Specialized programs

For patients with CHF, our nurses provide a coordinated effort to manage symptoms and prevent trips to the hospital. We do this through patient/family education about heart disease, recommendations regarding nutrition and physical activity, medication management, and close communication with the patient's physician and cardiologist. Therapists can teach patients how to conserve limited energy during daily tasks. Two services have been especially helpful for many patients with CHF: (1) Telehealth Monitoring Service (see below) and (2) intravenous diuretics (such as Lasix) administered in the home setting.

This program provides care by nurses and occupational therapists to patients with COPD and other respiratory illnesses. Our nurses provide medication management, strategies for symptom relief, and education for patients and their families. Our occupational therapists help patients to organize their daily activities and arrange their living environment in a way that will decrease fatigue and increase independence. Patients with severe shortness of breath may also benefit from our Telehealth Monitoring Service (see below).

Administered by a nurse who is a nationally Certified Diabetes Educator, this program provides the most current information, education and coaching to help patients manage this chronic disease. Our nurses consider the needs, goals and life experiences of each patient to support his/her decision-making, self-care behaviors, problem solving and active collaboration with the health care team. Areas of focus include nutrition, physical activity, medication safety, blood glucose monitoring, preventing complications, and developing strategies to address personal concerns. The goal is improved clinical outcomes, health status, and quality of life.

This program provides specialized nursing care for patients who need medication, therapies, fluids or nutrition delivered directly into the blood stream. Our nurses focus on insertion and maintenance of IV lines, education of the patient and caregivers, and assessment and monitoring of the patient's condition and comfort. Patients who need chemotherapy, antibiotics, or nutrition - because of conditions such as cancer, heart failure, Crohn's disease, or cellulitis, for example - can benefit from the technology and expertise that is available in the home setting.

Administered by a nationally Certified Wound, Ostomy, Continence Nurse, this program provides assessment and treatment to patients with challenging wounds, ostomies, or bladder/bowel disorders. Wounds may be the result of surgery, injury, pressure, or diseases such as diabetes or peripheral vascular disease. In addition to cleaning and dressing wounds, nurses also coach patients in managing their own wound and ostomy care. They teach behaviors that enhance healing - such as nutrition, physical activity, and smoking cessation. The goal is to heal wounds and prevent infections.

The Behavioral Health Program focuses on patients with a diagnosis of persistent sadness (depression), anxiety, bipolar disorder or schizophrenia. The program provides medication management, community linkages, and a program of information and education for patients and family members on coping strategies and long-term healthy living. This program serves many adults who have a diagnosed mental illness in addition to other medical conditions. The team includes nurses, occupational therapists, physical therapists and medical social workers.

This program addresses the needs of high-risk infants (such as those who are born with prematurity, congenital problems, low birth weight, neonatal addictive syndrome, failure to thrive), or young children who have a chronic or acute illness. Nurses also provide care for pregnant women and post-partum women who have complications. Our nurses provide monitoring and treatments for the child, and parenting education and support for their families. We recognize that expectant or new parents may need education, medical care and/or additional support during this new phase of their lives.

This program assists patients who struggle with daily tasks due to difficulty with vision. Those with glaucoma, macular degeneration or other eye diseases can benefit. Our occupational therapists provide coaching, teach the use of vision aids, and connect patients to other community resources. Patients receive low vision services in addition to other nursing or rehabilitation care. The goal is to help patients become more independent, comfortable and safe during their activities of daily living.

Palliative care is focused on alleviating distressing symptoms - such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, sleep problems and many others. These symptoms may be a result of the patient's medical condition, or they may be side effects of the treatments that the patient is undergoing. Palliative care focuses on the patient's experience of illness and quality of life. Patients receiving palliative care may also be receiving other medical treatments and care.

Through the use of innovative technology, our Telehealth Monitoring Service provides daily review, by our nurse, of the patient's weight, oxygen level, blood pressure and heart rate. Patients use the equipment at home, and the results are immediately transmitted to our office where our nurse reviews the results. If there is any deviation from expected measures, our nurse coordinates appropriate, rapid intervention with the patient's health care team. This program is focused on patients with Congestive Heart Failure (CHF) or Chronic Obstructive Pulmonary Disease (COPD). It has been proven successful in reducing hospital admissions and emergency room visits. Patients and their families report that this daily monitoring and clinical attention provides important guidance and reassurance.

This program is delivered by a team of nurses, therapists, social workers and home health aides with special education and experience. Based on an assessment of the patient's abilities and needs, our team teaches family caregivers how to manage challenging behaviors; establish daily routines regarding nutrition and physical activity; address safety concerns; and manage medications. We help patients to function at their optimum level, and we assist family caregivers in maintaining their loved one at home as long as possible.