This was the first week we were able to conduct home visits at our main clinical site Harbor Hill Senior Center and residences. The service coordinator set up many visits for the day. Our main duty was to take vital signs, check medications and speak with clients regarding recent hospital visits or medical conditions. The service coordinator started he had 14 visits scheduled for us and based on these visits we would select clients to follow up with on subsequent visits. The 14 clients were divided among the group. All clients signed the consent form to allow me to visit with them. They also received an index card with their name and blood pressure reading for the day. They were instructed to save the index card for future visits which would be used to check trend.
At the first stop I met an Asian couple Mr.. L. and Ms. Y., who did not speak English. They were welcoming and willing to allow me to conduct me business. They eagerly gave their arms for blood pressure reading and showed me all their medications for verification. The blood pressure readings were 140/70 and 136/78 respectively. We were able to decipher they would be taking the medications at 11am. Both were prescribed Atenolol and Aspirin. The next client was a Hispanic lady Ms. R. who was in the company of her home attendant. She was also welcoming and willing to provide information. The home attendant provided the medication packet indicating the client is prescribed Lisinopril and Norvasc. The blood pressure reading was 110/70. The next visit was another Asian couple Mr.. P. and Mrs.. P. Mr.. P speaks some English but his wife does not. He reports he had myocardial infarction with 4 stents placed. He provided his medication list of Nitro stat, Diovan, Plavix, Aspirin, Hydralazine, Ranexa and Simvastatin. He showed me how he takes his blood pressure via automatic blood pressure cuff and the reading for the last 3 days (146/58, 160/61, 170/60). The blood pressure reading at this visit was 120/40. He seemed surprised by the reading. He reported he took his medications for the day about an hour prior to the visit. He was instructed to take his blood pressure before and after taking his medications to see how the medications affect the blood pressure readings. He was asked to keep a log of the reading for the rest of the week and we would review everything when I return next Wednesday. He was assessed for symptoms of hypotension but denied any. The service coordinator was informed of the details of the visits and was asked to arrange a follow up visit. Mrs.. P’s blood pressure was 136/76. Her prescription list indicated she is prescribed Diovan, Norvasc and Aspirin. The last visit was with Ms. P. a Hispanic lady who we found walking up and down the hallway when we arrived on her apartment floor. She was accompanied by a home attendant. During the interview it was found she does not sleep well, wakes due to feeling sweaty, experiences some symptoms of anxiety and digestive problems. She reports she missed the last two PCP visits. The home attendant was asked to call the doctor’s office to reschedule the visit as soon as possible. The client expressed concern about taking medication and was informed there are many alternatives to try but she must speak with her PCP. She also requested more home attendant hours because she gets lonely. She was informed the service coordinator will be notified to see if he can assist with this matter. She will be put on the list for a return visit.
Our attendance was required at 11am at Shore Hill Senior center to be present for our classmates’ presentation. Due to this the visits were rushed t ensure we visited everyone scheduled and would not be late for the presentation. I hope we could avoid scheduling conflicts in the future to allow more time with the clients.
