Learning How to Speak Again

Our People


“I love what I do,” Melanie, RN, says. Melanie is pictured here posing with Joan.

“HEY, MEL!” Joan proudly says, welcoming Melanie, RN, into her bedroom during a recent home health visit.

Melanie, one of Independence Plus’s nurses, remembers this day fondly as it was the first time she heard Joan’s voice. The pair has been working together three days a week since Joan moved home last November after being hospitalized.

Joan, 45, a professional craps dealer and diehard Cubs fan, was diagnosed with Multiple Sclerosis almost 20 years ago.

Biggest Fear? Not Living at Home.

Joan’s biggest fear is living at a facility—and not at home.

Joan now lives with Armando and Shelly, a husband-and-wife team. Joan and Armando have known each other since college and been roommates on and off ever since. Together, the three of them are a family.

Shelly and Armando are committed to keeping Joan healthy at home. Joan’s bedroom, where she spends most of her days, is bright, comfortable, and well-organized, complete with a communication board that lists Joan’s goals, progress, and schedule.


“Everything is better when you’re wearing a crown,” Shelly declares.

When Joan was readmitted to the hospital this last time, Shelly and Armando didn’t know if Joan was going to make it.

“We continued to believe in her,” Shelly remembers. “I thought, we just have to get through this…”

Joan has been home for over one year now. Thanks to her family, Armando and Shelly, and Melanie, her home health nurse, Joan hasn’t been readmitted to the hospital since returning home.

Conquering the Speaking Valve

Recently, Joan started wearing a Passy Muir® valve over her trach tube, as tolerated. The speaking valve is a one-way valve that redirects airflow in Joan’s upper airway by allowing air to pass through her nose and mouth when her trach cuff is deflated. This allows Joan to vocalize words.

Joan is practicing up to 30 minutes every other day.

“It was so great to finally hear her voice,” Melanie begins. “We were practicing using the speaking valve during our visits, but Joan surprised me that morning when she said my name!”

As Joan relaxes, she is better able to tolerate the speaking valve.

“Relax, Joanie,” Shelly says.

When Joan is asked if it’s nice to finally hear her own voice, she replies, “Yeah.”


Joan during one of her IPV treatments.

Highlight of the Week

Shelly and Joan proclaim that Melanie is the highlight of every Monday, Wednesday and Friday.

Melanie blushes, “We solve a lot of issues together in one hour. We have a system now.”

One thing that’s helped Joan since coming home is the Intrapulmonary Percussive Ventilation® (IPV) treatments she receives during Melanie’s visits. With IPV treatments, Joan has improved her mobilization of lung secretions, lung recruitment, and ventilation and oxygenation.

“Joan’s lungs are beautiful,” Melanie proclaims as she listens to Joan’s lung sounds.


At the end of our visit, and with tears in her eyes, Shelly says, “I honestly don’t know where we’d be without Melanie.”

As we’re leaving, Melanie whispers, “I’m the lucky one. I get to feel appreciation like that every day from my patients and their families.”

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We’re expanding our services and offerings. We want you to be a part of the team that is delivering personalized, individual, people-focused skilled home healthcare to those in need. Come join us.

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