Whether it’s our marketing liaisons collaborating with our acute care partners, a care transitions coordinator working inside our hospitals or even a nurse navigator, who determines if hospice care is needed, our new brand encompasses a complete continuum of care. Here’s how it worked for one patient.
Michael Ledbetter was at his wit’s end when he called HealthSouth Reading in Pennsylvania. At more than 500 pounds, he was morbidly obese, and he had been housebound for more than a year. He spent his days in bed, eating junk food. His house was littered with takeout containers. Michael had reached out for help before, only to be humiliated and let down. Kelly Tyrrell, an Encompass Home Health & Hospice care transitions coordinator, was determined that wouldn’t be the case this time. In February, Michael called HealthSouth Reading to see if he could be admitted from home. The operator there transferred the call to Kelly, who said it was clear immediately that Michael wouldn’t be able to withstand three hours of therapy, five days a week at the hospital, but she was determined to help him.
“It was a terrible situation,” Kelly recalled. “He sounded like he was at the end of his rope. He had been let down so many times by the healthcare system, and he was terrified to now again reach out for help.”
Help came this time, though, thanks to Kelly and her collaborative efforts with her Encompass Home Health and Hospice and HealthSouth Reading co-workers. Michael couldn’t be admitted into HealthSouth Reading immediately, but the Encompass team could help him get in good enough shape to go there. He began home health shortly after his initial call to HealthSouth. Encompass Home Health and Hospice employees addressed his home conditions.
“He was living in very crowded unkempt living quarters of his house,” Kelly said. “He had little to no family support.”
After a few weeks, he was able to stand and march in place. Michael was ready for the more intense therapy at the rehabilitation hospital. HealthSouth loaned him a bariatric wheelchair to help with his transfer. After 21 days at the hospital he was able to transfer from his bed to a chair and could walk some 200 feet with the assistance of a walker. After he was discharged from HealthSouth Reading, he began home health a second time. Today, Kelly said Michael is moving around within his home and some outside, as well. Thanks to the constant communication between Encompass and HealthSouth Reading, Kelly said they were able to turn Michael’s life around.
“We really were communicating on a weekly basis,” she said. “I don’t think this would have been possible without that. Building that trusting relationship between HealthSouth and Encompass Home Health and Hospice really does provide better patient outcomes.”