'Hospital care' now 'home care'
While practice helps cuts costs, studies find patients recover better at home
Sunday, November 11, 2007WARREN COUNTY - There was a time, before medical costs began to skyrocket, that lengthy hospital stays were not uncommon. That is no longer the case. Because of home health care, people, such as 92-year-old John Smallwood, can return home sooner, but they still need medical care.
Smallwood, who farmed most of his life, receives regular visits from Amy Whiteside, a registered nurse from Western Illinois Home Health Care, and certified nurses' aide, Cathy Young. Alice Stenander, WIHHC's director of support services, said with home care, the shorter hospital and nursing home stays have turned out to do more than help control costs.
"It's proven that people do better in their own homes, in their own environment, with their families," Stenander said.
Smallwood recently sat in an easy chair in the living room of his comfortable Warren County home. Family photos filled a table near a grandfather clock. A painting of the farm house in Missouri where Smallwood and his late wife lived for many years hangs on one wall; a painting done by one of Smallwood's sisters.
After farming 500 acres in Knox County, Smallwood retired at age 72.
Whiteside and Young are godsends for Smallwood's daughter, Sharon Darnell. She is very involved in her father's care, something home care experts say is important, but having to do it all can be overwhelming.
"It helps a lot," his daughter said. "I know he's going to get good meals and checked on. He's got a schedule and knows when everybody's coming."
Although Sharon lives nearby, she admitted she does not have time to keep up two houses.
"They do the dishes, do the laundry," she said.
Nurses and aides vital
Young and Whiteside leave notes for Darnell when needed. Stenander said home care nurses and aides are vital in communicating with the patient's doctor. Young is a key to Smallwood's care, as are other CNAs caring for other patients.
"They spend more time with them," Whiteside said.
"We really depend on them to report to us," Stenander agreed. "A lot of times they see things we nurses don't see."
Whiteside said she sees from four to six patients each day. For Young, it's more like two or three, although there are days she will see four or five patients.
Whiteside is responsible for checking patients' vital signs, such as breathing, blood pressure and listening to the heart.
"A lot of time, we'll fill their meds for two weeks, although not with him," Whiteside said of Smallwood.
"Then Amy's responsible for all the paperwork necessary for orders from the doctor," Stenander said.
Friends and family
Young and Whiteside become friends with patients, providing welcome companionship along with medical care. With 17 years experience with WIHHC - 32 years total as a CNA - Young knows what it's all about.
"I've done it all my life and I enjoy it," she said.
Whiteside recently joined the WIHHC staff. She has worked there for eight months, although she has been an RN since 2000, having worked in the emergency room at Galesburg Cottage Hospital for seven years.
The sound of a John Deere tractor starting up fills the room - a clock near where Smallwood sat has the famous green tractors instead of numbers on its face - and reminds him of days gone by.
"Every time it hits the hour, a tractors starts up," Darnell said.
Smallwood enjoys the banter with Young and Whiteside.
"It's nice to have them," he said. "They're bigger than I am and I can't run."
Smallwood uses a walker. He had a stroke some years ago. His daughter said he's been home from the nursing home for about seven weeks after a bout with pneumonia.
"He's doing good," she said. "He's walking really good with the walker. He's really improved since that last hospital stay."
Enjoying time at home
Smallwood looks forward to the visits from Young and Whiteside. A running joke between him and Whiteside is his dislike of shots.
"She always comes with a needle," he said, attempting to look annoyed.
"Don't make me go out to the car and get my needle," Whiteside said, with mock sternness.
The house sits across from a farm field, giving the former farmer a chance for a visual connection to his life's work. When he looks at the painting done by his sister of his house in Missouri, the years fall away.
"That's the west side and this is south, the bay window," he said, seeing more than the picture in his mind. "Our bedroom was upstairs. The windows didn't fit. When it snowed, you had to brush the snow off the bed."
Smallwood, who looks at least 10 years younger than his age, thrives on being at home. He said when you need a nursing home, it's good to be there, but there's nothing like home.
The blades of a small, green windmill outside the picture window spin on this autumn day.
"The grandkids got him a windmill so it would seem more like a farm," Darnell said. Her dad has "23 or 24 grandkids."
"And great-grandkids and great-great-grandkids. If I had known grandchildren were so much fun, I would have had them first," he said laughing, a man enjoying the comfort of home sweet home.