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NP Amy
The member was lying in bed watching TV when I arrived.

He said he served in the Army and had his care provided through the local VA. He had a history of
stroke, leaving him with paralysis on his left side and making it difficult for him to perform many
activities of daily living on his own. His caregiver was a neighbor.

The medication review was the first clue things were not well. He said he wasnt sure what
medications he was taking, but he kept them under the sink. Sure enough, there were dozens of
medication bottles there. Many never opened. Others dating back to 2011. He said he took most of
his medications as he needed them. At which point, we had a long discussion about the importance
of taking medications as prescribed based on his past medical history.

When it came time for the physical exam, it was obvious the member had not bathed in well over a
month. At this point, his caregiver stopped in. He said caring for the member was becoming too
much for him.

The member asked if I could help him with personal hygiene. I took him to the bathroom and
bathed him and applied clean clothing. I also helped him with his catheter, which appeared not to
have been changed in several months. The caregiver and I applied clean sheets to his bed.

Clearly, the member needed more care. I called the VA and spoke with a case worker who made an
urgent referral for home health. They would immediately send someone to the member's home for
evaluation. Both the member and caregiver were extremely grateful for my actions.

In following up with the member's VA care team, I was told he is now receiving home health
services. This just goes to show that Matrix Nurse Practitioners are put in the right place at the right
time.