Housecalls for the Homebound

Nancy Leahy, Nurse Practitioner makes a Housecalls home visit to local artist Schomer Lichtner.

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Housecalls for the Homebound provides high quality primary care to frail elders in their homes in the Columbia St. Mary’s service area. Many elders are able to remain comfortably within their homes with the support of family members and service organizations, but find it extremely difficult to travel to physicians’ offices for their primary care. Housecalls combines the skills of two physicians and a nurse practitioner, each of whom have great experience and skill in geriatric care and will visit people in their own homes. These providers, along with an RN Case Manager, have real-world knowledge of resources and strategies for care giving support for elders at home. Care is provided with the compassion and respect that is so important to older adults.

Housecalls for the Homebound serves a patient roster of approximately 90 patients at any given time through an average of 45 home visits each month. Patients needing hospitalization or procedures receive services at the Columbia St. Mary's Columbia or Milwaukee campuses. Housecalls bills Medicare and supplemental insurances for patient care, although neither program recognizes the increased cost of providing care within the patient’s home setting.

Patient Stories

A Family Project
Managing many chronic illnesses and keeping valued family members at home has become a family project for the “B” family. Having retired from A.O. Smith after a career as a welder, Mr. B, age 84, has faced many challenging chronic illnesses. He has battled hypertension, peripheral vascular disease and gastrointestinal problems. Dealing with bilateral amputation and a colostomy would be enough to keep any family busy the entire week. Fortunately, Mr. B has been blessed with an amazing positive attitude, the love and support of his 77 year old wife, the help of adult children, ongoing home care from Horizon Home Care and the medical support of House Calls for the Homebound. Nancy Leahy, ANP and Dr. Sophie Kramer from Housecalls visit Mr. B at home to help manage all of his chronic illnesses. With all of this support, he is able to remain at home and be independent. He says, “Although I am here in these four walls all day; they are my four walls and it is where I want to be.”

Several months after starting to care for Mr. B., the Housecalls team noted that Mrs. B also was facing increasing challenges and difficulty getting out to her physician. Mrs. B asked to be added to the Housecalls practice and the team was happy to help her as well. Despite her problems with arthritis, diabetes and a recent pulmonary embolism, she has been able to stay at home at participate in Mr. B’s care.

A recent hospitalization of both Mr. B and Mrs. B made the family project of caregiving even harder; but the optimistic attitude of the B’s and the support of their children helped get the B’s back at home where they belong. The Housecalls team is honored to be part of this important family project of persistence and love.

A Simpler Time
George Binkowski was born in a simpler time. He came from a close knit family, which included his parents, his two brothers and himself. While he was employed at the local dairy, his mother became ill. His family had a meeting and they collectively decided that George had the most expendable job. Everyone decided that George would quit his job and take care of his ailing mother on a full- time basis. They agreed to provide George with whatever he needed for his own comfort, and as he tells it, they kept their promise.

George took his new role seriously. He took his mother to her many appointments outside the home and provided for her every need. She was well taken care of in her home until the end of her days.

It was when George prepared to re-enter the work force that the family once again had a meeting. His father was now in need of a caregiver. His brothers once again nominated George, who was thankful for the vote of confidence. He cared for his father at home until his death.

Today George is still living in the house he has lived in since age three. His care giving days are over. Both his brothers have passed away; but now George, the caregiver by election, at the age of 92 is in need of a little help.

That help came several years ago in the person of Bill Negron, a much younger neighbor who struck up a friendship with George. Even though Bill has a family of his own and responsibilities, he too became a caregiver. Bill shops for George, advises him and checks on him every day. Recently, Bill realized he was “in over his head” when it became apparent that George needed medical attention. George had a physician in the past, but when that M.D. left this area, George did not re-establish care with anyone else. And now George was unable physically to get to an office.

Bill called the Riverwest Health Initiative to ask for help. The community nurse visited the two men and talked about George’s care. She contacted Housecalls for the Homebound since Columbia St. Mary’s was a founding member of the Riverwest Health Initiative and she was familiar with the services.

Nancy Leahy, the Housecalls Nurse Practitioner, soon made a visit to George to evaluate him for the program. She found him to be a straightforward man, able to make his own decisions and interested in his own care. Since he was living in the boundaries of the service area, had Medicare coverage and had already completed a Power of Attorney for Health Care document, he was ideal for the program. She was able to reassure him that he could receive medical care right in his home, just like it was when life was simpler.

Nancy was able to start treatment that day for several chronic and acute conditions that had previously gone unattended and had been getting worse. Both George and Bill were relieved that they were not alone in providing George’s medical care. An appointment was made with the Housecalls physician to visit George and establish a routine follow-up schedule to meet George’s needs into the future.

How fitting that towards the end of George’s life, he is provided with a caregiver such as Bill and the care and resources of a program such as Housecalls for the Homebound. Housecalls is honored to be part of allowing George the dignity and simplicity of staying in his home as long as possible.

Contact Information

Housecalls for the Homebound
Columbia St. Mary's Heritage Center
2320 N. Lake Dr., Room E2635
Milwaukee, WI 53211

Renee Keuler, Program Secretary
T: (414) 270-4812
F: (414) 278-2891

Referrals
Housecalls provides care for homebound people over the age of 60 within the Columbia St. Mary's primary service area. This area includes the boundaries of Brown Deer Road, Mayfair Road, and the I-94 East/West freeway.

Appropriate patients are those who have:

• Medicare as their primary insurance coverage
• Difficulty in accessing traditional office-based care due to medical reasons
• Completed a Power of Attorney document
• Agreed to use Columbia St. Mary's facilities for inpatient or outpatient services

An initial phone assessment will be performed to determine whether Housecalls services are appropriate. The goal of Housecalls is to provide ongoing, comprehensive primary medical care in the patient's home. By monitoring the patient's care on an ongoing and consistent basis, we hope to eliminate unnecessary hospitalizations or trips to the emergency room.