Often, during an office visit with a patient, you will hear him or her say that they wished you made home visits.
So they are surprised when they hear that, now and then, I do make home visits.
I don’t do it often, and I don’t necessarily do it for the convenience of patients who don’t want to come to the office.
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Usually, it’s something I do for the elderly who are nearing the end of their lives.
Recently, I had the honor of visiting my patient Arthur at his home. Arthur was a wonderful man in his late eighties who was battling congestive heart failure. He had reached the point of recurrent hospitalizations and rehabilitation admissions with stays at home in between.
Arthur had been a very active man throughout his life including, until a few years ago, downhill skiing, one of his passions. Seeing that his quality of life was diminishing with his deteriorating health, he and his family decided to pursue hospice. He was scheduled to see me for a visit. However, since he was oxygen-dependent and exertion caused him significant dyspnea, I decided to make the visit to his home. So late in the afternoon a couple of days before Thanksgiving, I set out with our Nurse Care Manager to visit Arthur.
We were greeted by his family and the hospice nurse, and then got a chance to spend time with Arthur. Sitting next to him and looking out over the lake he lived on was a wonderful time. Before any examination or history taking, we just chatted. He had lived there for a long time and was going to die there, in his home — with his dignity preserved with the least amount of suffering possible.
After a brief exam and some discussion with the nurses about medications, we resumed the social part of our visit. Arthur wanted to show me his office in the basement. While his family was concerned that it would be too much for him to go down the stairs, he would not take “No” for an answer. So we got the portable oxygen connected and went downstairs. There he showed me his cowboy hat collection, his medals from 44 years of military service and pictures of his family. He was so proud to be able to show me all this, and I, in turn, was so honored to be able to see him in his home. It allowed me a deeper insight into what a special man he was.
We said our goodbyes, and I thanked him for welcoming us into his home, and told him how much I had enjoyed our visit. He asked when he should come see me in the office again.
About 3 weeks later, I had my final visit with Arthur when I attended his wake. Proudly wearing his military dress attire, he looked peaceful and comfortable. His family expressed their gratitude to me for my home visit and told me how much it had meant to Arthur.
They said that it was a very special visit for him and made him feel great. What Arthur and his family did not know is that that home visit had at least as much impact on me.
I intend to continue making home visits, when possible, knowing how truly valuable they are — for both patient and provider.
