MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'home visits'. Sat, 03 Sep 2011 02:39:47 +0100 http://www.medworm.com/index.php?rid=4300594&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F12%2Fred-scarf-and-cup-of-tea.html "I know we've met before but I actually don't remember you," she says."That's OK. I remember you, and that's what matters. Nice to see you." I sit down at the table after she shakes my hand."I'm sorry I don't remember you, but you are very tall and handsome. Are you married?" She gives her ubiquitously flirtatious octogenarian smile."Yes, I've been married for 21 years." I take out my notebook and her client folder."Oh, too bad. I was hoping you'd stay with me." She sips some tea and folds her hands neatly in her lap again."Well, I don't think my wife or my boss would approve," I say, winking at her and getting out my blood pressure cuff and stethoscope."Did you have a nice Christmas?" I ask as I wrap the cuff around her arm."Oh, was it just Christmas? Oh, yes! I did," she says tentatively... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=4300594 Thu, 30 Dec 2010 00:36:00 +0100 4300594 http://www.medworm.com/index.php?rid=4197155&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F11%2Fcielo.html "My, you're tall and handsome. Will you stay with me?"She looks up at me from her seat next to the window."I'm the nurse and I'm just coming by to check on you. Besides, I'm married, and my wife wouldn't like it if I didn't come home." I sit down next to her on the couch.She laughs. "What's your name again, my dear?" she says in Spanish."Keith," I repeat, for the third time in five minutes."Is it Christmas this week?" she asks. "Will you bring me a present?" Again in Spanish."No," I answer in Spanish this time. "This Thursday is Thanksgiving. Christmas is next month.""Oh," she says, and takes my hand in hers. "Are you staying with me?""My dear," I reply, "I'm the nurse, and I'm just here for a few minutes. It's so nice to sit with you here and chat.""What's your name again? You're so hands... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=4197155 Wed, 24 Nov 2010 05:34:00 +0100 4197155 http://www.medworm.com/index.php?rid=4053358&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F10%2Fgrateful-kiss.html The stroke robbed her of the powers of speech, and walking is still a struggle as well. Previously a vibrant and gregarious professional and mother of two, she has now been waging a nine-year battle to simply express herself in a world devoid of her voice.Her husband dotes on her with devotion and love, and though they both tire of the struggle from time to time, there is nothing to do but continue.Although she cries every few days, most likely out of frustration, her smile can still light up a room, and her eyes sparkle with a keen intelligence and wit that she simply cannot express with language.I have visited three or four times now to check on her and the assistance that the home health aides provide, and our connection becomes sweeter with each visit. At first, I would hold her hand a... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=4053358 Sun, 10 Oct 2010 14:29:00 +0100 4053358 http://www.medworm.com/index.php?rid=4018232&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F09%2Fof-oatmeal-and-mass.html She sits in her house all day, the heavy curtains closed against the New Mexican sun. Pictures of saints adorn the walls, and other evidence of her faith fills the house. Her life revolves around watching Catholic Mass on television three times per day, and everything else seems to take a back seat to her faith. She rarely parts the curtains and even more rarely ventures outside."How are you?" I ask as I sit down on the seat opposite the couch where she spends her days and nights."Fine," she says, looking at the floor."How are things going with the home health aides? Is there anything new you need them to do for you?""No. It's fine.""How are you sleeping these days? Do you get enough sleep?""I don't sleep too well. But I'm fine," she replies."Is there anything I can do for you? Is there an... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=4018232 Thu, 30 Sep 2010 23:30:00 +0100 4018232 http://www.medworm.com/index.php?rid=3961854&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F09%2Fold-and-lazy.html "I'm getting old and lazy," she said as she sipped her coffee and nibbled on a chocolate chip cookie."After ninety-five years, I figure I have a right to be lazy.""So," I responded, smiling, "what does old and lazy look like to you, my dear?""Well, I get up in the morning at my leisure, take my time getting washed and dressed, sip on some coffee, look out the window, and eventually make my way to the living room or the patio. Sometimes I eat lunch, sometimes I don't, and then the rest of the day I can do whatever I want, really." She sips some coffee and has another bite of a cookie, offering me one from the plate.Taking a cookie, I bite into it as we look into each other's eyes and smile, sharing the simultaneous experience of the flavor of the cookie, the brilliant New Mexican light, and... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=3961854 Sun, 12 Sep 2010 16:29:00 +0100 3961854 http://www.medworm.com/index.php?rid=3902963&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F08%2Fdid-i-miss-something.html The call came on my day off, asking me to go see a client who was not feeling well but was refusing to go the emergency room. So, I delayed my shopping and errands, changed my clothes, grabbed my bag, and headed cross town to her home, which was located about fifteen minutes from my neighborhood.When I arrived, she was supine in bed, the home health aide by her side. Questioning her, I could perceive nothing more than neck and leg pain, something that the orthopedist had recently confirmed as being caused by worsening chronic osteoarthritis."Have you been taking your pain medicine?" I asked."Not really," she replied. "I don't like to take that stuff." She made a face."Well, you might want to think about taking it at least a couple of times a day when the pain is this bad. You might not lik... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=3902963 Thu, 26 Aug 2010 02:25:00 +0100 3902963 http://www.medworm.com/index.php?rid=3807447&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F07%2Fwere-all-in-this-together.html She is delightful. Her eyes twinkle when she talks, and her stories---often repeated, I'm told---reveal her cultured European upbringing and her very good memory.She sits in her chair most of the day, looking forward to happy hour at five. She's lived a good life, and there's nothing that will change her habit of drinking a bourbon and water (or two) at the end of each long afternoon. Nearing 100, she's even taken up smoking a cigarette with her bourbon, and there's nothing that will change that, either."I never expected to live this long. Who could have imagined it?" she says with apparent sincerity. And when questioned about the new habit of smoking, she says, "And why not?" with a smile."My life has been lovely, my children are wonderful, and I have no complaints other than my loss of m... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=3807447 Sat, 31 Jul 2010 20:47:00 +0100 3807447 http://www.medworm.com/index.php?rid=3370679&cid=t_173701_151_f&fid=35805&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Ftwelvestepfacilitation%2FwAgT%2F%7E3%2FMof0YHGz-Sk%2F Cost-Effectiveness of Home Visits in the Outpatient Treatment of Patients with Alcohol Dependence The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure – abstinent cases at the end of trea... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3370679 Thu, 11 Mar 2010 17:26:06 +0100 3370679 http://www.medworm.com/index.php?rid=1888107&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F10%2Fdementia-and-devotion.html In the home they have owned for more than 40 years, they live their lives as they always have. The same trees are visible through the kitchen window. The grass is still green. The grandfather clock given to them by her parents for their tenth wedding anniversary still chimes in the foyer. The curtains and the sofas haven't changed in years, and the silver flatware in the breakfront drawer still evokes memories of Thanksgiving dinners, birthdays, and family gatherings galore. From the kitchen linoleum to the wood paneling in the family room, little has changed in this cozy suburban home.While the outward appearances are relatively static, it is her dementia that has permanently changed the calculus of their relationship. It began with mild, transitory forgetfulness, only to slowly escalate ... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1888107 Sat, 18 Oct 2008 12:09:00 +0100 1888107 http://www.medworm.com/index.php?rid=1750084&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F08%2Fcell-phone-ring-tones-cautionary-tale.html Just this past week I was doing some home visits for my local visiting nurse agency. Three out of four visits were for psychiatric patients who live on their own and need daily visits to monitor their medication compliance. I've been doing this sort of thing for years, so I always know what to expect, more or less.While I was visiting my second patient, we sat at his kitchen table as I prefilled his medication box for the upcoming four days. We chatted about the weather, his apartment, his general health, and his family. It was a normal visit with a paranoid schizophrenic, and our rapport was comfortable despite the fact that we had never met before.Halfway through filling his medication box, my cell phone rang. Unfortunately, I had not set my phone on silent and the sound of the phone's r... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1750084 Sun, 31 Aug 2008 21:39:00 +0100 1750084 http://www.medworm.com/index.php?rid=1709044&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F08%2Fvisiting-nurse-and-puzzle-of-humanity.html Last night, I was doing some visits for the visiting nurse agency who recently employed me. On my fourth and final visit, I had a revelation of sorts.I drove about twenty minutes to reach this patient's home, winding through lovely country roads, past old farm houses and pastures. Reaching his neighborhood of middle- and upper middle-class homes, I was struck by how out of the ordinary this situation seemed to me. For the last eight years, almost all of my home visits have been to poor, inner-city neighborhoods, trailer parks, or lower income neighborhoods with modest single family homes. Not since I was a visiting nurse back in the late 90's had I actually visited a patient whose home reminded me, perhaps, of my own parents' home back in the day.The home smelled of garlic, tomato sauce an... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1709044 Thu, 14 Aug 2008 16:24:00 +0100 1709044 http://www.medworm.com/index.php?rid=1683134&cid=t_173701_137_f&fid=35357&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAlzheimersNotes%2F%7E3%2FgYdKTCh-9TM%2F AlzheimersNotes.com When I mentioned previously my idea of starting a Tea Time at Alzheimer’s Notes, where I’d chat with visitors, through their comments or e-mails, I realized this was a tradition typical of my family and one we continued with Mother in the nursing home. Sitting down to a cup of tea (or coffee for my aunts) runs through my memories of visiting my grandmother at her farm.  Every afternoon at 3:00, we stopped what we were doing, took a break and had a chat over tea and snacks.  Mother was ready to offer visitors a cup of tea when they stopped by our farm home, too. Tea Time During Alzheimer’s Years When I began helping Mother during her beginning Alzheimer’s years, first on the ajenda when I arrived from my home 275 miles away, was sitting down ... Alzheimer's Notes blogs http://www.medworm.com/rss/comments.php?id=1683134 Tue, 05 Aug 2008 19:59:53 +0100 1683134 http://www.medworm.com/index.php?rid=1671483&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F08%2Fbe-silent-and-listen.html The apartment is stiflingly hot. The carpets are worn and stained, and the kitchen floor is ghastly in its filthiness. Cigarette butts litter the tables, and it's difficult to tell how many were put out in the overflowing ash tray and how many were simply snuffed out on the scarred wooden coffee table.I am shadowing a psychiatric visiting nurse, learning the ropes so that I can help out with mental health visiting nurse visits on a per diem basis. She knows this patient well and seems able to easily understand his mumbling answers to her questions.The next apartment we visit is relatively neat and clean. The patient is engaging and much more talkative. He likes to write, has a Master's degree, and uses a Smith-Corona typewriter that sits on the kitchen table. His psychosis has prevented hi... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1671483 Fri, 01 Aug 2008 08:03:00 +0100 1671483 http://www.medworm.com/index.php?rid=1344207&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F04%2Fconnection-and-wonder.html The house was filled with screaming and playing children and I could barely think straight. Trying to fill med boxes and query my patient about her health, I was having trouble concentrating.All of a sudden, I looked up from my work at the kitchen table to see four earnest young faces staring at me. Sensing an opportunity, I decided to set the meds aside for a moment and check my patient's blood pressure instead. The children watched with rapt attention as I wrapped the cuff around their grandmother's arm, their fascination growing as I began to pump up the cuff and place the bell of my stethoscope on the crook of her elbow.Finishing with the blood pressure, I knelt down and offered the oldest girl my stethoscope. I guided the ear-pieces into her small ears and then placed the bell of the ... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1344207 Wed, 02 Apr 2008 01:03:00 +0100 1344207 http://www.medworm.com/index.php?rid=1331348&cid=t_173701_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F03%2Fcrippen-diaries-2008-march-4.html What do you want to do when you grow up...March 2008 (4)A phone call put through in the middle of a busy morning surgery. Would I speak to Mrs Smith about her two year old son, Tom. She says it is very urgent. Mrs Smith sounded agitated. Tom had had a bit of a cough all night, but had now developed a high temperature and was not taking fluids. She really did sound flustererd. "Bring him down, and I will squeeze him in now" I said."I can't bring him down now, I am at work.""You mean, you are not with him?""No he is at the childminders. She has just phoned me and she sounds worried.""Well, get her to bring him down then" I said."She cannot leave the house, she has other children to look after. Could you not just pop round and see him?"Tom had been quite off colour when mum dropped him off at... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1331348 Thu, 27 Mar 2008 16:26:00 +0100 1331348 http://www.medworm.com/index.php?rid=1298689&cid=t_173701_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F03%2Fbrief-and-pleasant-exchange.html She's waiting for me in front of the tired clapboard house on a busy city street. I'm doing a visit for a colleague (in my new consultant position), dropping off some meds and checking in on this very lively couple with whom I am totally unacquainted."Hey! Thanks for coming over with the meds!" her partner yells. He is jovial and talkative, slapping my back and shaking my hand.The house is a boarding house: shared kitchen, office downstairs with staff during the day. Pretty clean inside, a little rough around the edges. Their room is one large bedroom with a bathroom and a closet. A little small and dark, I think."How long have you been here?""About a month," she says."It's great. You both seem really happy. Can I check your blood pressure while I'm here?" I hand him his prefilled medicati... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1298689 Thu, 13 Mar 2008 01:44:00 +0100 1298689