Last winter Peter Wilson, a 47-year-old Cheshire man, was suffering from peripheral vascular disease. Three toes on his right foot had to be amputated, and he had bypass surgery on his lower extremities. Peter had forty staples and seven sutures on his left leg and a draining wound on his right foot. He needed dressing changes two times per day, and he had no health insurance to pay for this care. He was high risk for infection and poor healing because of his impaired vascular status.

Peter was referred to Northern Berkshire Visiting Nurses Association, and the nurse who came to his home helped him develop a low cost plan for care that included enlisting a friend to help. The VNA nurse taught both Peter and his friend how to change the dressings on Peter's wounds and safely dispose of soiled dressings. The nurse instructed both of them on pain management, diet to promote healing, and how to recognize and report adverse symptoms. The VNA nurse continued to visit Peter at his home for over four weeks until he was out of immediate danger, and before she was done, she also helped him apply for MassHealth to cover future medical expenses.

A Tough Start for Ben

This past spring, Benjamin was born to an alcoholic mother, and custody was given to his 44 year-old father who lived separately in a small, scarcely furnished apartment in North Adams. When Benjamin was 5-months old, he and his father were referred to the Visiting Nurses Association because Ben was failing to thrive. He was very thin, weighing just over eleven pounds, and he was sleeping in a bassinette that was too small for him. The visiting nurse made several visits, teaching Ben's father how to prepare and store formula, how and when to feed Ben, how to 'baby-proof' a home, and what signs of illness to look for. Ben's father was cooperative and receptive to the VNA instruction and assistance, but had limited parenting skills and no immediate support network. The nurse monitored Ben's weight, assessed his general physical condition and maintained contact with the pediatrician. With regular instruction and support for his father by the VNA team, Ben began to grow stronger, but after a time, he was unable to sustain the increased weight, and the visiting nurse realized that he would fail unless he could be placed in a more nurturing environment. Though it was a painful decision, his dad agreed, and Benjamin was soon placed in a foster home. He is now gaining weight and developing normally.