House-call Ministry

Faith motivates a doctor to treat homebound patients in need.

By Beth Macy
published Sunday, June 22, 2008

When Dr. Alice Inouye arrived at a terminally ill patient’s home a few years ago, she found a distraught caregiver. The patient, a large man who was bedridden, had lost control of his bowels, and his tiny, elderly wife hadn’t been able to lift him to clean the bed.

Doctors don’t do this, Inouye thought, when she first glimpsed the mess.

Dr. Alice Inouye listens to Harriet Small's lungs at Small’s home in Roanoke.Dr. Alice Inouye listens to Harriet Small's lungs at Small’s home in Roanoke.

A moment later she grabbed a towel, and for 90 minutes she helped the woman clean up.

Back when she was a more traditional doctor seeing 20 patients a day, Inouye would have never stooped to such a task. For one thing, there simply wasn’t time.

For another, she had nurses and medical assistants to help her and an actual doctor’s office to practice out of — not just a Subaru station wagon.

But this is how life has changed since the former hospice director and family practice doctor gave up corporate medicine five years ago to begin tending to the Roanoke Valley’s frail elderly in their homes.

Experts say that reviving the old-fashioned practice of treating people at home could reduce emergency room visits, shorten hospital stays and help control escalating health care costs. The American Academy of Home Care Physicians estimates that the number of elderly patients who could benefit from regular house calls will double by 2020, to 2 million nationwide.

But while the trend is picking up, doctors who make house calls are still relatively rare; 1,400 in the country have house call-only practices.

Inouye is an even more singular breed: Equal parts ministry and medicine, her Jubilee Housecalls practice treats homebound patients who are nearing the end of life — and she often works without being paid.

Her name appears regularly in newspaper obituaries, tributes from grieving families who want to thank her for her treatments and her prayers.

Talk to any social worker or home-care aide, and it’s Inouye they rely upon to tend the neediest seniors in the Roanoke Valley. She helps patients reduce the number of medications they’re taking and coordinates with area pharmacists to make sure her charges can afford the drugs she does prescribe.

She urges families to heal decades-old rifts — before it’s too late — and has helped even nonbelievers establish a relationship with God.

“This is truly a ministry for her,” said Carolyn Dungee, an LOA Area Agency on Aging case manager. “She is not fooling around.”

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