HAMILTON - Every morning at the same time, a cheerful voice fills Martha Granrud's kitchen.
“Good morning,” it says.
But this voice isn't attached to flesh and blood.
The happy voice belongs to the Honeywell HomMed Health Monitoring System that's helping this Hamilton woman and another 14 elderly people in the Bitterroot Valley remain in their own homes as the years go by.
Each morning, Granrud pulls up a chair in front of the talking machine and goes through a ritual that helps ensure no hidden health problem is sneaking up on her.
The machine takes her blood pressure, heart rate, oxygen saturation and weight. When it's finished, the machine electronically sends that information to a central station at the Marcus Daly Memorial Hospital's Home Care program.
Once it arrives, a registered nurse takes a look to ensure that Granrud is doing just fine. If something seems amiss or if the machine doesn't deliver her daily vitals, Home Care will send out a clinician to find out why.
“It gives me a lot of security,” Granrud said. “It makes it so I can stay in my own home. There's no place like home, you know.”
As Montana's population ages, many elderly people hope to stay in their homes as long as possible, but for many it's a fragile existence.
One illness can change everything.
A combination of visits by home health care clinicians and new technology like the Honeywell monitoring system is helping people achieve that goal.
Bitterroot Valley residents are among the fortunate few who have access to both. The Marcus Daly Home Care program is the third agency in the state to offer the remote monitoring system for homebound patients facing critical health issues.
“We only have 15 monitors available,” said Marcus Daly Home Care director Jane Hron. “We started using them a year ago last September. All of them are out in the field.”
While not every patient has been excited to hear the machine report they'd gained a couple a pounds from that feast of pizza the night before, Hron said, most are discouraged when their health improves enough that home health care is no longer available to them and the machines are taken away.
“We're really advocating that people monitor themselves,” Hron said. “In turn, they become responsible for their own health care. ... We often can really make a difference when we're able to intervene in the early stages of an illness.
“We can keep people out of the hospital,” she said. “Home health care is less costly than other more intensive forms of care. When people are in their own homes, they sleep better, they eat better and they just generally feel better.”
Decreases in Medicare payments and tightening criteria have made it more difficult for organizations like Hamilton's to offer the program to seniors.
In 1996, Marcus Daly served an average of nearly 250 home health care patients, Hron said. Today it's closer to 60 or 70.
“At least 14 counties in Montana have no services for home health care,” Hron said.
Right now, Medicare doesn't pay for the remote monitoring system. Marcus Daly Home Care is funding the demonstration project as part of a grant.
“We're doing the studies now to try to justify their use so we can get more people using them,” Hron said. “We want to do what we can to keep people in their homes and out of the hospital.”
Registered nurse Nancy Sallee knows just how important that can be to people.
For the last four years, Sallee has been working as a home health care nurse. On almost every workday, she'll travel across Ravalli County to check in on four or five patients.
“Home health is really different from other forms of nursing,” she said. “Many of the people I see are starting to feel better. They're out of the hospital and back in their own homes.”
Some patients she'll see every day. For others doing a bit better, the visits might come less often.
“Sometimes, I'm the only person they may see for days on end,” Sallee said. “Just last week, I checked in on this nice little man. He didn't look too well that morning and we had him admitted to the hospital. That probably saved his life.”
“I think we make a big difference,” she said. “That's what makes it all worthwhile.”
The goal for home health isn't focused as much on daily care. Instead, Sallee and others help people make it past the initial difficulties of returning home after an illness and then teach them how to care for themselves.
“We assist people in providing their own care,” she said. “For instance, if someone needs to have an injection, we'll teach them or a family member how to do it.”
To do the job right, Sallee said, a nurse has to truly care about a patient. Sometimes that means just being there to listen and provide some company for someone who's leading an otherwise lonely life.
Granrud looks forward to Sallee's visit every few days.
“I really love her,” Granrud said. “I look forward to seeing her.”
Granrud has been in Hamilton for 41 years. The last 18 were spent in this home. She's on oxygen and doesn't dare leave the place in the winter for fear of falling on slippery walkways.
Granrud suffers from heart failure that sometimes causes her to gain several pounds of water weight in a short period of time. Without home health care, it's unlikely she could live on her own.
“I feel so lucky to have this service,” she said. “Everything has just been excellent.”
Even the talking machine can be a bit of company.
“It tells me good morning every day,” she said. “Sometimes I think it's real and so I answer back. It's almost like having someone here.”
Reporter Perry Backus can be reached at 1-800-366-7186 or at pbackus@missoulian.com.
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