From Hospital to Home

more than a decade ago, dr. brenda matti was summoned to her first house call late in the afternoon. she packed up a nebulizer machine and inhalers and headed off to see the elderly woman who was having asthma trouble.

"the nurse met me at the apartment before we went in," she said. "the nurse turned to me and said, 'dr. matti, take a deep breath, this is the last fresh breath you get.'"

she entered the apartment and the nurse's warning became clear. the rooms were packed with dust, old newspapers and dirty dishes-yet the woman thought she'd had the attack because someone had cleaned the windows.

"we doctors don't even know, or realize, how many people live like that," she said. "i am sure if i saw this patient in the office, i wouldn't have thought about her home environment

and would have just treated the asthma."

homecare for seniors has become matti's specialty at st. luke's roosevelt hospital, where she has held the title of chief of geriatrics since 2001. matti started the physician home visit program in 1997, four years after she began her residency at the hospital.

"she is really somebody who has changed the character of interaction between st. luke's and the community," said dr. gary burke, who hired matti. "it's about setting up a framework where you think about how you can provide service outside the hospital and doctor's office."

the program caters to patients who are bedbound with multiple chronic diseases. healthcare providers see about three to four people a week, with the priority given to upper west siders. since the program's inception, matti estimated that the hospital has seen around 700 patients.

while she loves her work now, medicine wasn't at the top of her career list when she was growing up in the philippines. but after an affluent aunt offered to pay for her education, with the stipulation that she went into medicine, matti went to medical school and became the first in her family to work as a doctor.

"i think it turned out to be the profession for me," she said. "i enjoy being a physician, it was something i thrived in."

matti's entire career has a serendipitous flow to it. in 1992, she reconnected with a friend from medical school who lived across the street from st. luke's roosevelt hospital. matti applied to study there and was accepted. the doctor, who was raising a family of four with her husband, stayed at the hospital for three more years and became the chief medical resident.

though matti ended up in the geriatric department, a direct consequence of her work in the home visit program, she technically isn't a geriatrician. but her dedication and effort with the program keep her on top of the game, helping seniors retain their independence while keeping them healthy.

"how do we keep our seniors as independent and functional as possible?" she asked. "you have to provide them with goals for their own house and keep them engaged in their lives and in the communities."

with matti spearheading the home visit, many more will be able to do just that.