Ginny* had a lot on her hands. As her husband’s primary caregiver, she was on call 24/7, keeping close watch on his health, nutrition, and medications. But despite her vigilance, Doug, 85, was having frequent falls and urinary tract infections (UTI) which needed immediate medical attention. And typical of most emergencies, Doug’s nearly always happened in the middle of the night or on the weekend when a hospital emergency room was their only option.
Like many family caregivers, especially those caring for a spouse with complex health issues, Ginny, 83, was at risk of caregiver burnout, a combination of physical, emotion, and mental exhaustion. To maintain some balance in her life, she was still performing as a violinist with a local chorus and as a concert soloist, but as Doug’s health become more precarious, she found herself missing rehearsals and performances.
In-home primary care
The couple have Lifespark COMPLETE which gives them access to in-home primary care, life management support, Urgent Response Services, and other senior services. When Lifespark Nurse Practitioner (NP), Kathryn Crawford, NP, began working with the couple last April, Doug had just come off another string of ER visits and hospitalizations related to falls and Urinary Tract Infections (UTIs).
According to Kathryn, Doug’s incontinence issues started after his prostate surgery. “It really bothered him, so he tried not to drink any water, which left him dizzy, lightheaded, and prone to falls,” she said. “We had a lot of conversations about the importance of staying hydrated, not just to keep him from falling but also to prevent UTIs.”
Taking “Call us first” to heart
In late May, Doug was hospitalized with another UTI. He was given an antibiotic that eventually cleared up the infection, but in the process, destroyed his good bacteria. By mid-August, he was experiencing intense diarrhea and severe dehydration, symptoms often associated with C. diff, a bacterium that causes infection in the gut, often after a course of antibiotics. Seeing her husband so weak and lethargic was frightening to Ginny, but instead of taking him to the ER, she called Lifespark triage for Urgent Response Services (URS).
Lifespark launched URS in June to provide in-home acute-level care with the goal of reducing unnecessary ER and hospital visits. “We’re always reminding members to ‘Call us first,’ and Ginny took that to heart,” Kathryn said. “If we’d had URS back in May when Doug was hospitalized for his UTI, they definitely would have used it.”
IV fluids and more
When Leah Castle, RN, Lifespark Mobile Urgent Responder, arrived at the couple’s condo, she already had a good understanding of Doug’s current and past health issues, recent hospitalizations, and medications, as well as his support system, including his wife, their adult son, their NP, Kathryn, and their Life Manager, Dana Bushway, RN. Leah took his vitals, consulted with the on-call physician, and started him on intravenous fluids. She also collected several vials of stool that the lab would use to determine whether he had C. diff,.
Ginny was grateful for Leah’s help. “She was so calm and competent, which was such a relief to me,” Ginny said. “She was here at least three hours, talking with the on-call provider, giving Doug IV fluids, getting those stool samples and checking to make sure they were adequate, and answering our questions. If we’d gone to the ER, we would have been there all night.”
Timely and responsive
The lab results confirmed that Doug had C. diff, which he may have picked up during his hospitalization in May. Unfortunately, C. diff is notoriously difficult to treat and has a high rate of recurrence. That was Doug’s experience. Over the next two months, he had three recurrent C. diff infections, leaving him increasingly weakened and dehydrated. But each time Ginny called, the Mobile Urgent Response team was able to treat him at home and avoid another hospitalization.
Staying on top of Doug’s health issues became a priority for Dana, his Life Manager,, who started working with the couple in August during his first C. diff attack. Since then, she’s made a point of scheduling frequent hybrid visits, meeting with them in person and having Kathryn join them virtually. Between visits, she checks in by phone. “I know Ginny has experienced some caregiver burnout, so whatever we can do to support her is going to help her stay active and independent,” Dana said.
As a Life Manager, Dana talks with members about their goals and wishes, and together, they create an action plan focused on those goals. “Ginny gets so much joy from music and performing, so one of her goals is to keep doing what she loves,” Dana said. “Doug’s goal is to get stronger and healthier, and I think we’re getting closer.”
Consistency of care
After Doug’s third C. diff episode, Lifespark’s medical director had referred him to a gastroenterology clinic to manage his GI issues. So, when he started having symptoms of yet another recurrence, Kathryn encouraged Ginny to contact the clinic. After several hours with no word from the clinic, Kathryn knew she had to step in. “Doug gets very sick very quickly, so I looked at the clinic’s treatment plan and prescribed vancomycin, a powerful antibiotic they recommended for C. diff.” The clinic never did get back to either Ginny or Kathryn, but the good news is that Doug is getting better thanks to his Lifespark team who are proactively monitoring his health
One of the things Ginny appreciates about Lifespark is the consistency. “Whenever we had to go to Urgent Care or the ER, we always had to start from the beginning, but everyone we talk to at Lifespark—the triage nurses, the mobile urgent responders, the on-call physician—knows our medical history and who we are as people. And they provide services right in our home. ”
Lately, Kathryn has been having conversation with Ginny and Doug about adding layers of support, including getting him a fall pendant. “Ginny is with him most of the time, but even so, he recently had a fall taking out the garbage, so this could give her more independence and peace of mind,” Kathryn said.
Another layer of support took the form of an in-home procedure to remove Doug’s impacted ear wax. Instead of Ginny having to drive him to an appointment, Kathryn prescribed drops to soften his ear wax and a Lifespark licensed practical nurse (LPN) came to their home to perform an ear lavage. As Ginny said, “I can manage Doug’s day-to-day care, but it’s so helpful that Lifespark brings all these services to our home.”
To learn more about Lifespark’s approach to complete senior health, visit Lifespark COMPLETE or call us at 952-345-8770.
*Names have been changed to protect client privacy.
