family Home health care through the eyes of professional caregivers BY ASHTYN MATHEWS PHOTOGRAPHS BY CHRISTINA KUHLMANN & CYDNEY WAITLEY
hen physical therapist Nancy Sulak walked into the bedroom, it was almost impossible to hear the woman inside quietly calling out, “I’m in here!” The patient seemed a bit hesitant at ﬁrst, until Sulak spoke. “Knock, knock! Hello, hello, hello,” said Sulak, who works for Bluebonnet Health Services, a home health care provider. This was her third patient of the day, but the warmth and energy in her voice would’ve suggested it was her ﬁrst. “Hello, Ms. Nancy. I got excited and decided I’d be nice, so I changed my diaper for you,” said the patient. The two played catch-up, like old friends meeting in a coffee shop. Getting to spend time with her patients in a one-on-one, personal setting is what Sulak values most about her position in home health care. “I really enjoy getting to be in the patient’s home,” Sulak said. “It’s a special feeling, knowing that I am helping them work through their problems within the comfort of their everyday environment.” After a series of questions concerning pain levels and vital signs, the visit continued much like a physical therapy appointment would in a clinical setting — pain check, stretching, exercise, pain check. Though some of the
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For many patients receiving at home care, an appointment with a home health care professional may offer their only chance for interaction some days. As physical therapist Nancy Sulak (right) and registered nurse Dana Adee (next page) care for their patients, they share conversations that are warm and full of laughter. In this intimate setting, patient and caregiver often become true friends.
Oh, Ms. Nancy, I don’t ever want to get rid of you. You’re my best friend.
exercises appeared to be uncomfortable for the patient, the moments in between each series of movements were ﬁlled with cheerful, warm conversation, and Sulak’s smile never faltered. When it was time to leave, Sulak completed her charting and assisted the patient in reclaiming a comfortable spot in front of the television. “All right, sweetie, now even though we’re discharging you from nursing care, we’re still going to continue with physical therapy,” Sulak said. “You can’t get rid of me just yet.” The patient laughed and said, “Oh, Ms. Nancy, I don’t ever want to get rid of you. You’re my best friend.” To most patients — including this woman — home health care professionals aren’t merely caregivers. They’re friends. Many patients might live alone, far from relatives or have no relatives remaining. Some of them are physically incapable of such daily activities as cleaning the house or doing laundry, much less going to the store for groceries and having a quick chat at the checkout counter. A one-on-one interaction with their nurse or physical therapist might be some of these patients’ only access to conversation. More than just serving in the role of caregiver, home health care professionals wear many hats, including entertainer, storyteller and companion. In many cases, these professionals become like family to their patients. Home health care is designed to help patients live independently in their own home for as long as possible, with respect to the limits of their medical condition. Home health usually covers a
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variety of services and can often postpone the need for long-term nursing care. Kristi Burkett, registered nurse and administrator at Bluebonnet, explained the beneﬁts of caring for a patient in their home. “I love the concept of being able to age at home and heal at home,” Burkett said. “I ﬁnd it a little unfair of us to ask sick, elderly patients to get up and go to the doctor’s office when a healthy nurse can easily come to them. It’s a very humane practice of medicine.” Dana Adee, a registered nurse, entered the home of a new patient — a woman in her 80s, who had recently had a medical procedure. There was light-hearted conversation as Adee familiarized herself with her new patient’s medical condition and history. The patient was full of jokes, and the entire visit was full of smiles. It appeared that Adee had already made a new friend. “When working as an ER nurse, things became kind of monotonous, and I never really got to know my patients,” Adee said. “I had no way of knowing what they had access to in their home environment, or who was going to take care of them once they were discharged.” In home health care, a medical regimen is designed to assist qualiﬁed patients who continue to live at home. Although the job is primarily medical, there are many aspects that are more holistic and relational than clinical. Burkett said the ﬁeld’s holistic nature is the most important and enjoyable attribute for her. “We’re going to look at not only the
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patient’s diagnosis, but how do they function in their home,” Burkett said. “Do they have steps they cannot navigate? How do they get their meals each day? Can they do their laundry? We rely a lot on social [interaction] to help us know our patients better.” Unlike the monotony Adee said she experienced working in the ER, the schedule of a home health care professional can be very different from one day to the next. “Some days, I’ll do as many as 10 visits. Some days, it’s as few as three,” Adee said. “And oftentimes, I have no idea what to expect.” After patients are recommended, evaluated and admitted to home health care, a staff member, like North Area Team Leader Amanda Kettler, a registered nurse, will manage and assign the visit schedule for the day. “It’s my job to ensure that our patients are seeing the same nurse, the same therapist, day in and day out so that they know that patient just as if they were family,” Kettler said. Depending on how many visits are scheduled and where the homes are located, a nurse or therapist might head to a patient’s residence from their own house and never set foot in the office. “I may be doing an evaluation of a new patient, or I may just check on a regular patient I’ve been seeing, or I might be upgrading goals or dealing with a patient’s declined condition. It all depends,” Sulak said. “No matter what my agenda is for the day, I’m getting to spend that precious, one-on-one time with these people, talking with them and learning from them. It’s a privilege, and it’s the greatest job in the world.” W