Eugly has lived in the independent living section at Quarry Hill for 12 years, first with her husband, and since he died a few years back, on her own. She enjoys an active lifestyle that includes playing bridge with her neighbors, writing short stories, keeping up a lively email correspondence, having friends over for dinner, and going into town in the Quarry Hill van for shopping and restaurant meals.
Still, Eugly has some significant vulnerabilities. She has diabetes and must take a daily insulin injection. She checks her blood sugar every day, too, and has to pay close attention to her diet. The diabetes makes her more prone to problems such as urinary tract infections, poor circulation, swelling in her feet and legs and other conditions. She's fallen in the shower. She also must take a variety of oral medicines, on a strict schedule, four times per day.
"It's easy to get overloaded when you get older," she said during a recent visit. "What I would do without Judy, I don't know."
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Despite these medical frailties and her advanced age, Eugly doesn't qualify for home visits from MaineHealth Care at Home, the local visiting nurse agency that gets paid by
So instead, Eugly pays the
"It has always been our philosophy to provide nursing care regardless of ability to pay," said Lydon, who is the agency director as well as one of the two part-time nurses who work there.
Rather than relying on
Nursing at the community level
As communities across
Community nurses once were common across
In the town of
"I live in a community where many people are not church-goers," she said.
Accordingly, she rarely brings religion into her visits.
"But I do get involved in their spirit of hope," she said.
Johnson said there are a few other church-based nurses in
The majority of Johnson's word-of-mouth clients are elderly and frail. She performs the services a trained family member might -- sets up medicines, checks blood pressure, changes dressings and assesses general well-being, suggesting changes to improve health and safety. She'll sit with the ill and dying while other caregivers take a break. She advises people on whether to contact a physician or visit the nearest emergency room, and she makes referrals to all kinds of home services, from affordable handyman services to
While she's not deeply religious, Johnson is guided by a sense of mission.
"It is so satisfying to help people, and they're so grateful," she said.
She never accepts any payment for her services.
Farther up the coast in
"There just aren't enough hours to do this planning work and also make home visits," Paradis said, and her time right now is better spent developing a long-term strategy that likely will include nursing visits, transportation, home repairs and other support services.
An upcoming meeting on
Strengthening the community nursing network
The nurses in
Harding was a presenter at the recent Summit on Aging hosted by the
Harding's program has helped nine communities in her area to develop nurse services, including church-based parish nurses, nurses on the municipal payroll, nurses funded partly through private donations and other models. Most have started as very part-time positions, with some nurses working only four hours per week at the beginning.
"But it hasn't taken long to develop a caseload," Harding said, and at this point, several of those communities are employing half-time nurses for about
While it's hard to prove that these interventions directly prevent medication errors, injuries, illness and hospitalization, Harding said the expertise and
"You get a really big bang for your buck when you have a nurse," she said.
Her project is gaining visibility, Harding said, and she is glad to talk with groups in
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