Anthony Whitaker is 68 years old. He has high blood pressure, a past heart attack, and osteoarthritis in his knees and hips, and medications for all of these conditions. Recently, he underwent a complete knee replacement surgery and was sent home to recover.
Discharge planning included physical therapy at home for the first few weeks until he was well enough to go to outpatient physical therapy. If it was not for the excellent home care options that are increasingly available to patients like Mr. Whitaker, that transition might have capped his recovery at a considerably lower level.
The day after her arrived home, his home health nurse called to make an appointment to evaluate him for home health care. In that assessment, Anthony’s blood pressure was very low, and he felt sick to his stomach so he wasn’t eating or drinking very much. He was in pain, but resisted taking pain medication because it made him nauseous. Without pain relief, he did not think he would be able to do the prescribed physical therapy. Needless to say, he was beginning to grapple with some serious depression on top of all this.
The nurse became immediately concerned about potential drug interaction issues between the new drugs he had been given post-surgery and his regular medications. She instructed him that he must eat before taking certain medications (which he had not been doing), and that he was taking the blood pressure medication he had been taking in addition to a new blood pressure medication he had been given when he left the hospital. She contacted the heart physician to clarify which blood pressure medication he should continue and then explained the side effects it might cause and the best time of the day to take the pills.
The nurse also looked at his surgical incision. She showed Mr. Whitaker how to change the dressing and the signs of infection. She also reinforced the information that the Whitakers had received in the hospital about blood clots and about the optimal diet for his rehabilitation.
When the physical therapist came to see Mr. Whitaker, he was in a vastly improved physical and emotional state. She evaluated Mr. Whitaker’s knee mobility, his level of pain, and discussed his concerns about a full recovery. She taught his wife how to use the exercise machine properly, the best ways for transferring from the bed to the chair, bathing without getting his incision wet, using his walker and controlling his pain.
Four weeks later, Mr. Whitaker had no further issues with his blood pressure. His ability to manage his pain medication without getting nauseous facilitated his physical therapy progress. After physical therapy session three times a week and much supplemental work in between, had graduated from a walker to a cane. He was now ready to stop home care and continue his progress through outpatient physical therapy.
The theme of Home Health Care Month in November is that home is the center of health care. This story exemplifies this beautifully. Patients who have had a stroke or heart attack, major surgery, a fall, a new diagnosis of a disease, issues with wounds and infections are just a few examples of patients and families who have utilized home health care as a critical component for improving their health outcomes.
Robert Hoyt, Ph.D.
Allied Health Professionals LLC