Mrs. Smith’s ability to stay safely in her home relies on several critical components that address her health needs, mobility challenges, and support requirements

QUESTION

Mrs. Smith is 82 years old and is diagnosed with hypertension, diabetes, and congestive heart failure. Her two children live in California, whereas she lives in North Carolina in a small family home on 10 acres of land in the Blue Ridge Mountains. Mrs. Smith has been in the hospital four times in the last year because of congestive heart failure. As her eyesight and mobility get worse with age, she has found it a challenge to stay on her medical plan and to do her shopping for the right foods she knows she should be eating. Mrs. Smith’s health plan, Purple Cross of North Carolina, assigned a nurse case manager to address her situation. Purple Cross provided a digital scale and a remote monitoring device that recorded Mrs. Smith’s condition every day by uploading her weight and transmitting the answers to a series of questions on a touch screen kiosk. The case manager also coordinates ongoing delivery of Meals on Wheels, providing low-sodium, diabetic-compliant dinners to Mrs. Smith. The case manager calls Mrs. Smith twice a week, taking the time to educate her about her medications, her activities, and the disease-specific elements that will keep her healthy and out of the hospital. When the case manager identifies that Mrs. Smith can no longer organize her daily medications, a digital medication dispenser will be provided that will keep her on her medication regimen. The medication dispenser will be preloaded with Mrs. Smith’s medications and will issue a subtle doorbell tone when it is time to take her medicines. With the combination of remote and real-time (telephonic) support persons and technologies, Mrs. Smith is able to remain in her home and avoid further inpatient admissions.

Discussion Questions

1. Which components are critical to Mrs. Smith staying safely in her home? Identify them and explain why they are critical to her staying in her home.
2. Describe whether Mrs. Smith’s regimen might be augmented using new/additional telehealth applications and list which applications you think would benefit Mrs. Smith.

ANSWER

Mrs. Smith’s ability to stay safely in her home relies on several critical components that address her health needs, mobility challenges, and support requirements

Remote Monitoring Devices: The digital scale and remote monitoring device play a crucial role in Mrs. Smith’s care. By recording and transmitting her weight and health data daily, healthcare providers can track her condition closely and detect any fluctuations that may indicate potential health issues. This allows for early intervention and prevents further deterioration.

Telephonic Case Management: The nurse case manager’s regular calls to Mrs. Smith are essential for providing ongoing education, support, and guidance. The case manager can address her questions, educate her about her medications and activities, and identify any potential concerns. The personalized telephonic support keeps Mrs. Smith engaged and informed about her health, empowering her to take an active role in managing her conditions.

Meals on Wheels: The coordinated delivery of low-sodium, diabetic-compliant dinners through Meals on Wheels ensures that Mrs. Smith has access to nutritious meals despite her challenges with shopping and meal preparation. Proper nutrition is critical for managing her diabetes and congestive heart failure, contributing to her overall well-being.

Digital Medication Dispenser: As Mrs. Smith’s eyesight and mobility decline, the digital medication dispenser becomes a vital tool for managing her medications effectively. The preloaded dispenser provides reminders to take her medicines, ensuring she adheres to her medication regimen without missing doses.

To further augment Mrs. Smith’s regimen and enhance her ability to stay in her home, additional telehealth applications can be considered

Telehealth Consultations: Telehealth appointments with her primary care physician, specialists, and other healthcare providers can minimize the need for in-person visits, especially for routine check-ups or follow-ups. This reduces the burden of travel and physical exertion for Mrs. Smith.

Remote Vital Signs Monitoring: In addition to the existing remote monitoring devices, the integration of other vital signs monitoring tools, such as blood glucose meters or blood pressure monitors, can provide a comprehensive view of Mrs. Smith’s health status. This allows healthcare providers to detect any changes or trends that require attention.

Medication Management Apps: Mobile applications that provide medication reminders, dosage instructions, and refill alerts can complement the digital medication dispenser. These apps can be personalized to Mrs. Smith’s medication regimen and help her stay on track with her prescriptions.

Home Safety Technology: Installing home safety technology, such as motion sensors, fall detection devices, and emergency call buttons, can enhance Mrs. Smith’s safety and security at home. These technologies can alert caregivers or emergency services in case of a fall or other emergencies.

By integrating these telehealth applications into Mrs. Smith’s care plan, healthcare providers can further support her health management, improve her overall quality of life, and enable her to continue living independently in her cherished home in the Blue Ridge Mountains.