Stories from patients receiving in-home nursing, CNA, housekeeping, and pastorial/spiritual care.

Lydia was forgetful, disorganized, noncompliant with her medications and emotionally paralyzed. The emotional paralysis developed when she was told she had breast cancer. From that moment on, she said she would just sit unable to eat, unable to take her medications, or clean her house. She wondered ‘how could this happen to me… I have been such a good Christian mother all my life. How can a mother raise five children, yet five children cannot help care for one mother?” As is often the case, children abandon their parent when their parent needs them the most.

For Lydia, Dominican Sisters Home Health Agency (DSHHA) helped her see the innate power and independence that she possessed, even though she was sick. DSHHA intervened and provided a skilled nurse and housekeeper to assist her through the immediate process of healing and then regaining her strength and confidence. Key to success for Lydia was to develop a trusting relationship with her nurse. The nurse worked with her and presented the areas of needed attention so that the patient would control what needed to change—not her nurse. Her nurse provided the support, words of encouragement and healthcare knowledge and teaching. Her nurse explained that emotional and psychological ‘paralysis’ can result from depression, sadness and anger. Step-by-step, they began a plan of care that included medication management, ordering of medications, scheduled doctor visits, and cleaning months of untended mail strewn on the floor. n February of 2001, Maria had suffered a seizure and stroke that resulted in right-sided paralysis. She was then placed on seizure medication, but there was a mix up in medicines and she suffered another seizure. She had completed all radiation treatments but continued to get chemotherapy, which often left her feeling weak and tired. Her most recent x-ray had been about a month ago and had shown that the size of her tumor had become slightly smaller.

Through DSHHA’s Durable Medical Equipment Loan program, Lydia received a hand-held shower and shower chair so that she could sit in her bathtub and bathe independently, without fear of being unable to get out of the tub. Cleaning her house, making sure she saw her doctor, monitoring her vital signs, getting her to routinely take her medication and eating well, are seemingly small things. But together, the Dominican Sisters’ nurse and with Lydia’s participation, it was a recipe for better health, feeling more independent and knowing that she is still the women she always knew she was!

Henry is a very social person who lives alone. While he does have family, like so many elderly, the family is not very involved with him. Unfortunately, the disease that he has ---chronic dermatitis, hyper-pigmentation and hyper-keratosis on his back, requires someone to apply a medication cream on his back daily. Doing that by himself is nearly impossible, as he cannot reach his back. Without this medication, the skin cracks, becomes infected and is extremely itchy and painful. With Dominican Sisters Home Health Agency intervention, both a nurse and certified nursing assistant were assigned to help control his chronic back dermatitis. As a result, the pain has diminished considerably and the skin is smooth and without infection. Henry is so appreciative. However, as with many other elderly, the aging process alone can stimulate other chronic diseases to appear. He now has diabetes. But, with the intervention of his nurse, he is very knowledgeable of diet and medication management of this disease. This management has kept him out of the hospital and safely in his house, independent and well-functioning.

Violet tries to sort her medications into a medication organizer but never gets it right. Often, this is the case of poor eyesight, dementia, lack of focus and poor patient knowledge of their medication (s) for many elderly ---- and often a primary reason why the elderly end up in the hospital---a result of poor medication compliance and/or medication errors. Additionally, the large co-pays or the co-pays from a vast array of daily medications make the elderly who are on fixed incomes choose between eating or taking their medicine. Both scenarios have devastating effects to each individual and to our healthcare system.

Violet is one elderly woman who had to choose. She recently asked her two grandchildren to leave her house, as they were stealing both her medications and her money from her. This is so very hard for a grandma to do. She still has days of remorse, but knows that she must look after herself first. Safety is important to keeping one’s independence. In Violet’s case, her grandchildren also hurt her physically including breaking her thumb.

Dominican Sisters Home Health Agency interventions included emotional, safety and psychological support as well as medical intervention. The turmoil for Violet is now over, and she is comfortable in her home. She says “Now, I know I am not crazy—that the things that went missing in my house or checkbook were not my doing.” Violet is now very compliant with her medications, has the money to pay for the co-pays and is safe and independent in her own home. DSHHA provides not only the nursing and housekeeping services for her but she is part of the DSHHA exercise program (which is strengthening her endurance, muscles and focus) and the Friendly Visitor program (where a trained volunteer calls her several times a week for a social call). Violet is a great example of this year’s staff motto – “Together is Better!”