When Homecare and Hospice caregivers who support St. George Regional Hospital discovered a troubling situation for a one-year-old patient and his Spanish-speaking family, they worked hard to help connect the family with resources and hope.
Case manager Brittney Hill, RN, initially admitted the patient to Homecare when he was doing well, and his mother at first had no concerns. But the patient’s mother was facing a difficult road. The infant had heart conditions and had recently been hospitalized because he was having difficulty eating and a viral infection. Brittany says he not only needed to relearn how to swallow and take bottles, but he was at risk for choking to death.
Brittney Hill, RN
Speech therapist Sara Smith met with the patient and his mother, and afterward called Brittney to share additional concerns. As Sara and Brittney teamed up, they worked along with social worker Liz Houser-Berrett. They learned the family was facing tough obstacles, including lack of food, tight housing quarters, lack of transportation, and being faced with a COVID-19 quarantine at the worst possible time.
“Our one-year-old patient was not only struggling to eat, but his mother was facing a situation where she was running out of formula for him,” says Brittney, who began joining Sara for weekly visits where they spoke to the mom with an interpreter on speakerphone.
When they investigated more, they learned the mom was very overwhelmed with her baby’s care and felt she was failing. Brittney became concerned that the mother didn’t have what she needed to feed herself or her family either.
At the same time, the entire family and their housemates in their small home all tested positive for COVID-19—all except the one-year-old patient.
“The patient had just come home from the hospital when the virus hit the family,” Brittney says. “The silver lining was he tested negative. This was like a godsend because I don’t know how he would’ve fared. This poor baby had already been through a lot.”
The mom had to stay in quarantine and didn’t have help or access to community resources, so Brittney got her a few boxes of food from the homeless shelter and drove the boxes to her house after work. She was suited up in PPE for the visit.
“This was just before Thanksgiving and I was really concerned,” Brittney says. “I hadn’t heard from the mom all day and I felt like I needed to check on her in person. This isn’t anything I’ve ever done before.”
During the visit, Brittney gave her boxes of food and asked how else she could help. “The mom broke down and cried,” she says. “It was all too much for one person to face. She had one sick baby and now everyone around her was sick. She didn’t have transportation. She was very worried her baby wasn’t getting what he needed nutritionally and was going to end up back in the hospital.”
For the next few weeks Brittney worked with the patient’s primary care doctor to make sure the mom had all the supplies she needed. With help from Liz, she was set up on a community program for food, which included formula for the one-year-old fed directly through a nasogastric (NG) tube. Brittney also helped the mom get set up with a therapy appointment for herself.
“It was really sad and now it’s gotten so much better,” Brittney says. “The mother is functioning in a more hopeful place. Sara has been continuing to teach the baby how to swallow and showing the mom exercises to get him interested in taking bottles. While he’s not drinking the goal amount yet and is still on the NG tube, things are better.”
A few weeks ago, the mom asked if she could make Brittney and Sara some colorful, threaded bracelets to say thank you. She asked them to pick their favorite color.
“It was so sweet,” says Brittney. “I get emotional thinking about it. This has been the hardest case I’ve ever worked on and I’ve put so much time into helping this mom. There are so many layers to their situation.”
“This team provided a couple of bridges to get this patient and family by until they could get set up in the community,” says Robyn Bench, clinical operations manager. “Liz and Brittney specifically worked to make sure the one-year-old didn’t run out of food. They went above and beyond.”
On top of all the other hardships they’d been facing, the family then lost their housing—in part because they were unable to work during quarantine. Liz and Brittney worked all hours to help, calling and speaking with community resources. They were able to get the family placed in a local shelter that functions more like a hotel. Brittany says they’re now in a safe place with privacy and lots of room, and the mother is very grateful.
“It’s a hard situation, but this may actually help them, as they’ll have food, warmth, and stability,” she says. “They’ll be traveling out of state soon for the baby’s surgery where they’ll have housing for at least six months. In the meantime, they’ve got a lot of people looking out for them. When I spoke to the mother, she’s very happy and feeling hopeful.”
“This story could’ve easily ended with this family in far worse circumstances,” says Lisa Nichols, assistant vice president of Community Health. “This example shows the profound impact that the social determinants of health can have on patient care and outcomes. When people are faced with housing problems, food insecurity, lack of transportation, and employment problems, these factors all create a disadvantage. Our efforts as a health system to combat things like homelessness and poverty are exactly why equity is one of our Fundamentals of Care.”