By Regina Dennis

Tribune-Herald staff writer

Ada Nunn remembers panicking as a simple nose bleed threatened to take her life.

“My nose was bleeding, and when the ambulance got here, they couldn’t get it to stop,” said the 78-year-old Wacoan, who has had high blood pressure for nearly 60 years. “Then I went to the hospital, and they liked to not be able to stop it. At one time, I was giving up.”

After two stints in the hospital from blood pressure complications, Nunn was referred to Providence Home Care. Recently, she was visited by her case manager, Patty Stovall, who hashed out a daily health plan to lower her blood pressure.

“A lot of what we do is general teaching, getting them to take their meds on time, showing them how to take their blood pressure or take their insulin, things like that,” Stovall said.

Local medical officials say the demand for home care services has increased as hospitals have reformed their business model to get patients the care they need at more efficient costs.

“People are sicker now than they were 10 years ago because they’re leaving the hospital sooner now,” said Regina Robertson, nursing manager of Hillcrest Home Care. “They’re not staying weeks and weeks but still have some nursing needs, or they may not have to enter the hospital at all. They can go home and be managed at home.”

Stovall, who has been in home care for 17 years, has about 20 patients at a time under her care, some of whom she sees on a weekly or monthly basis. A calendar on her desk outlines each client’s medical appointments and treatments, and she remains in frequent contact with her clients’ primary physicians.

Much of Stovall’s work entails coordinating services that improve her clients’ overall health, from changing catheters and dressing wounds to arranging physical and speech therapy services. She arranged for Meals on Wheels to deliver food to Nunn three times a week after learning her patient was skipping meals because of the costs, despite taking several medicines that must be ingested with food.

“She reminds me of what I need to do to take care of myself,” Nunn said. “I’ve started eating toast in the mornings, because I normally wouldn’t eat breakfast, but I kept getting weaker.”

Help for ailing parents

Roberta Robinson, director of Providence Home Care, said adult children often come to the organization on behalf of their aging and sick parents to get them medical care while living at home.

“After a hospitalization, newly diagnosed illnesses such as congestive heart failure or diabetes, wounds that won’t heal, medication management problems, frequent falls and many other situations, patients and families are overwhelmed and don’t know what to do,” Robinson said.

Hewitt resident Maxine Medlin, 83, suffered a stroke four years ago that affected her memory and peripheral vision. She can no longer drive and has frequent falls, in part because of arthritis in her legs. Her son arranged a caretaker to tend to her five days a week from Visiting Angels, an agency that provides nonmedical home care services, such as cooking and cleaning.

“I try to do as much as I can on my own, but (caretaker Dorothy Simmons) is here to help me get around,” Medlin said. “My son doesn’t want me to go outside on my own, so she will walk with me in the yard.”

Brent Wilson, founder of Visiting Angels, personally knows the struggle to find a trustworthy home care provider for a loved one. He placed an ad in the newspaper to find a caregiver for his live-in grandmother, Louise Wilson, who was paralyzed on one side of her body after a stroke in 2002. All went well until the caregiver missed two days of work in a row.

“We couldn’t get a hold of her, and then we learned she was in jail, and we found out she was a prostitute,” Wilson said. “My grandmother was in an extremely vulnerable state, and we would never have exposed her to a person like that on purpose, but we did so on accident because we didn’t have a pool of quality caregivers to choose from.”

Flexibility for caregivers

More nurses are becoming interested in home care because of the flexible schedules and opportunities to be more hands-on with patients, said Robertson, of Hillcrest. She added that the Hillcrest program has not had difficulties recruiting nurses, even with a current shortage of nurses statewide.

“Nurses are looking for a change. They’re getting tired of shift work and finding the hospital setting not as fulfilling as they thought it would be,” Robertson said. “In a hospital they’re running and running so much that they feel, at least I felt, that I never really took care of the total needs of my patients. But now, I feel I am taking the time I need to, to take care of all of their needs.”

rdennis@wacotrib.com

757-5755

Home health care

* There are 7.6 million Americans who require home care services each year, according to the National Association of Home Care and Hospice.

* Medicare and most insurance plans cover medical home care services. Most home care programs require a doctor’s referral or that the patient is homebound and in need of skilled care.