House Calls

Grads join to provide medical care for the elderly

No longer a standard of the medical profession, house calls were once a routine practice for doctors.

Now with an increased elderly population, house calls are making a comeback, and two Georgia Southern Doctor of Nursing Practice (DNP) graduates are aiding the elderly in need of convenient care with plans to open their own house call franchise business this summer.

Carmen Hill-Mekoba and Ludella Brown recognized that when some frail, elderly patients are faced with the difficulties and challenges of traveling to see their doctors, they often skip the visit. To remedy the problem, the pair is providing comprehensive care for seniors in two Georgia cities and their new business venture is a combination of their house call expertise in nursing homes, assisted living facilities and independent senior residences.

“The elderly often find it difficult to visit a doctor, and we bring personalized care to them. This has really brought nursing and medicine back to the forefront,” said Brown.

Plans are underway for the franchises to begin operating this summer in Georgia and South Carolina, and preparations include employing nurse practitioners with specialized experience. “We would like to select nurse practitioners with backgrounds in geriatrics,” said Brown. “Eventually, our plan is to have a nurse practitioner on-site for one to two days a week at individual nursing homes.” The business includes a team of collaborating physicians who consult with the nurse practitioners.

The goal-oriented pair credits Georgia Southern’s DNP program because its vision of serving a diverse, ethnic community matched the goal of meeting the needs of underserved populations.

“I want to raise the level of healthcare,” said Hill-Mekoba, whose career has also included working in a small, inner-city hospital and creating health and wellness initiatives for companies including Kimberly Clark and Ciba Vision. She founded the Visiting Nurse Program at General Motors, in which staff nurses ride golf carts to provide routine blood pressure and glucose checks for employees who are unable to leave their jobs on the production line.

While in the DNP program, Hill-Mekoba focused on the promotion of health and wellness initiatives with a different group: senior citizens. She has contracted with the Atlanta Housing Authority to provide weekly health care services in one facility’s wellness room and visit seniors living in high rises.

“These people were not receiving the care they needed because of limited resources such as transportation,” she said. Hill-Mekoba makes house calls to approximately 30 people each week, and enlisted the services of a pharmacy to deliver medications. Even more significant is that seniors do not incur any out-of-pocket costs for a visit. “Seniors living in public housing deserve the same health care as everyone else,” she added. In addition to Hill-Mekoba’s busy house call schedule, the mother of three is also a nursing instructor for three universities: the University of Texas at Arlington, the Chamberlain College of Nursing and Boise State University.

Brown has the distinction of being the only nurse practitioner in the Savannah area to open a private practice, Women’s Healthcare and Family Medicine. “When I wrote the business plan for my practice, I had absolutely no idea that my career would expand into home visits,” said Brown, who has provided emergency treatment to patients in private practice and in hospital settings and has also worked as a nursing instructor. For seven years, she worked as the clinical director and nurse practitioner for the Community Health Mission in Savannah, an organization that offers free primary health care to uninsured patients in Chatham County and surrounding areas.

“When I opened the door to my practice the first day and my first patient walked in, I was always thinking about other opportunities, and ways to help the underserved,” she said.

Brown’s house call idea formed when she went to see her mother, an Alzheimer’s patient. “When I visited my mother, I wondered how many other residents at the facility were receiving physical examinations and routine health care on site. I started making a list of assisted living facilities and nursing homes in the area to contact,” she revealed. Brown discovered that many residents were unable to travel to a provider and that area medical professionals weren’t making house calls.

“Today, I make house calls at five assisted living facilities and two nursing homes to provide physical exams and labs for the residents,” said Brown. While she sees patients in her office three days a week, Brown is also on call for two additional assisted living facilities. “The facilities have been so receptive. It is easier to make house calls versus staff transporting patients in a van to a physician’s office, where they may have to wait two hours or more,” she said.

The call to help the elderly has changed the lives of the two women. “I feel so much professional satisfaction working with the underserved,” said Hill-Mekoba. “This is America’s forgotten group, and many of them don’t have a support system. Seniors really appreciate that someone cares about their overall health and well-being.”

As a result of this hands-on approach to nursing, Brown has developed special and meaningful connections with her patients. “I love to communicate, and I feel that it helps me contribute more to my patient’s lives,” she said.

—Mary Beth Spence