Home-care program gives mother and daughter, 110 and 85, long-awaited reunion

By Michael E. Ruane
Washington Post Staff Writer
Sunday, July 18, 2010; C01

Eddye L. Williams's left hand dances in the air like a shining brown bird, rising and falling as she imitates the ocean waves of her native Florida, where she was a child more than a century ago.

At 110, she doesn't see or hear so well, and her speech is hard to understand. So her hands help tell her story, as she speaks of the moon and the stars and of waiting on the Lord.

"Wait, wait, wait," she will say with a finger in the air. God will answer. Three weeks ago, her patience was rewarded when her 85-year-old daughter, Edythe Simmons, returned from the nursing home where she had been for the past three years.

Simmons, partially paralyzed from a stroke 20 years ago, had been recovering from breast cancer. Now she is back in the bedroom with the blue curtains, across the landing from her mother in the plain brick house they have shared for decades.

Seeing the Lord's work, Williams says, "Why, then, should I worry?"

Both women are miracles, of sorts, as is their reunion in their Northeast Washington home. Williams is believed to be Washington's oldest citizen. Simmons, despite her afflictions, is overjoyed to be back with her mother.

Their reunion is also the result of an intensive program at the Washington Hospital Center designed to care for very sick elder people in their homes and keep them out of the hospital.

"The idea . . . is to do home-based primary care for the most ill elders in the community," said Eric De Jonge, a physician with the hospital's Medical House Call Program. "That's the mission."

"The patients that we care for are really the most ill and disabled elders," De Jonge said. "These are folks with multiple chronic illnesses, often physical or mental disabilities, and have been in the health-care system with a lot of high costs for an extended period of time."

Three years, few visits

Williams, the daughter of a well driller, was born in Tampa in 1900, the year the Wright Brothers went to Kitty Hawk, N.C. She was married, though she declines to talk about her husband. Simmons, her only child, said her father was a fireman on the Atlantic Coast railroad. He has been dead for decades, she said.

Williams appears thin and frail but erect as she sits in her wheelchair. She leans close to see visitors because her eyesight is so poor, but she wears bracelets, earrings and rings and has her nails done in pink. Her face looks like a sculpture in wood.

She has diabetes and high blood pressure, as well as glaucoma and poor hearing, De Jonge said. She survived a life-threatening infection four years ago, was in and out of hospice, and has suffered a minor stroke.

Through a District "Medicaid Waiver" program, she has had a 16-hours-a-day home-care aide. She maintains her health, she says, by consuming bread-and-butter pickles and papaya juice.

She had lived with her wheelchair-bound daughter for many years until 2007, when Simmons learned she had breast cancer that had spread to her bone and fractured one of her legs.

Simmons, a retired teacher, was taken to the hospital, and then to a nursing home where she was stabilized. "Turns out that in elderly women metastatic breast cancer is not as life-threatening as in young women," De Jonge said. "It's a slower-growing cancer."

Three years passed. Mother and daughter managed only a few visits. Simmons said she was comfortable at the nursing home but felt there was something missing. Six months ago she announced that she wanted to go home.

The house-call program is staffed by a team of doctors, nurse practitioners and social workers who visit elders in their homes and coordinate the complex care they often require. The program has 600 patients enrolled in the neighborhoods around the hospital.

The waiver program also allowed Simmons to get a home health-care aide, and a social worker with the house-call program, Sari Greene, coordinated the move.

One day this month, De Jonge and Greene drove to see how the two women were doing.

Williams, whose first name is pronounced Eddy, wore a gold-trimmed white dress she had designed, a jeweled lavender pin and a silver necklace and cross. She sat in her wheelchair beside her daughter.

Simmons, who has no children, rested in a new hospital bed the program had just acquired for her. A jovial woman in eyeglasses and big earrings, she said of the bed: "I'm so comfortable. I use it like a toy." The two women often held hands. An elegant framed photograph of Simmons as a smiling young woman hung on the wall.

"So how do you feel about your daughter coming home?" De Jonge said as he prepared to examine Williams.

"Oh, I'm delighted," she said. "Three long years. . . . To stay together now, and to pray together."

It was a painful wait, she said, but "I know that God will answer. . . . I know that God won't let me down. . . . All I have to do is have patience."

A different kind of care

Simmons said she felt like a different person being home, with her mother's "spirit going into mine."

De Jonge checked Williams's vital signs and entered the data into a laptop, as his patient recited some of her poetry.

"I get a lot of joy out of this kind of relationship, and the trust that we have," the doctor said. "I get a lot of hugs, affection, and it really makes my day worthwhile."

His program, however, loses money, he said, because Medicare pays for only about 60 percent of its costs.

But a pilot program in the new health-care overhaul bill will test a different approach: Successful house-call projects could share with the government savings generated by treating elders outside of hospitals. "We're not asking Medicare to spend more money," De Jonge said, only to better fund care of its most fragile patients.

As Williams sat in her bedroom, where a plaster image of Jesus is attached to the door, Greene, the social worker, asked her how she has been able to live so long.

Williams leaned her aged face close and began to caress Greene's arms and hair with her hands.

The old woman talked about the importance of connecting with nature, and listening to "what makes you tick."

"The moon has a story to tell," she said. "The stars have a story to tell."

It was a mystical moment. A picture of her as a young woman wearing hoop earrings and a pink corsage hung over a bed. A large wall clock that appeared to have stopped sat face up on a chair.

Williams talked about the stars and the ocean as she stroked Greene's arm, then began to recite what sounded like a poem.

It ended with the gentle refrain:

"Go home now . . . "

"Go home now . . . "

"Bye, bye . . . bye-bye."

© 2010 The Washington Post Company