CHRONIC ILLNESS MANAGEMENT AT HOME

We are very proud of this service because we are the only agency offering this unique service.

This is the service for the person that is challenged with a chronic illness and multiple comorbidities such as Parkinson’s with dementia, Congestive heart failure with Chronic Obstructive Pulmonary Disease (COPD), heart problems, and kidney disease etc. 


The problem with Chronic Illness is that the care recipient spends too many hours in a hospital ER because they have symptoms that need to be managed.  

  

We Have A Great Solution and here is how is works. 


Our geriatric care managers work with the doctors to come up with care programs that take care of the symptoms and improves quality of life. 



image257

Success story

Here is one of our success stories to give you an idea of what this service can do for you.

On Labor Day several years ago we got a call from a gentleman (son, medical doctor and surgeon) wanting to know if we could help with his mom who was at the hospital. 


She was being discharged from the hospital for the 3rd time in one month and this time her heart had stopped, and they had to do CPR and put her in the ICU. 


The problem is that her heart only worked 10% (what medicine calls ejection fraction), her bladder did not work at all so she needs to be straight catharized 3 times a day, her rotator cuffs were both damaged so she could not raise her arms above her shoulder so getting dressed is very hard. She had congestive heart failure and COPD as well as diabetes and needed blood sugar checks done four times a day. Her walking was getting worse with each hospital stay and, on that day, she needed to be transferred from bed to chair by a really strong person. She was very week, very tired, and very sick. 


She wanted to go home and die and the hospice team was called in because the doctors said at the ripe age of 85, she was not a surgery candidate and had too many comorbidities. 

The son who called us was a physician and had a big and busy medical practice. His mom would call several times a day because she could not breathe and sometimes he was called out of surgery because his mom needed him. He had a brother who lived out of town and so he needed an agency that could not only provide caregivers but could also manage her medical needs. A neighbor had learned about our program from another friend and she referred him to us. 

With our chronic illness management program, we were able to put a hold on her hospice admission, we took her home with 24 hours care home certified home care aides and a nurse. 


The aides provided around the clock care (initially in shifts of 12 hours each and then as she got better in shifts of 24 hours) and the nurse worked with her only 4 hours day for the first week then 3 hours a day for the second and two hours a day for third week and then one hour a day for the fourth week and there after the nurse worked with her for one hour three days a week. 


She lived a full and beautiful life for four and a half years without hospice and without a trip to the doctors. By 10 am every morning, she was fully dressed and ready to go out to lunch and shopping and every event that would allow her and her round the clock caregivers.  

 

To find out how to help your loved one with a chronic illness to have a good quality of life,
manage their chronic illness, stay symptom free and out of the hospital, call our office today
at 201-300-6565.