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Sunday, October 23, 2016

Keeping Care Close to Home

Posted By: Advancing Care

Margaretville Hospital offers caregivers a welcome relief from looking after their loved ones around the clock.

By Debra Bresnan

When you’re a member of the “sandwich generation” — adults caring for aging parents while raising their own children — balancing work and family responsibilities can be overwhelming. In the close-knit, rural community of Margaretville, NY, however, one hospital’s programs have been helping caregivers juggle these competing demands for more than two decades.

Since 1994, the Respite and Swing Bed Programs at Margaretville Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has provided regional residents with a wide range of temporary-care services in a hospital setting. These include IV therapy, wound care, post-orthopedic surgery care, pain management, injury rehabilitation, artificial feeding, respite care and hospice services. The programs provide a welcome relief for caregivers who need to attend to their own medical needs, go on vacation, or just require a break from their duties.

Lifelong Margaretville resident Rebecca McDermott, 33, works as a certified nurse assistant at an area residential-care facility. Her father, Charles, who passed away this past September, had suffered from end-stage chronic obstructive pulmonary disease. He had received hospice care and lived with Rebecca and her family since November, 2015. She relied upon the Respite program at various times, such as when she and her family were invited to a birthday party in New York City and decided to stay overnight.

“Dad had a G-tube [gastrostomy feeding tube] and a Foley catheter, and I cared for him at home,” McDermott explains. “He’d never been a big talker, but towards the end, it hurt for him to talk. Twenty-one years ago, he had throat cancer, and we think it might have come back, but he didn’t want to do the tests.”

Typically, Charles didn’t interact with people very much, whether at home or at the Respite program. But about six months prior to his passing, when picking him up from a stay at the program, Rebecca was surprised to find him in the Activity Room. “One of his longtime friends was feeding him! They were laughing and smiling ear to ear. “I don’t remember ever seeing him smile so big. It was certainly the only time he did that in years. It was the greatest thing to see.”

Carol Bouton, Case Manager for the programs, says it “has been wonderful for patients because they can receive care in their own community. Family members and loved ones who live nearby can easily visit to offer support and encouragement. Also, these caregivers are better prepared to be more involved when a patient goes home,” she says. “Overall, the program enhances safe discharges and reduces readmissions.”


Carol Bouton and Rebecca McDermott, who relied on the Respite program to help care for her late father, Charles.

The program’s clientele range in age from 75 to 85, and many are orthopedic patients recovering from hip- or knee-replacement surgery. Beyond nursing care and case management, these patients have access to a dietitian, podiatrist, dentist, and physical and speech therapists. While most insurance providers prefer nursing-home admission for rehab patients due to cost considerations, according to Bouton, “That’s not always best for patients, emotionally and psychologically. Most of the people who stay here are able to go home afterward, and that’s very important to them and their families.”

In addition to insurance-coverage restrictions, the shortage of home-care services is another key challenge facing local families. “Medicare doesn’t pay for private care at home,” Bouton says. “Delaware County is a huge rural county, with only two home-care agencies. When patients are discharged to go home, a family member has to be there with them.” While Bouton can help set up Meals on Wheels, hospice care and other important services, the brunt of care usually falls on the family.

Bouton adds that the program’s comprehensive end-of-life services, offered through a partnership with Catskill Area Hospice and Palliative Care, provide skilled nursing, palliative care and comfort care.

For McDermott, this atmosphere of warmth and familiarity offered her and her family tremendous peace of mind. “When I left Dad at the Respite program, I knew he was in great hands,” she says. “It’s a small program, so people get a lot of one-on-one attention at Margaretville.”

McDermott was so confident in the program that she, her husband and their girls took a weeklong vacation at Myrtle Beach, SC, this past summer, while Charles was cared for at the Respite program for seven days. “It was a comfort to me to know he was there, because he knows everyone. He was blind at that point, so they brought the phone to him, and I could speak with him while we were away,” Rebecca recalls. “Thanks to the Margaretville Respite program, I could relax and enjoy our vacation, because I knew my dad was in good hands, being cared for by people I trust.”

Photos By Mark Loete