I stood in front of Terri’s house and let the tears stream down. It’s been only a week since Terri died, peacefully surrounded by her family. I’ve been a nurse for 35 years and Terri is one of the most inspiring women I have ever worked with. This is one case study that is so remarkable, I simply remember it as “The Comeback.” Although our team worked with her for over 15 months, we only know a fraction of the woman who she was.
By Gina Murray, Co-Founder and Director of Aware Senior Care
Gina Murray Case Study: “The Comeback”
We got a call from a physician who was looking for help with her mother. Tim had recently stopped by this MD’s office and left information about our new home care agency. The physician, Terri’s daughter Rachel, said she didn’t know where to start looking for help and our agency’s information was on the top of the pile in her office. Tim and I met with Rachel and listened to her describe what had happened to her Mom.
Terri was in a skilled nursing facility for rehab when she suffered a massive brain bleed. The resulting injury left Terri unable to move her right arm or leg, unable to eat, speak or control her bowels or bladder. Terri was fed through a tube surgically inserted in her stomach and had a catheter.
Rachel explained that she did not want her mom to go back to the skilled nursing facility; she wanted to take her mom to her home. We explained the scope of our services and suggested that Rachel also contact Gentiva Home Health to provide the skilled services for Terri- PT, OT and ST. Rachel, like so many other people, did not know there was a difference between home care and home health care.
Assessment and Plan of Care
I went to the hospital the next day to meet with Rachel and Terri, and to assess whether we could provide the services that were needed. Rachel had not arrived yet and I spoke with Terri’s nurse. The nurse described how incapacitated Terri was and the doctor was not going to order therapy at home.
They believed ‘It would not do any good’. They were recommending hospice services to help Terri be comfortable in her final days. I sat alone with Terri, who instantly gave me a smile.
Her right hand did not respond to being held, but Terri’s smile never faded. Rachel arrived and we talked about the services Terri would need at home. Rachel dismissed the idea of hospice and told the staff Terri would need Home Health- “Please contact Gentiva.”
I’ll admit be being a little nervous on my way back to the office. I knew we had great caregivers who could perform the physical tasks, I worried that Rachel expectations might not be realistic. Over the years, I had participated in many team meetings where families and patients were given news that was difficult to hear. At times, the staff was blamed for ‘giving up’ despite evidence that the patient could not physically recover. Thankfully, Rachel knew her mother’s spirit and wanted the skilled therapists to evaluate her.
Terri was transported to Rachel’s home the next day. I assisted Terri’s transfer from the stretcher to the hospital bed. Terri could barely move any part of her body. The plan was for Terri to be fed via the tube over night, Rachel would give her medicines in the morning before she left for work and caregivers would be there all day to provide personal care. The family had a private caregiver they wanted as part of team and soon, Terri’s home care team was set. She would have the same caregivers throughout the rest of her life.
Gina Murray’s final thoughts on the Case Study known as “The Comeback”:
Enough cannot be said about the Gentiva Home Health team. They arrived the next day and each evaluated Terri. The therapists instantly saw the potential that Terri had. Although Terri could not speak words, she communicated volumes with her eyes and her facial expressions. The therapists showed our caregivers various exercises that helped rebuild Terri’s strength and her communication skills. Terri’s family support was beyond measure- no one doubting her recovery at any time.
Terri’s determination amazed the therapists and caregivers but not her family. This is the way Terri had lived her entire life. Less than four months after Terri moved into Rachel’s home- unable to move her body, eat food, or control her bowels or bladder- she boarded a plane for Atlanta and danced at her granddaughter’s wedding. She walked with a walker (or without it when she jumped up before the caregiver could get the walker to her), had full control of her bowels and bladder and feeds herself whatever she would like to eat.
After the wedding, Terri moved back to her own home with the help of her caregivers. She was able to live there for the next 11 months. Throughout this time, her loyal caregivers helped her thrive and live life on her terms in her own home.
She had a few hospitalizations but came back stronger each time. Recently, Terri fell in the middle of the night and fractured her hip. After her surgery, other medical complications set in and Terri was not able to recover. Her family’s dedication and love never wavered. Her caregivers continued to stay with her at the hospital during her last days.
I enjoy telling Terri’s story as one of the greatest ‘comeback’ stories in my nursing career. With the combination of personal determination, family support and a strong care team the possibilities are endless.
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