Barbara* had always tended to the needs of others—her second-grade students, her cats, and her beloved husband. As his seizure disorder and dementia progressed, she became his full-time caregiver, neglecting her own health. Shortly after he died, she also lost her younger sister and her cat, which increased her depression and anxiety. She was losing weight, sleeping poorly, and forgetting to take her medications.
By the time she was referred to Homespire, an Intermountain Healthcare company, Barbara, 82, was suffering from debilitating back pain due to a fractured tailbone, uncontrolled diabetes, high blood pressure, and high cholesterol. Her anxiety disorder had led to hoarding, making it nearly impossible for her to navigate her walker through the living room.
Immediate needs and long-term goals
When Meggan Newbold, RN, Nurse Care Manager at Homespire, arrived at Barbara’s home, she found her new client sitting on the couch, soiled with urine, and in too much pain to take care of her needs. The first thing Meggan did was help her to the bathroom, bathe her, and dress her in clean clothes. Then, the two women sat down and began to map out a care plan.
Meggan’s goals were to address Barbara’s immediate needs and also show her the light at the end of the tunnel. As her Nurse Care Manager, Meggan coordinated care with the larger team: Diane, an RN with Intermountain Homecare, a team of in-home caregivers, her primary care physician, and the occupational and physical therapists (OT/PT).
Meggan took over medication management and quickly identified a gap in her client’s care: the pain meds had been prescribed as needed, but often Barbara couldn’t remember if she’d taken them or not. Meggan contacted her doctor to find out the correct dosage and frequency and continued to work with him to get her pain under control.
To help her client take small steps toward independence, Meggan outfitted her walker with a tray for carrying meals from the kitchen and a basket for her phone. One of Barbara’s caregivers and a neighbor put together a new power-lift recliner which allowed her to stand up on her own.
Financial health intervention
Barbara’s finances also needed triaging. Before Homespire, she had been paying neighbors to buy groceries and cook meals twice a week, but mostly, she survived on water and high-sugar Special K bars—a troubling diet, especially for someone with type 2 diabetes.
Her grocery bills were a major source of concern. “Barbara’s neighbors bought whatever she asked for, without checking to see what she needed,” Meggan said. That pattern helped explain a massive inventory of toilet paper and a monthly grocery tab of $1,200.
To help Barbara rein in her expenses, her caregivers started making shopping lists for neighbors who offered to pick up groceries. Meggan worked with her client to identify and eliminate services she didn’t need or use, including TV and internet, and reduced her $200/month lawn service to a more affordable bi-annual contract.
Progress on multiple fronts
Initially, Barbara needed around-the-clock care from caregivers working 24-hour “awake” shifts to bathe her, make her meals, organize the house, and provide companionship. But the physical demand of helping her to the bathroom as often as every 15 minutes day and night was taking a toll on her Homespire caregivers. Something had to change. Meggan reached out to Barbara’s doctor and Intermountain Homecare to figure out what was causing her continence problems. After a scan revealed bladder spasms, her doctor prescribed a medication to ease the spasms, dramatically reducing the frequency of bathroom visits and making it possible to change from 24-hour “awake” shifts to a live-in caregiver.
As Barbara’s pain and anxiety eased, she was able to wean herself off the pain meds and began to make a major comeback. For example, when she first got her new recliner, Barbara depended on the power-lift feature to stand up. With encouragement from Meggan and the OT and PT team, she stopped using the lift and, today she can get out of the chair on her own. She’s also eating much better, taking her meds as prescribed, dressing herself, and getting to and from the bathroom by herself.
Barbara’s growing independence has also been good for her finances. In the early days, Meggan visited as often as twice a week but now meets with her client every two weeks to see how she’s doing, organize her meds, and run errands for her. “We have great visits, now,” Meggan said. Barbara has also been able to save on caregiver costs, from a high of 24-hour care to six hours/day and to just four hours/day of housekeeping services. “She doesn’t actually need much help but still loves the daily visits from her caregiver, Toa,” Meggan said.
Now that Barbara has become more self-sufficient, she’s friendlier and more outgoing. As a result, friends and neighbors come by to check in on her and have a chat. (Due to COVID-19, they stay outside.) “Barbara is constantly telling me how grateful she is for our services, that she doesn’t know what she would have done without us,” Meggan said. For the Homespire team, being part of Barbara’s transformation has been deeply rewarding. “We’re all really happy with how well she’s doing,” she said.
To learn how Homespire can help your loved one experience a happier, healthier, and more independent life, schedule a free consultation today.
*Barbara’s real name has been changed to protect client privacy.