Home health can educate, rehabilitate

Luther Irons is used to being an active person.

He's known in local cafes and courthouses as a man who for years kept his finger on the pulse of Shoals politics.

But a little more than a year ago, Irons was sidelined when several medical problems, including diabetes and congestive heart failure, sent him to the hospital.

When Irons was well enough to go home, he was told that he would still need medical care, which included therapy for his legs and daily insulin shots for his diabetes. He receives those services in the comfort of home through a home health care agency.

Unlike hospice care, which is geared toward terminally ill patients, the goal of home health care is to bring the person back to a state of independence. Many, such as Irons, who are 65 and older, can afford the benefits of home health care because Medicare covers the cost of these services.

Home health care providers not only carry out doctor's instructions, they educate the patient and assess the home for anything that could be a hazard to the patient's condition.

Doctors don't want Irons to drive, so they suggested a home health care agency to provide the services he would need to fully recover.

For the past year, a registered nurse and physical therapist have been coming to help Irons get back on his feet.

"When I left rehab, I had just completely given up. I was just about to quit," Irons said as he relaxed in a recliner in the den his Sheffield residence.

Irons, 73, was receiving his daily therapy from Tawana Rickard, a therapist with Mid South Home Health Care, and registered nurse Lisa Malone.

Malone comes by each day and checks Irons' vital signs, including his blood sugar levels, and administers a shot of insulin.

She said Irons needs daily insulin shots for his diabetes, but his eyesight is such that he cannot see the numbers on the syringe clearly enough.

When Malone is done, Rickard helps Irons exercise his legs.

"He does have a lot of fluid on his knee," Rickard said during the procedure.

Exercise, she said, can help prevent surgery for Irons and other patients.

Beth Brumley, a registered nurse and an account executive with Mid South Home Health Care, said 99 percent of their patients are older than 65.

Brumley said nurses such as Malone and therapists such as Rickard can do much of what is done in the hospital.

Irons said his doctors, including his primary care physician, Dr. Flora Kayfan, don't want him to get out much right now.

"I'm just doing what was advised by my doctors," Irons said. "I'm improving. These girls have really been a godsend."

Malone and Rickard drive their personal vehicles on their daily routes and are reimbursed for the mileage. Malone said she might see six to eight patients a day, sometimes 12. She will spend anywhere from 30 minutes to two hours with them, depending on the type of treatment they require.

Rickard said she will see six to eight patients per day and will spend from 30 minutes to an hour doing a lot of the things the patient would do in a well-care center.

Medicare requires her to spend at least 30 minutes with each patient.

Part of her job involves educating patients about their rehabilitation. She will determine if the patient needs handrails in the bathroom, a bedside commode or a bench in the bathtub.

"We're the doctors' eyes and ears out there," Malone said.

Brumley said the services they provide are more economical than a hospital stay and can save Medicare money.

"The major thing is, we want to keep them out of the hospital," she said.

Brumley said Mid South's Muscle Shoals office serves about 350 patients. Their Florence office serves 350-400 and another 200 receive health care services from their office in Russellville.

There are many other home care services in the Shoals, including those that provide hospice care for terminally ill patients.

November is recognized by local governments as National Home Care and Hospice Month, a time to recognize the individuals who provide home health care and hospice services.

Rickard said the job allows her some flexibility as a working mother, plus she enjoys working with elderly people.

"I may see six people a day and be done by lunch, but there is tons of paperwork," she said.

Malone said she has worked in the hospital setting and prefers the one-on-one relationship she develops with patients during home care visits.

"This is hands-on patient care," she said.

Malone said she has returned to visit patients after they recovered to the point where her services are no longer needed.

Brumley said patients are certified to receive services for 60 days and recertified for another 60 days if their doctor requires continued treatment.

While Irons can still stay in touch while he's at home, what he really looks forward to is getting back on the road.

"It won't be long before I'm back on my feet," Irons said.

Russ Corey can be reached at 740-5738 or russ.corey@TimesDaily.com.