Close-ups

A Patient's Perspective

A Home Visit



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Am Fam Physician. 2011 Feb 1;83(3):254.

My doctor is very special because she did a home visit for me. I was having difficulty maintaining my blood pressure, I needed to lose weight, and I had trouble following my doctor's treatment plan. Food traditions are very important to me, and I was having a hard time sticking to a low-salt, low-fat diet, even when my doctor told me how important it was for my blood pressure.

The home visit also allowed my doctor to get to know my husband, even though he was not her patient. Coincidentally, she had met him, and even cared for him, during a previous hospitalization. When she came to our home, she recognized him right away. My husband and I shared with her our life story, including how we came to the United States from Mexico 30 years ago, and how we take care of our four children and six grandchildren. My husband showed my doctor the pillow that was given to him when he was in the hospital for coronary bypass surgery. Our family was so proud of this pillow, because we'd all written our names on it so that he could hold it and remember us and be strong when he was in the hospital.

My doctor's care in our home helped me take my medicines more regularly, and it gave me even more trust and confidence in her as a person and a doctor. It also helped later, when my husband was in the hospital for his heart again. My doctor recognized us in the emergency room and remembered how we had talked about my husband's medicines when she was in our home. Although she wasn't on the team caring for him, she stayed in close contact with his doctor and our family, explaining to us what was happening. She even recognized the family pillow my husband had brought with him to the hospital.

My doctor was with him at the end. When he passed away, she explained everything to our family. It gave me peace of mind. I still have the pain of losing someone, but at least I know he was in the hands of someone who cares.—m.f.

COMMENTARY

This story underscores the family physician's role in visiting a patient's home. The home visit has value for the patient and the physician, and it can strengthen the doctor-patient relationship. Learning about family dynamics and the patient's psychosocial environment can help in the assessment of medications and home safety. It also illustrates the comprehensive role of the family physician as a person who works with families through an entire life span. In this case, the physician also had the privilege of facilitating the end-of-life journey with the family.

RESOURCES

For patients

American Academy of Home Care Physicians (Web site: http://www.aahcp.org/displaycommon.cfm?an=1&subarticlenbr=64)

 

For physicians

American Academy of Home Care Physicians (Web site: http://www.aahcp.org)

Kao H, Conant R, Soriano T, McCormick W. The past, present, and future of house calls. Clin Geriatr Med. 2009;25(1):19–34.

Landers SH, Gunn PW, Stange KC. An emerging model of primary care for older adults: the house call-home care practice. Care Manag J. 2009;10(3):110–114.

Landers SH. Home care: a key to the future of family medicine? Ann Fam Med. 2006;4(4):366–368.

 

Close-ups is coordinated by Caroline Wellbery, MD, associate deputy editor, with assistance from Amy Crawford-Faucher, MD; Jo Marie Reilly, MD; and Sanaz Sara Majd, MD. Questions about this department may be sent to Dr. Wellbery at afpjournal@georgetown.edu.

A collection of Close-ups published in AFP is available at http://www.aafp.org/afp/closeups.

The editors of AFP welcome submissions for Close-ups. Guidelines for contributing to this feature can be found in the Authors' Guide at http://www.aafp.org/afp/authors.



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