Yesterday I went on a home visit in the community I spent a great deal of time in over the course of undergrad. Last semester the research and work my classmate and I were doing had to be put on hold because of our increasingly busy schedules but I am still very interested in this community and it’s residents so I always look forward to an opportunity to work there.What I found yesterday is having the background knowledge I do on this community really can really make a difference when engaging with clients in the community.
We were there to see an older couple and unbeknownst to our team the couple did not make their family/caregivers aware we were coming. This is a tight knit community where people know their neighbors and outsiders are treated with great skepticism. Our patients greeted us warmly but the family treated us with mistrust initially and were clearly uncomfortable with our presence in the home, it felt like they thought we had an ulterior motive for being there.
Our lead doctor introduced the team and explained the reason for the visit but the tension in the room did not lift. After taking vitals and reviewing one of the patient’s medications half of the team left the room to go inspect a hospital bed in the bedroom that was reported to not work properly. This left myself, a med student, and the chaplain with the two patients and their still very suspecting family to sit together staring at each other.
When we arrived I noticed on the doorstep the year 1941 had been written in the pavement. I asked the patient if she had grown up in the community and she confirmed my guess, that she had in fact grown up in this very house. The patient told us the story of how her father built the home with the help of neighbors in 1946 (apparently I misread the year but that is ok) and then turned around and helped those neighbors build their homes. We talked about the local school she went to, back then there were still schools in the community, and how after she finished school there was no work so she moved to NY which is where she met her husband.
I asked her if she or her family ever went to the local hotel/casino in the community growing up, knowing that was a big part of the community back then and that celebrities such as Jackie Robinson would stay there when they came to town. I know some history about the community from my research and from speaking to residents but never have I had the opportunity to speak to anyone her age who has truly seen how the community has changed over the years.
This also gave us a chance to connect with her family because this is their history too. They all grew up in this community, they all had a story for us. By the end of the conversation everyone in the room, our team and the family, were taking part. Our patient’s have been married for 66 years, the wife was giving our med student advice on how to make a relationship last, “trust”, “love”,”you have to believe in each other” and know “it ain’t a bed of roses”.
By the end of the home visit the family had completely opened up, they were working with the doctors to brainstorm the best course of care for the patients, what the next steps should be to address current conditions, and questions were raised and answered. At the beginning of the visit I honestly thought they might throw us out because they seemed so unsure of our being there in the first place, at the end we couldn’t get out the door because they kept thinking of more questions.
While I waited on the side walk outside with some of the team, the rest had been pulled back in again for more questions, one team member made a comment about how rude one of the family members had been at the beginning. I knew the behavior she was referencing had nothing to do with manners or rudeness. I explained to her about the level of oppression this community has historically faced and about the gentrification and how the community views outsiders.. By having just a little knowledge about where your clients are coming from it can give so much context to what is actually happening in a encounter.
To someone on the outside what took place in there may just look like a conversation but I know that conversation built a bridge, a bridge of trust that our team was able to cross to then work with the family. If that conversation had not happened, if we had not taken an interest and showed the client’s and the family that we really do care and are interested I do not know that the appointment would have been as productive.
For me yesterday was a good day. Maybe it was just a conversation but I feel really good about my contribution.