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 Visiting Nurses Association (VNA / VNAA) 
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Joined: Sat Jan 27, 2007 8:38 pm
Posts: 712
Location: CA
Post Visiting Nurses Association (VNA / VNAA)
Live and learn! Another resource about which I was ignorant.

Over a year ago, I asked Jerome's private GP to approve him for an evaluation by the VNA to find out what services they offer and what might be available in our situation. Of course, their office dropped the ball.

This past week, Jerome had some type of abdominal illness. We now use the VA for medical stuff. Took him to the VA clinic, and the substitute doc clearly graduated in the bottom 1% of her med school class. Did not even bother to examine him, touch him, etc. Just said it must be acid reflux.

By next evening pain was much worse and getting Jerome to ER was not an appropriate option. So I called the local house call doctor (only one in our entire area). The downside is you have to private pay.

Upside -- he was GREAT!!! Spent an hour and a half with Jerome really checking him out, all in the comfort of our own home. Determined that ER was not necessary that night, but wanted him to have lab and CT work in the a.m. as liver/gallbladder were suspect (the tests ARE covered by Medicare and insurance).

Jerome seems to be heading into another bout of diverticulitis. Told doc I was concerned that Jerome is chronically dehydrated. He asked how I would feel about VNA coming to set up IV hydration.

VNA nurse came on Friday, all necessary equipment (down to hand soap) was delivered, nurse set up the IV and taught me how to set it up each morning (NOT the needle in vein part).

Then asked if we thought physical therapy, occupational therapy, or speech therapy services, or a social services consult would be helpful. If doctor orders it, it is all covered by Medicare and insurance as Jerome is considered homebound. I said YES!!!!!

VNA will call Jerome's new doctor (I'm making that relationship permanent!) who has already told me he would absolutely approve those services for Jerome.

Lots of us know that VNAs can provide hospice services, but I really did not know about the other services, how it can be paid for, or what role the doctor plays in getting those services lined up.

To learn more about VNA in your community, go to, enter your city or zip, and it will link to your local VNA.

Hope this info is helpful to others ...

Renata (and Jerome-in-Heaven)

Sun Sep 14, 2008 6:42 pm

Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)

Thanks for the update on Jerome's GI problem. Glad to know that Jerome is getting good care, and that you found a great MD (didn't even know house call MDs still existed) and home health resource.

Most hospice organizations are also home health organizations (and vice versa), and I assume you are receiving these VNA services under Medicare's home health benefit. We found some of the home health rules to be annoying [examples: our HH outfit couldn't supply non-latex catheters; you couldn't work with two different HH organizations at the same time...we liked the PT with one and the SLP with another but couldn't mix and match].

Keep us posted on how the IV hydration works out. I've never heard of that being done before so am very interested in knowing if it works in a home health setting.


Sun Sep 14, 2008 8:09 pm
Just goes to show you persistence does pay, I am so glad you found a "new" doctor and that these services will be available to Jerome, I do hope the IV hydration is a hugh success for him and he will be feeling better in no time.
Keep us posted on how it all works out!

Mon Sep 15, 2008 11:44 am

Joined: Sat Oct 06, 2007 4:28 pm
Posts: 781
Location: LA
Post Hydration
Renata, I, too, have wanted to hear the latest on Jerome. Has the fluid helped the itching go away? I sincerely hope so.

"See this lady she's 85 but she's nice", This is the way my husband, Mr B., introduced me in 2006 to the people only he knew. Death due to pneumonia. Lewy Body Dementia diagnosed post mortem at Mayo Clinic in Jacksonville Florida.

Mon Sep 15, 2008 3:38 pm

Joined: Sat Jan 27, 2007 8:38 pm
Posts: 712
Location: CA
Update on IV hydration ...
Overall, Jerome felt better for the two days he was on the IV, had more of an appetite, seemed clearer-headed. Of course, it was like leading a horse to water again this morning trying to get Jerome to drink. He is nauseous so much lately, that I think the very idea of drinking makes him feel ill. The VA has him scheduled for an upper GI tomorrow, but I may save us the very long drive and have his new MD order the test to be done locally (thank God for continuing with Medicare and Blue Cross as it makes cost a non-issue). His guts still hurt and it's looking more and more like a fresh case of diverticulitis. Thanks for all of your good thoughts, I'll let you know where we go from here.

Renata (and Jerome-in-Heaven)

Mon Sep 15, 2008 3:49 pm
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