects of the pain medication.

The nurse also looked at his surgical incision. She showed Mrs. Clark how to change the dressing and discussed any signs of infection or complications for which to be on the alert. She reinforced the information the Clarks had received in the hospital about preventing blood clots, and about Mr. Clark’s diet, and she explained that the physical therapist would be out later that day to set up his exercise program. She also told Mr. Clark and his wife how to get in touch with the home health agency, day or night, if they had any questions or concerns. Both Mr. Clark and his wife felt a lot better after the nurse’s visit.

Later that day, the physical therapist arrived. She evaluated Mr. Clark’s knee, his ability to move it, his level of pain, and discussed his concerns for his recovery. She reviewed the exercise machine for his knee, and taught him and his wife the best methods for transferring from the bed to his chair, bathing without getting his incision wet, using his walker, and controlling his pain. With Mr. and Mrs. Clark, the therapist set up an exercise program, reviewed the goals for his progress, what they could expect week to week, and how many times a week she would be visiting with him.

Within four weeks time, Mr. Clark made great progress. He had no further issues with his blood pressure and was able to take his pain medication so that he wasn’t sick to his stomach and was comfortable enough to do his therapy. His incision healed beautifully. He did his home exercise program faithfully, and worked with the physical therapist at home three times a week. He graduated from a walker and was using a cane to assist with walking. He was now ready to start going to an outpatient physical therapy program.

“This little story might sound like a fairy tale”, says Celina Thompson, Physical Therapist for Lincoln Medical Home Health and Hospice, “but, it is really pretty typical for our joint replacement patients. Home physical therapy is an excellent way to ensure postoperative success for a patient who it not able to go immediately into an outpatient physical therapy program following surgery”.

Collaboration with other members of the patient’s team is crucial. “We are a patient’s advocate in the home” explains Mary Frances Jones, RN. “Therapists, nurses, and all others assigned to the patient work together and communicate the patient’s needs to each other and to the patient’s physician to make sure that patient is receiving the most comprehensive care possible”.

Mr. Clark received two of several available home care services: nursing and physical therapy. But the services of occupational therapy, speech therapy, a social worker, and/or home health aides can also be provided, depending on what the patient needs and what the physician orders. While it is a great resource for patients who have been discharged from the hospital after an illness or injury, home health care is also very beneficial for patients with chronic diseases who may need additional teaching, skilled care, or therapy to improve their health and avoid a costly hospital stay.

“The theme for Home Care Month is ‘Home is the center of health care’ and I think this story illustrates that beautifully” says Susie Compton, Administrator. “We have so many success stories similar to this one. Patients who have had a stroke or heart attack, major surgery, a fall, a new diagnosis of diabetes, issues with wounds or infections are just a few examples of patients and families who have turned to home health care for support as they recover or improve their health while remaining in their homes”.

For more information about home heath and hospice, readers may explore the Lincoln Medical Home Health and Hospice website at https://www.lchealthsystem.com/lincoln_medical_home_health_hospice.aspx

Or call and speak with the staff at (931) 433 – 8088.