An elderly woman has congestive heart failure. Her condition has worsened over the past few years and she requires frequent trips to her physician to obtain lab work and manage her illness. She knows her son must miss work to take her to doctor appointments and she worries that she is becoming a burden to him. Because of these feelings of guilt, she ignores her symptoms and postpones seeking care.

Typical home health care response:

Skilled nursing could be implemented. This would allow the nurse an opportunity to perform such interventions as:

• Assess the client’s understanding of how to successfully manage her heart failure and instruct her on techniques to promote wellness.
• Assess the client’s physical status and report symptoms or complications to the physician before they become severe. Doing so can drastically decrease the need for nonroutine physician visits and reduce dependence on overburdened caregivers.
• Obtain any required labwork, such as monthly fingerstick PTcINR’s.

Result: With the assistance of home health, the client becomes more knowledgable about how to manage her heart failure. This results in an improvement in her condition and fewer unscheduled doctor visits. This, along with home health’s ability to obtain her monthly labs, decreases how often the client’s son must take off work to take her to the physician.