Hospital at Home

For almost three years, twelve-year-old Martin had been living in hospitals or convalescent homes. He is back home now in the fifth-floor, $44-a-month Manhattan walk-up apartment with his mother & father, grandmother, younger sister and older brother. Martin still suffers from rheumatic heart disease (caused by rheumatic fever), is still bedfast, still needs the kind of medical care that hospitals give. He is getting that kind of care now at home.

One day last week, Martin sat cross-legged on his bed and waited for the regular visit of his doctor. Panting a bit after the climb, Dr. Dennison Young, 36, greeted him with a cheery "How are you feeling?", nodded when the boy replied, "I'm pretty good, but my neck's still stiff." Once a month, to test Martin's heart, Dr. Young lugs a 30-lb. portable electrocardiograph up the stairs (the doctor grumbles good-naturedly that "they all seem to live at the very top or the very bottom").

A Project to Watch. Martin is one of twelve children (eight boys, four girls), ranging in age from 4 to 17, who are being treated at home for rheumatic heart disease by The Bronx's Montefiore Hospital. The experiment, begun last October as part of Montefiore's broader plan for home care, is being carried out with the help of $52,600 from the New York Heart Association.* The project is being watched closely by hospitals all over the U.S.

There is still no drug cure for rheumatic heart disease. Patients need complete rest and good nursing care, perhaps for many months. Under the Montefiore plan, mothers are taught to keep a chart of temperature, pulse, etc. A visiting nurse calls regularly to give instruction in home nursing and to check up for the doctor. A dietician gives advice on proper meals.

Rag Dolls & Baby-Sitters. Trying to keep a child happy nn bed is a big order. An occupational therapist calls around to give lessons in making leather belts, wallets, rag dolls, etc. The Board of Education sends a teacher for four hours a week. If necessary, the hospital furnishes drugs, lends bed, sheets and bedpans. For a mother who gets worn out with nursing, or just needs to get away from the sick child once in a while, the hospital sends a housekeeper or a babysitter.

Everything is free for families who cannot afford private medical care (rheumatic fever seems to be most common among low-income families). But the hospital first checks carefully to make sure that the mother is willing to accept the burden of caring for a child at home, and that the home is not overcrowded or ill-kept.

So far, the plan is working out. If the Montefiore experiment proves a success at the end of a 15-month test period, overcrowded hospitals in other cities will probably try similar plans.

* An affiliate of the American Heart Association, which last week opened a nationwide campaign for $5,000,000.

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