- The Washington Times - Saturday, October 25, 2003

Licensed clinical social worker Sherry Showalter greets Beatrice West with a big smile. Mrs. West, 93, tells Ms. Showalter about her medications and the spaghetti and “beautiful salad” she had for lunch.

Ms. Showalter and Mrs. West are not in the same room. Rather, they are greeting one another over a video monitor while Ms. Showalter is in her Alexandria office and Mrs. West is a few miles away in her Alexandria home.

Mrs. West is one of 29 geriatric participants in the Elder Community Care pilot program started by Inova VNA Home Health two years ago. Through the use of a computer and other high-tech tools, medical and social services personnel are able to check in with patients. They can monitor vital signs, keep track of medications, even check in just to make sure a client looks OK.

“Most of these folks want to be able to stay in their own homes,” says Ms. Showalter, the Elder Community Care program director and a geriatric care manager. “Hopefully, we are enhancing their quality of life by enabling them to stay at home.”

To be eligible for the program, a client must be older than 65, have congestive heart failure, have had at least one hospitalization in the past six months and live alone or with a compromised caregiver. The program is free of charge for the clients.

Checking in the high-tech way saves patients money in the long run, Ms. Showalter says. The general rate of readmission to the hospital for an elderly person with congestive heart failure and other medical issues is 85 percent, she says. Participants in the Elderly Community Care program have a readmission rate of about 4 percent, Ms. Showalter says.

Ms. Showalter checks in on Mrs. West and other participants at least once a week. She calls on a regular phone, and Mrs. West or her home health care aide, Margaret Paul, switches on the video camera. Ms. Showalter can ask that Mrs. West move the camera around so she can check to see if her patient has lost weight or is experiencing edema (swelling) in her legs, a warning sign of further heart trouble.

On the computer in her office, Ms. Showalter has a list of the more than one dozen medications Mrs. West is taking, along with charts featuring the patient’s weight, blood pressure and heart rate at previous visits.

At home in Alexandria, Mrs. West dons a blood-pressure cuff with the help of her aide, Ms. Paul. The results appear in real time on Ms. Showalter’s screen. Mrs. West then puts the stethoscope up to her chest. The “tha-thump, tha-thump” of her heartbeat pounds into a headset in Ms. Showalter’s office.

“The stethoscope is as sensitive as if I was in the room,” Ms. Showalter says. “You’re tickin’ like a spring chicken.”

If any of the readings are suspect, Ms. Showalter will fax them to Mrs. West’s doctors, who can recommend an in-person appointment for further evaluation and treatment.

“This machine is wonderful,” Mrs. West says. “I take my blood pressure three times a day, and it is no trouble at all. I don’t even have to go out. Right now I have to go out to get blood drawn three times a week. I wish this machine could draw blood. I would rather that than have to get all bundled up and go in the car. That would be a help.”

Telemedicine is a growing field that has not only medical benefits, but also social implications for the elderly, Ms. Showalter says. Social workers checking in on the elderly, even by video conference, can check for depression and well-being, an important piece of the health care puzzle.

“Care of the body means nothing without care of the soul,” Ms. Showalter says. “When I started in telemedicine, I wasn’t so sure about it. Now I am a firm believer that you can establish meaningful contact this way. I have one lady who blows me a kiss every time we say goodbye. She is 98 years old and living alone. She is doing remarkably well.”

The Elder Community Care program also supplements the telemedicine with visits from volunteers.

“By participating in the program, patients are getting a lot,” Ms. Showalter says. “I really think this is where medicine is heading. It has got great, great implications for something as common as what we used to call home care.”

LOAD COMMENTS ()

 

Click to Read More

Click to Hide