Audio-visual communication

Clark, B. Providing home-based palliative care for people with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). (2003). Innovations in End-of-Life Care 5 (4); 1-16.

Tele-tool of note: Telephone, as needed.

In this extended interview with Betsy Clark, of the Hospice & Palliative CareCenter (Winston-Salem, NC) by Karen S. Heller (associate editor of Innovations in End-of-Life Care), the FOCUS project initiative, begun in 1999, is described as a means for serving patients living with CHF and COPD. The goal of FOCUS has been to provide a coordinated and comprehensive disease management program for these patients in order to reduce the number of exacerbations of symptoms they experienced that require outside interventions, such as emergency room visits or hospitalizations. Particular focus is placed on availability and training in the use of a customized urgent home medication kit to tide patients over until medical care can be summoned to the home, rather than on any telehealth devices/interventions (except for the telephone to alert the medical personnel of the need). However, other, regular use of the telephone is noted: there is a 24/7 on-call service availability and a weekend check-in telephone call by a social worker. Asked how this compares to the more usual telephone monitoring used by some home and hospice agencies, Clark notes that the staff works with patients and families to teach them how to manage their symptoms and feel in control of what they need to do until an agency staff person can come to assist: comfort level as a result is high, and patient’ and families’ satisfaction levels excellent.

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