Theresa Alt began her career in healthcare as a nurse's aide, working in the long-term care and home care settings. As a physical therapist, she has enjoyed working in hospitals, outpatient clinics, and long-term care facilities. She finds her greatest joy, however, seeing clients at home, and helping them function at the highest possible level in their own environment.


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As home healthcare professionals, we are given a unique opportunity to become a part of our patients' lives. We know that our clinical skills help to keep our patients safe in their homes and allow them to maintain their independence for as long as possible. In many cases, though, it is not our clinical expertise, but our care, compassion, and interest in our patients that make the greatest impact, especially on our patients' memories.


In our agency, we were recently challenged to develop a mission statement specific to home care. As I was considering what our mission is, and how that translates into promises to our clients, it occurred to me that sometimes the things that mean the most to our clients have little to do with our skills as nurses and therapists, or with the outcomes we achieve.


This list of promises to our clients will never appear in an agency brochure, but those of us who work in home care know that this is what makes our visits memorable and meaningful for our clients.


We, your home healthcare providers, promise to:


* Treat you as we would our grandmother, father, or sister, even if it means telling you things you would rather not hear, or asking you to get up and move when you would rather stay in the recliner and watch "The Price Is Right."


* Enjoy pictures and stories of your children and grandchildren (and great grandchildren!!)


* Always treat with respect the place that you call home, whether that is a room in assisted living, an upscale condo, or a modest mobile home.


* Listen with understanding to the frustrations you have had with other healthcare providers, and strive to avoid repeating those mistakes.


* Compliment your decorating prowess!!


* Bring with us on every visit a smile, a sense of humor, and a story or two that will help put everything in perspective, if needed.


* Answer your puppy's boisterous greeting with an appreciative pat on the head or scratch on the tummy.


* Make you feel better when we leave than when we came, even if we have to cause some pain in the interim.


* Overlook worn clothing, messy hair, and dust on the shelf.


* Seek out things we have in common, such as the weather, to keep the conversation going.


* Remember your face, address, and diagnosis, even if we forget your name.


* Think of you and your family each time work or pleasure brings us back to your neighborhood, and send up a quick prayer that you are still doing well.


* Listen to your advice. Heeding the voice of experience can help us to make the most of life."Do the things that you enjoy while you are still young enough to enjoy them.""Retire early!!""Time spent with a loving family is a great gift, even if they drive you crazy sometimes.""They are not the 'Golden Years,' they're the 'Rusty Years!!'"


* Treasure the memories of the brief opportunity we had to be a part of your life.



It is getting harder and harder for healthcare organizations to make ends meet, with all of the reimbursement changes that have occurred in recent years. That often results in pressure on clinicians to do more in less time. As you adjust your practice to these changing demands, please remember who it is that you are here to serve. For an older adult who has lost most of her family and rarely gets outside of her own front door, a listening ear and a caring smile may be more therapeutic than all of the educational materials in the filing cabinet.