The road is puddle-filled from the morning’s rain as Jennifer Desmond, a family nurse practioner, walks down the muddy dirt lane in her rubber boots and rain poncho, carrying her classic black doctor’s bag. She is headed to see her neighbor, 71-year-old Evelyn Ames, for a house call.
Ames is diabetic and lives alone. Her failing eyesight prevents her from giving herself the insulin shot she has required since she was in her teens, so “Dr. Jen,” as she is known, stops in to see Evelyn nearly every day. When Desmond isn’t able to come, her husband, Kevin Desmond, comes instead. During this visit, Desmond asks Ames routine questions about her diet and her hearing, and checks her blood pressure and insulin level.
For patients like Ames, home visits are a lifesaver. Ames lives far from town, and has little family to speak of who could help her with medication or transportation to the medical center. It is likely that without home visits, Ames would not get her medication. “It means a great lot,” said Ames. “[The Desmonds] are the best two that’s up here. They’re the best friends I’ve had here for a long time.”
While house calls are a thing of the past in most of the rest of the country, on Vinalhaven and other Maine islands they are a mainstay in the host of medical services offered.
House calls have always been a normal part of life on Vinalhaven, but Desmond thinks she and Dr. Rich Entel do more house calls now than ever. Desmond estimated her house calls at an average of three per week, “depending on what’s going on.” Entel makes house calls as well, though not as many.
At the Islands Community Medical Center “they let you think about your interests and pursue them,” said Desmond. “I really like to do house calls, so that’s why we do so many. People out here are so willing to let you into their homes, and summer people love it.”
There are practical reasons for doing house calls. Desmond believes making house calls allows her to provide better care for her patients. “People feel more comfortable in their homes,” she said. “They are more comfortable opening up about what’s going on in their lives.”
The typical house call lasts about an hour, as opposed to an office visit in which a patient might see the doctor or Desmond for 15 to 20 minutes. “You get to know the patient much better,” said Desmond. “You get to know their family, who’s around to help, what they need. There’s a lot of social work that goes into it.”
Most house calls are made to Vinalhaven’s elderly for routine checkups and medication management. However, there isn’t an age requirement. Last summer Desmond made a house call to a summer visitor who had a minor emergency and nobody to watch her children while she went to the medical center.
Desmond makes a lot of house calls on her days off. “That’s my choice,” she said. “I like it here, and I like being here, so it’s much easier for me to have a day off, then stop by to see someone on my way home from town or the quarry. I think it’s difficult to schedule a house call on a normal day at the office.”
Home hospice care makes up a large part of the house calls made by Islands Community Medical Center staff. “Here, if someone has to leave home [for medical care] they have to leave the whole community,” said Desmond. “The reality of it is a lot of people here don’t want to go to the mainland. Home visits allow people to stay.” In addition, Desmond pointed out that home hospice care on the mainland most often includes a huge network of medical professionals. “Here KnoWalLin [Home Care and Hospice, based in Rockland] comes once a week, then it’s just us and the family” providing care. “It’s a good example of how the medical center here is different than others,” she said.
Isabelle Osgood, 86, is a patient of Desmond’s who receives home visits. Her late husband, Albert Osgood, Sr., received home hospice care from Desmond before he died in 2008. According to Isabelle, “Dad thought a lot of [Desmond.] It meant everything to him” to be able to stay on the island, she said. “He wanted to be home, and I was awful glad he could be home.” In terms of her own care, Isabelle said home visits “are a big help. [Desmond’s] like a friend. She asks how things are, how you’re feeling, what’s going on.”
For Desmond, “one reason I’m still here is because I can do house calls and hospice care. Being able to do that is such a gift for people, but that’s what I like best about this job. It’s so worth it.”
Isabelle and the late Albert Osgood, Sr. are Kris Osgood’s grandparents-in-law. Kris Osgood is a freelance writer who lives on Vinalhaven.