Helping seniors stay home

CEDAR RAPIDS - Once a week, nurse Kelli Jo Bieber stops by George and Carol Dahms's Monticello home to refill their medications and take their vitals - including pulse, weight and blood pressure.

Bieber has been doing these weekly home visits, which increase if either of the two gets sick, for about four years. She's part of a team that includes a therapist who works with Carol to improve her strength and balance so she can get around her home more easily.

'We want to keep them out of the hospital,” said Bieber, who is with UnityPoint Health-Cedar Rapids Home Care. 'I make sure they take their medications properly and try to catch things.”

While the idea of providing care in a patient's home isn't new, home care is gaining prominence, especially among aging Iowans who want to stay in their homes longer.

'Home care is finding its way back,” said Peg Bradke, UnityPoint Health - St. Luke's Hospital vice president of post-acute care, which includes home care.

As Iowans live longer - many of them with a chronic illness - Corridor hospitals are starting to see an increase in their home care services, which monitor, educate and care for patients, helping keep them out of the hospital and in their homes.

'We're not just focused on the hospital anymore,” Bradke said. 'We want to meet patients' needs and do it efficiently.”

Growing Demand

Bieber's visits also help the Dahms, both in their 70s, not have to worry about traveling to see the doctor, which can be difficult for the couple. They live in a rural area, are unable to drive and have difficulty walking.

'There's also a tremendous benefit to patients when they're taken care of in the home,” said Margie Pence, Mercy Home Care director. 'A nurse can sit down and teach them in their own living room.”

Hospitals first assess patients to see if they'd benefit from home care and then assign them a team, which can include social workers, nurses and physical, occupational or speech therapists.

St. Luke's Home Care program averages about 1,900 visits per month. Its 70 employees cover a 50 mile radius.

Since 2008, UnityPoint at Home has seen about a 16 percent increase in the need for its services.

And as hospitals have put a larger emphasis on decreasing a patient's average length of stay in the hospital, home care has become a more cost-effective option, Bradke said.

Mercy Medical Center in Cedar Rapids has seen a huge increase in its home care program, which increased 20 percent in the last year, Pence said. In fact, the hospital held a career fair in October to better handle the department's growth.

Mercy Home Care sees 350 to 400 patients each month across a nine-county area, which includes Linn, Johnson, Iowa, Benton, Tama, Buchanan, Delaware, Jones and Cedar counties.

Benefits

Part of the push for home care, Pence said, comes from health care reform, which is encouraging hospitals to decrease readmission rates and visits to the emergency department as well as to better coordinate care.

Hospitals stand to benefit financially if they meet these new requirements, and home care is well suited to help them. That's because a patient and his or her illness can be better assessed, monitored and managed.

Nurses or therapists regularly check up on a patient to see how he or she is getting around, if the patient is taking medications properly and whether the patient is having other problems.

'We go into people's homes, evaluate their needs - typically after a hospital stay - and help them be safe in their home and maintain their quality of life,” said Austin Isham, a Mercy physical therapist.

Isham and a team of workers began seeing Olive Pauline Romero, 87, about a year ago.

Romero was admitted to the hospital earlier this year after she over exerted herself during a family trip. She also suffered several falls in her home and was assigned strengthening exercises to help her move around her house more easily.

'They make sure you do them, too,” Romero joked.

'A patient is more comfortable when they're in the comfort of their own home, sleeping in their own bed and eating their own meals,” Isham said. 'And a physical therapist can see specific needs, like where the spot on the carpet is that might make Olive trip.”

Romero started with sitting exercises, moved to standing exercises - such as marching, which helps her not trip, and rising to her toes, which helps with balance.

She no longer needs to see Isham or her other therapists.

'I'm planning on living to 100 with the help of these guys,” Romero said. 'I think I'll make it.”