, Corbin, KY

March 24, 2014

House Calls

In-home medical care has become a thing of the past. Until now . . .

The Times-Tribune

CORBIN — By Bobbie Poynter / Features Editor

Laura King, 93, sits back and smiles, relaxed and comfortable in the armchair as the doctor takes her blood pressure and checks on her condition.

No, wait. That’s not a doctor.

If Laura were seeing a doctor, she would be sitting in an uncomfortable wheelchair in the doctor’s waiting room full of sick people, sick people with children and people with sick children.

But this is not the doctor’s office, and the lady standing beside Laura’s chair is, indeed, not a doctor. But she is, by far, the next best thing.

She is Shelley Foord-Kelcey, APRN. Kelcey is a nurse practitioner working with MD2U, a full-service medical practice based in Louisville that sends the medical provider to the patient’s home for no more cost than what the patient’s insurance pays.

Kelsey makes regular medical house calls on patients who are homebound and home limited — that is, people who have a hard time making or keeping their appointments with a doctor.

Often, chronically ill patients are brought into the emergency room by ambulance because they can’t get in to see their regular doctors. There are also patients who have had recent surgery and are having a hard time or simply cannot leave the house in their current state of disability.

This is where MD2U can help.

In these cases, the nurse practitioner tries to visit the patients within 24-48 hours of returning home in an effort to prevent the patient’s re-admission into the hospital.

As a nurse practitioner, Kelcey is qualified to prescribe medications (although she stresses the fact that she never carries any medications with her). She will order any needed tests and exams for her patient, and even order the use of equipment to help manage her patient’s conditions. However, her main focus is on prevention, wellness, and patient education.

Kelcey is a primary care nurse with her own practice, not to be confused with home health, a nursing program that assists the patient in his or her home.

“Primary care is when you go to your doctor’s office,” said Kelcey. “I’m an in-home primary care practice (or micro-practice, meaning I don’t have more than 150 patients). This way I know all my patients. I know who they are and what their circumstances are when they call.”

Opal Root has been a caregiver for Laura King for more than a year and a half.

“Before Shelley got here, Laura was in the hospital nearly every week because she couldn’t breathe, most times by ambulance,” said Root. “She hasn’t been back to the hospital since.”

When Kelcey came into Laura’s home, she took the time to talk with not only her patient, but also her family and caregivers, doctors and pharmacist.

Laura’s trouble turned out to be a breathing problem brought on by medications, which were causing her to have panic attacks. Once this was corrected, Laura began feeling better.

“Everything’s so much better now,” said Root. “Laura went from being bedridden to sitting up, walking around and laughing, joking and even telling us stories.”

As a practicing nurse in a doctor’s office, Nurse Kelcey saw the need of rural patients coming in and how hard it was for them to get out and get to the doctor. Then she saw an even deeper need.

“Caregivers work so hard to take care of their loved ones, they don’t take care of themselves,” she explained. “The need is so great, and the families are suffering, trying to get their loved ones to the doctor to refill their meds and get assistance. I go into the home and see what’s going on. There are just so many patients who are not getting quality care, and in some instances, any quality care because they can’t get out due to money or transportation problems.”

And that’s where Kelcey’s in-home medical practice comes in. She is able to go into the home and see the difficulties both the patients and families are going through and get them the help they need.

Today, Laura King is well aware of how much her life has improved in the months since Shelley Foord-Kelsey began visiting her.

“She’s wonderful,” said King of her nurse practitioner. “She fills the gap. She’s just what we need now.”

Kelcey’s current business covers London and Corbin, but she hopes to expand into Williamsburg, Barbourville and even Manchester.

“As my practice grows, I hope to hire other nurse practitioners to assist me,” said Nurse Kelsey. “I know there’s a huge need in all those areas, but I can’t be driving that far to see one or two patients.”

In the office, patients come and go, but a nurse practitioner becomes vested in the whole family, not just the patient. Kelcey explained her philosophy for working so well with homebound patients.

“You have to be a good listener,” she said. “Your patients will tell you what’s wrong, if you just take the time to listen to what they have to say. You have to listen to both the verbal and non-verbal language of the patients.”

For now, Shelley Foord-Kelsey’s clients are just happy to know that if they have a medical problem, all they have to do is make a single phone call, and there will always be a nice, knowledgeable, medical professional at the other end of the line.

Shelley Foord-Kelcey and husband Michael, a nurse practitioner in cardiology, have been married 17 years. They currently live in London and have four dogs and two cats.