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Reporter Reflections: Home-care program a win-win situation

Cuts stress for patients, saves hospital resources

By: Larry Kusch

Posted: 12/28/2012 1:00 AM | Comments: 0

Dr. Paul Sawchuk examines Terry Miller with Don Miller and case co-ordinator Arle Jones. (KEN GIGLIOTTI / FREE PRESS ARCHIVES)

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Don Miller is grateful for each day he and his wife Terry can live together in their comfortable North Kildonan home.

It's not something he takes for granted. And it wouldn't be possible without intensive home care and a new medical home-visit program the Millers helped pilot in Manitoba.

Terry, 90, has late-stage Alzheimer's disease and can only walk if aided. A series of mini-strokes has left her unable to speak. Her skin is fragile and prone to bed ulcers. She requires a great deal of care.

Beginning in 2011, Terry became one of 10 northeast Winnipeg patients -- all chronically ill and all frequent users of hospital emergency rooms -- to participate in what was called a 'virtual hospital ward' project.

A team consisting of a doctor, nurse and home care co-ordinator blazed a new trail in Manitoba medical outreach by attending to these fragile folks in their homes, reducing their need for hospital beds and keeping at least some from being institutionalized in a personal-care home.

The pilot project was successful. Participating patients saw a 58 per cent decrease in ER visits and a 60 per cent drop in hospital admissions.

Family caregivers had someone to turn to for help if they were unsure whether they should take their loved one to hospital. Many times, a visit from a doctor or nurse or even a reassuring phone conversation prevented a trip to emergency.

The government was so impressed by the pilot project that this past November, Premier Greg Selinger and Health Minister Theresa Oswald announced an expanded program that will see "hospital home teams" visit up to 100 patients in 2013. The teams will work out of the Access River East health centre and Deer Lodge Centre's seniors clinic. More teams are expected to be added in the future.

The financial trade-offs are unknown at this time. Frequent home-care visits and medical house calls cost money, but so do hospital and personal care home beds.

But what was clear to Free Press photographer Ken Gigliotti and myself when we chronicled Don and Terry Miller's experiences earlier this year is that this novel approach is good for patients and their families.

A few years ago, before she lost her ability to speak, Terry pleaded with Don to let her live out her remaining years in their sunny North Kildonan bungalow. "I just love it here," the former army sergeant told her husband.

And, for now, she is getting her wish. She's had several seizures recently, but instead of taking her to emergency, Don has called Dr. Paul Sawchuk, who has attended to Terry in their home. "And things have worked out fine," Don told me recently.

"She bounces back. She has a lot of spirit and spunk, I'll tell you," he said of his wife.

On Saturdays, Don still manages to take Terry out to get her hair done. She's been going to the same hairdresser for years, so the outings are not stressful for her.

"Actually, she enjoys that," Don said.

larry.kusch@freepress.mb.ca

Republished from the Winnipeg Free Press print edition December 28, 2012 A11

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