Glenn (name has been changed) is 53 years old with a diagnosis of Chronic Obstructive Pulmonary Disease. Prior to receiving home health services, he was in the hospital on a ventilator. Glenn was then discharged and referred to Professional Home Health for two months of follow-up home care.
GETTING STARTED ON THE TELEMONITOR
Initially, Glenn was in denial about how serious his condition actually was, and did very little to improve his health. For example, he did not always take his medications as prescribed. Immediately upon his start of care, his Case Manager, Luann Boettler, RN, placed the Honeywell HomMed monitor in his home. She programmed the monitor to go off at 8:00 every morning in order to catch anything that might be wrong, and allow for adequate time to handle the situation. His blood pressure, heart rate, weight, and oxygen levels were all carefully monitored.
USING THE MONITOR TO PROMOTE PROPER HEALTH CARE
Over the course of Glenn's home health care, the monitor provided an alert to several potential health problems. One instance was an overnight weight gain of 8 pounds, and a "yes" response to the monitor question, "Have your ankles been more swollen than usual?" His nurse, SueMae Bertenshaw, RN, called immediately and discovered he had celebrated his nephew's birthday by eating a salty meal the night before. An extra skilled nursing visit was scheduled that morning. His legs were swollen to his knees, and he was having great difficulty breathing- even with oxygen. SueMae instructed him to make a doctor's appointment before she left, telling him, "you are the one needing to make responsible choices for your health." Glenn eventually agreed. "There were two times, where overnight, I had gained 5-10 pounds, and it was because of what I had eaten the night before. I decided then that pizza was no longer in my diet." After seeing the direct effect of his salt intake, it was easier to convince Glenn of the importance of a healthy diet. He said, "Several visits later, Sue Mae looked through my cabinets in order to teach me the proper foods to eat. I surprised her by having some low-salt foods on my shelves."
Seeing his daily blood pressure and heart rate readings, Glenn began to take his medications properly. His diuretic was adjusted twice by his physician, without making any unscheduled nursing or doctor visits. He also suffers from sleep apnea. "The monitor was also a big help in looking at my oxygen levels, and as a result I now use my bi-PAP at night." The bi-PAP is equipment that uses positive airway pressure to trigger inspirations during brief episodes of non-breathing. His doctor had already ordered the use of the bi-PAP, but until he used the monitor to check his oxygen levels he hadn't properly used it.
POSITIVE EFFECTS OF THE MONITOR
Upon discharge, Glenn was capable of understanding the information provided by the monitor and how he needed to take an active role in his own health care. By his last nursing visit, he had already purchased his own set of scales as well as his own pulse oximeter and blood pressure machine, knowing he could now manage his health without a nurse. The effects of his well-managed care have given him a new lease on life, as well as relieved the stress of dealing with illness and hospitalizations for both him and his family.
Last updated: 3-4-2008