As Florence Gundlach’s dementia progressed, she needed the help of her sons to eat and get out of bed. In September 2019, 她的家庭医生建议她的儿子们联系约翰霍普金斯家庭医学中心(JHOME)寻求支持. Through JHOME, 医生和其他卫生保健专业人员在推荐十大正规网赌平台居住的地方治疗他们, 因此，行动受限不会影响人们获得医疗服务.
“有一段时间，我们不确定我们是否能继续独自照顾她,” Rob Gundlach says regarding his mother. “JHOME has given us the tools we need. We can keep her at home. 有了他们的帮助，我们更有信心、更有把握做好这项工作.”
Florence, now 97, needs continuous care. Using JHOME’s recommendations, her sons remodeled her home so the bathroom, kitchen and bedroom are all on the same level. 他们还安装了一个动作探测器，这样他们就能知道弗洛伦斯是否能自己站起来.
“Through JHOME, we got her a hospital bed. 现在我们可以陪她从那里走到厨房或浴室。. “他们建议我们在地板上铺上泡沫垫，这样即使她摔倒了，也不会伤到自己. Nurses came and helped train us on how to care for her. 他们还教我们在她的腰上系上步行带，帮助我们在房子里引导她.”
冈拉克说，JHOME最好的地方是可以方便地获得医疗保健服务.
“The doctors come to us,” he says. “They have helped us get her medicines in order. 他们了解衰老的过程，让我们知道什么是正常的. 他们似乎有完美的个性来处理你无法控制的情况. It’s a wonderful fit for us.”
约翰霍普金斯湾景医疗中心自20世纪70年代以来一直有上门服务项目, 但在担任医疗总监时，它被扩展并重新命名为JHOME Mattan Schuchman, M.D., came on board in 2016. 该项目为由于慢性健康状况而无法进入诊所的患者提供长期初级保健. 舒克曼说，JHOME推荐十大正规网赌平台的平均年龄约为80岁, and many have conditions such as heart failure, dementia and chronic obstructive pulmonary disease.
舒克曼说:“这些人本来就无法获得医疗服务。. “他们没有办法得到帮助，因为他们不能离开. We fill that gap. 这很重要，因为他们被发现的唯一方法就是拨打911. They don’t want to go into the hospital if they don’t have to.”
JHOME还将患者与移动服务等资源联系起来, health care supplies and help with insurance navigation. By working with partners such as Medicare Advantage Plans, 舒克曼说，JHOME为医疗保健系统和患者节省了资金，因为患者不需要去急诊室.
“We have really made an impact on the health system,” he says.
JHOME的临床护士Mae Koontz说，成为JHOME的推荐十大正规网赌平台有时是一个艰难的转变.
“这很有挑战性，因为我们的推荐十大正规网赌平台面临着放弃一些独立性,” Koontz says. “他们正在进入另一个他们不想进入的人生阶段，他们经常感到沮丧. Resources can be costly, 而且他们不确定在没有指导的情况下如何去获取资源. 他们中的许多人会在医院、康复中心和家中来回奔波. JHOME gives them more choice in their care.”
昆茨试图让这种转变变得平稳的一种方法是密切倾听推荐十大正规网赌平台的需求.
“我问他们今天的目标是什么，什么对他们最有帮助，”她说. “They need someone in the moment. 我试着联系他们，让他们放心，他们会得到很好的照顾. I always remind them of how soon we’ll see them next.”
冈拉克说，JHOME的护士已经推荐了一些工具来鼓励他的母亲进行互动.
“他们建议给她毛绒玩具，让她开口说话，”他说. “现在我们有小羊羔琳达、树懒萨米和羊驼安妮. 所以当她心烦意乱开始哭泣时，她可以和动物们说话.”
When Erin Hudson began working at JHOME, 她跟随一名护士进行一项新的患者评估，并为痴呆症护理提供家庭指导. Hudson, who is now JHOME’s clinic program coordinator, medical assistant and community health worker, 她说照顾她的两个儿子给了她一个数码相框，用来展示她的生活. 当她大儿子的婴儿照片出现时，尽管有照片说明，她还是认不出他来.
“My son was about a year and a half old at the time, 我还记得，一想到自己无法记住他，我就感到难过,” says Hudson. “这绝对令人心碎，在回办公室的路上我泪流满面. 这是我第一次有机会目睹这种毁灭性的疾病，亲眼目睹我们的护理人员和家庭的经历. 我当时就知道我要做的是真正有意义的工作, and I felt a sense of pride in being able to care for them.”
哈德森说，一些推荐十大正规网赌平台有优秀的照顾者，比如他们的孩子或配偶. For those families, JHOME plays more of a supportive role. Other patients have low incomes and low health literacy, and they often end up in life-threatening situations.
“A lot of these folks are completely isolated,” Hudson says. “JHOME is a lifeline for them. 我们帮助推荐十大正规网赌平台远离急诊室，让他们对自己的生活结果有更多的发言权.”
