Share The Health

Bridging the Gap


Seventy-four-year old Mary Brandenburg of Adamstown has COPD, a progressive lung disease characterized by breathlessness, wheezing, and a chronic cough. She is also a diabetic. Both diseases are difficult to manage separately, but in combination, they can present even more of a challenge.

In March, Mary was admitted to Frederick Memorial Hospital with difficulty breathing. Previously controlled symptoms of her diabetes reappeared, causing her to feel nauseated and weak. After five days in the Intensive Care Unit, she was finally able to breathe normally on oxygen, and the symptoms of her diabetes had subsided. Still, her energy and stamina had been greatly compromised, and it was apparent that Mary would need continuing care to avoid re-hospitalization and get back on her feet.

Keeping Mary’s recovery on track took good communication among everyone involved in her care across a variety of settings.Prior to discharge from FMH, a social worker from the hospital’s Care Transitions team visited her and discussed her transfer to the Skilled Nursing Facility for rehab. Then, the FMH social worker reached out to Mary’s new care team at the skilled nursing facility to review her history with them, including medications she was taking, her past treatment plan, and any goals she had been working toward in Physical and Occupational Therapy while in the hospital.

After five weeks in rehab, Mary was strong enough to go home—but help was still needed. She chose FMH Home Health Services for the last phase of her recovery. A nurse visited several times per week to make sure Mary’s health was on track. Occupational therapists showed her new ways to manage daily activities, and a physical therapist worked with her on strength, mobility and balance. Education about food choices, exercise, and other lifestyle choices was also an important part of Mary’s home health care.

During her care, a team of providers across three different settings worked together to coordinate Mary’s care. As a result, Mary has made some important lifestyle changes, and is feeling better than she has in a long time.

“As part of the Frederick Regional Health System, FMH Home Health Services is closely aligned with the hospital’s goals for patients—especially those who have begun their treatment there,” says Director Heidi Brown. “With access to everything related to a patient’s care and treatment, we are the next step on their continuum of care.”

Wondering if you or someone you know would qualify for FMH Home Health Services? Talk to your doctor, or call us at 240-566-3222. A staff member will work with you to determine eligibility for service, verify insurance benefits and coverage, help determine any financial obligations, and work with you to obtain a doctor’s order.