Home is where the health is
Home health nurses Tessa Galemore and Darla Ulrich sorted through Iolan Meredith Rogers’ medications Thursday, making sure everything was in order for the days ahead.
They had just one more responsibility, though, before they could leave. Galemore reached into a bag of dog treats and asked Chopper, the family’s German shepherd, for a handshake in exchange for the morsel.
Giving treats to dogs isn’t an official part of the job description for home health nurses, but it’s an effective way to bond with patients and their family members.
The Allen County Regional Hospital Home Health and Hospice unit has seen a resurgence in recent months after struggling with a revolving door of nurses for the past couple of years. When longtime nurses retired from the unit, they were replaced by an outside nursing agency. As a result, patient numbers dwindled.
In the past several months, though, a new, local nursing crew has come on board. The return to local care has yielded positive results. Patient numbers have increased. The new staff is diverse, with a mix of experience and youth, and they’re especially passionate about their job, social worker Susan Hawk said. Hawk, home health aide Jamie Karns and longtime secretary Jaye Zirjacks are the veterans of the office; Dr. Brian Wolfe serves as medical director.
Susan Hawk provides counseling services for home health and hospice patients. Click here to learn more about hospice. REGISTER/VICKIE MOSS
Sharon Camp of Memphis, Tenn., is the interim director for the unit. She came on board in June to help the unit regroup after the years of turnover. She recently renewed her contract through October but expects to return home to Memphis at some point.
“It’s a whole new team and they are phenomenal,” Camp said. “They’re all competent and smart. We’re making sure to learn all the regulatory requirements and getting our name back out there to the community.”
HOME HEALTH and hospice care requires a special type of nursing, with demands not every nurse can handle for a long period of time. Through hospice, they care for patients who are terminally ill. Home health requires caring for patients who are homebound, such as those who have recently been released from a hospital but need continued medical care or therapy.
That’s the case for Rogers, who has received home health care since June 13. In May, she underwent emergency surgery for a spot on the back of her thigh that turned out to be a flesh-eating bacteria. It required a skin graft and more than a month in the hospital. She asked to recover at home, but was told she would be homebound and must stay off her feet as much as possible. She also must deal with complications from diabetes that require dialysis in Chanute three times a week.
Initially, Rogers received home health services every day that tapered to every other day. Rogers is dreading her next doctor’s visit, because she expects to get the “all clear” for her recovery and the visits will come to an end.
“They are awesome,” Rogers said of the nurses. “All I have to do is make a phone call and they are right here. They care about people and want to do everything they can to help a person have a better quality of life.”
She previously worked in the healthcare industry, including as a home health aide, so she has a good understanding of what the job requires.
“We’ve developed a bond,” Rogers said. “They’re very uplifting. When I’ve had a bad day, they’ll sit and talk to me until I get to feeling better.”
Meredith Rogers, left, receives home health services through Allen County Regional Hospital. She has developed a bond with her nurses, Darla Ulrich in back and Tessa Galemore.
IN THE home health and hospice office at 826 E. Madison, Garrett Booth works as a male nurse in what has traditionally been a female-dominated field. That surprises some clients, especially older men, but “the ladies love him,” according to his co-workers.
“He’s very patient and very kind and gentle,” Ulrich said.
Booth was as surprised as anyone that the work would be his calling, expecting he’d be a better fit in an emergency room setting. He earned his nursing degree in June and worked in the med-surge unit at ACRH until they asked him to help out with home health and hospice.
“I ended up loving it and staying here,” Booth said. “It’s a whole different style of nursing. You get to connect with patients better and form relationships you wouldn’t have time to do in a hospital.”
The ability to develop strong bonds with patients and families appeals to the nurses. Those who work in the field can’t be judgmental or critical, Camp said.
“There’s a needed level of respect,” Camp said. “In today’s world, you don’t let very many people into your house. It says a lot that our patients and families trust us to come into their home and take care of them.”
She recalled one of Booth’s patients, who had been declined by another home health agency. Some nurses probably considered the patient to be difficult and demanding, and his living conditions were not ideal. Even so, he deserved the best possible care, Booth and Camp said.
“As a nurse, you’re not looking at the environment. You’re looking at the patient and loving on the patient,” Camp said. “There are days you wonder, ‘Did I even make a difference?’ But you do.”
JUDY LACEY, a registered nurse with four decades of experience, returned to home health and hospice after about 10 years working in nursing management in Chanute and Greenwood County. With just about every type of nursing under her belt, she’s most passionate about home health and hospice care.
The work can be emotionally draining, Lacey said. She recalled caring for two young boys for years, watching them grow until they passed away while in high school.
“After the second one passed, I was done. They were the same age as my boys and it killed me when they passed away,” Lacey said. “Sometimes there’s a time in your career that you’ve just got to get away for awhile. I took a 10-year break, but I missed it. I was ready to come back.”
She describes the Allen County team as the best she’s ever worked with.
“There’s no drama. Everybody is willing to help and we don’t judge each other,” she said.
That’s important in this field, said Hawk. She provides counseling to patients and families, as well as the nursing staff when they need to talk about a case.
Hawk earned a master’s degree in 2002 and joined the home health and hospice unit in 2007. Though she didn’t have a lot of experience in the field, she had always enjoyed working with senior citizens.
Nurses, families, patients, even Hawk herself, need to find ways to deal with the many emotions that come with a serious or terminal illness. “You have to build up your own coping skills or you won’t last. This profession takes someone who knows how to manage their emotions and who is comfortable with their own mortality.”
Hawk finds her escape through camping. She’s worked with families who deal with illness or grief in their own ways, like the farmer who processes his emotions from atop his tractor, or the widow who plays cards with her friends. “Use your own natural resources,” she tells them.
IN ADDITION to the nursing staff, the home health and hospice unit requires the assistance of volunteers. Currently, the unit has about 10 volunteers, including local chaplains that minister to the families.
Volunteers receive training and must pass a background check. They may be asked to sit with a patient while a family member or caregiver takes a break or runs errands. They can read to patient, do crafts or just talk.
“Our volunteers are very important,” Camp said.
The unit also is trying to grow its volunteer base.
OBTAINING home health or hospice services starts with getting a physician’s referral.
Home health services require a patient to be homebound. Staff provides a variety of services, including medical care, therapy and counseling for patients in a 40-mile radius. The unit also is a home health care provider for the Veterans Administration.
Hospice care follows a terminal diagnosis, with symptoms that indicate a patient is likely to pass away in six months to a year. Families can continue bereavement and grief support services for 13 months after a patient’s death, at no cost.
Staff at Allen County Regional Hospital Home Health and Hospice include, from left, secretary Jaye Zirjacks, interim director Sharon Camp, and nurses Garrett Booth, Darla Ulrich and Judy Lacey. Not pictured: Nurse Tessa Galemore and social worker Susan Hawk. REGISTER/VICKIE MOSS
Medicare pays 100 percent of the cost of services. Commercial insurance typically determines how many home health visits and services a patient can receive. Hospice care is based on need, not ability to pay, and patients will not be turned away because of financial issues.
Some patients enter home health or hospice services immediately after leaving a hospital; some are recommended after visiting a family physician.
Receiving a referral for such services, especially hospice, can be quite frightening for families, Hawk said. Sometimes, a patient can accept a terminal diagnosis better than family members. Staff are trained to help families through the process in whatever way is needed.
That’s why Hawk is glad to see the return of a local, permanent nursing staff at the home health and hospice unit.
“These are our families and friends,” she said. “We take pride in the fact that we can help families in our community through this journey.”