Early Lessons inspire thoughtful approach to Home-based Care

“A small town with a big heart.” 

That’s how Prospero Health social worker Antoinette McMillan describes Charleston, West Virginia, where she was born and raised. 

“It was the type of town where everybody knew everybody. One of the friendliest places I’ve ever been. When you grow up in a community like that, you expect that’s the way it is for everyone.” 

When Antoinette was a teenager, she started helping out at her grandfather’s medical practice during breaks from school. Her grandfather, whom the kids called “Candy,” was a general surgeon who ran his office out of an old Victorian home. Working as a receptionist, Antoinette greeted patients when they came through the front door and chatted with them while they waited for Candy.

Antoinette noticed early on that some patients brought gifts for Candy, such as fresh eggs from the chickens in their yard or a blanket they had knitted. As it turned out, the surgeon bartered with people who didn’t have the money to pay for his services.

“He loved medicine and he loved helping people. He wanted people to feel better when they left his office, and he was going to make sure that happened regardless of their ability to pay. Because of this experience, I grew up thinking, ‘Why can’t everyone have access to what they need?’”

With Candy’s generosity and compassion as a guiding light, Antoinette set out to find her own place in the world. After earning her undergraduate degree in political science from Hollins College in Virginia, she did some career-hopping in her 20s. Antoinette tried out politics, the legal profession, and healthcare administration. None of them felt quite right, but her experience as a congressional intern gave her some insight into the kind of work that would be most fulfilling for her. 

“I worked up on Capitol Hill in my Congressman’s office,” she said. “I was responsible for responding to letters. And oftentimes, the letters were coming from constituents who had problems they needed resolved. I loved that I got to connect with real human beings and try to help them solve real-life problems.” 

A chance conversation with a friend led Antoinette to the field of social work. She was excited by the thought of a life of service, much like her grandfather’s. As a graduate student at the University of Georgia, Antoinette chose children and adolescents as her specialty and figured she would stick with this population after graduation. But a job opportunity in home health solidified her passion for working with older adults. 

“Older folks have such rich stories and love sitting down to share them with you. And they really, truly need and appreciate the human contact.” 

Because most of Antoinette’s home health clients suffered from serious illness, she would often collaborate with palliative and hospice providers as the people under her care neared the final stages of life. She saw the tremendous benefits of both palliative and hospice care and felt that too many people missed out on those services until it was too late, in part because providers shied away from difficult conversations with patients and their families. So, she decided to become a hospice social worker herself. To Antoinette, speaking honestly to people about their treatment decisions was a way to empower them.

“It feels weird to say we ‘get’ to have those conversations with people, but they’re very personal, and many people haven’t had them yet. And it is oftentimes a very uncomfortable conversation, but it’s one they deserve to have. It’s the respectful thing to do, to say, ‘This is your life, how do you want to live it?’”

Antoinette’s experiences in home health and hospice prepared her well for her role with Prospero, which she joined at the beginning of the year. Collaborating with a team of doctors, nurses, and care coordinators, she strives to give the people she serves in the Charlotte, North Carolina, area the same sense of family and community she experienced growing up. 

“We try very hard to build connections with people’s current physicians so that they feel like they have a really strong support system, even if they perhaps don’t have that in their own family,” said Antoinette.

In one noteworthy case, Antoinette and her team helped an older man, “Charles,” work through his difficult past and reconnect with this family. When Antoinette first met Charles, he was extremely anxious about his health and would call 911 several times a week to request medical attention. If the paramedics decided to take him to the hospital, he would usually be sent home after a day or two, and his anxiety inevitably returned. The few friends Charles had in the area could see the toll that this cruel cycle was taking on him and voiced their concerns to Antoinette.

By taking a genuine interest in Charles’ health and wellbeing, Antoinette gradually gained his trust and eventually convinced him to call her or his Prospero nurse practitioner whenever his health worries became overwhelming. Through their frequent phone calls, Antoinette discovered Charles had a daughter, Kim, whom he hadn’t spoken to or seen in nearly a decade. Charles’ relationship with Kim became strained many years ago after he and Kim’s mother split up. Antoinette was able to track down Kim’s phone number through some amateur sleuthing, and with Charles’ blessing, she reached out to Kim to let her know that her dad had been meaning to get in touch with her but wasn’t sure how because it had been so long since their last interaction.

“I shared a little bit about how her father was doing, with his permission of course. And she shared a little bit about their history, which was painful to hear because Charles was, unfortunately, not the greatest father. I put the ball in her court and said that it was up to her if she wanted to communicate with him. She said that she would love to.”

Just a few weeks after her first phone call with her father in years, Kim and her husband traveled from their home in Georgia to visit Charles in North Carolina. Charles now talks to his daughter on a regular basis and is delighted that he can put her name down as an emergency contact when he goes to the doctor. Mending his relationship with Kim has also given Charles some peace as he considers what he wants the next stages of his life to look like.

“When I spoke to Charles, he told me how grateful he was to have Kim back in his life. I told him that it sounded like he was doing a lot of soul searching. And he said, ‘Absolutely. And this reconnection with her has really allowed me to kind of scratch some things off that list that I needed to take care of before my day comes.’ That really, really stuck with me. I was lucky to be a part of it.”