How in-home care helped Shirley live well on her own terms

Published July 2025 | 5 min read
Expert contributor: Monique Berger, Senior Manager, Out of Hospital Care, HCF
Words by Beth Wallace

What started as a trip overseas turned into a life-changing diagnosis for Shirley. HCF’s in-home care program helped her reclaim her life.

A trip to London 12 years ago took an unexpected turn when HCF member Shirley Barbuto developed a debilitating lung condition.

Shirley, 72, was staying in accommodation with a damp bathroom heavily covered in mould. She believes this environment triggered a fungal infection, which left her with flu-like symptoms and a relentless cough.

After returning to Australia, Shirley was misdiagnosed with tuberculosis (TB) and placed in isolation for 14 days. Further testing revealed she had nontuberculous mycobacteria (NTM) – a non-contagious condition that can cause serious illness and lung damage.

When Shirley was able to return home, she continued working as a nurse. However, she says the diagnosis changed her life. “Before that, I was very active, working full-time, raising a family, studying,” she says. But in the decade that followed, she would face health setbacks and lifestyle changes, learning to adapt to the challenges of living with a chronic illness.

Shirley’s journey with chronic disease management

Since her diagnosis, Shirley has had a variety of treatments to help manage her condition. These included taking part in “every drug trial possible” and spending a lot of time in hospital.

In 2024, as her disease progressed rapidly, Shirley’s doctors recommended a new combination of antibiotics that offered hope. But there was a catch: they had to be administered twice daily through an intravenous line (IV), requiring her to stay in hospital for more than a year.

“I actually thought I was going in for a couple of weeks to have an IV line, and then transition to oral antibiotics. But there were no oral antibiotics to match the efficacy of the IV drugs,” she says.

“I would’ve been mortified at the thought of having 12 months of treatment in hospital. I would’ve said no, because I have to live as well. And as a nurse, I saw how long hospital stays could seriously affect patients, emotionally, physically and socially.”

Fortunately, Shirley's doctor worked with the team at HCF to find a way for her IV antibiotics to be administered through HCF’s Treatment at Home program, which meant that Shirley – an HCF member for more than 15 years – didn't have to stay in hospital for a year.

What is treatment at home?

HCF covers the costs of treatment at home – known as hospital-substitute treatment (HST) – for eligible members* who need:

• antibiotic IV therapy
• complex wound care with negative pressure wound therapy
• rehabilitation after a hip or knee replacement
• IV chemotherapy.

Monique Berger, HCF’s Senior Manager, Out of Hospital Care, says HCF maintains close contact with all Treatment at Home providers who deliver these services to members. “We have a very close relationship with all our treatment at home providers."

Treatment at home can be a game-changer for patients, she adds – whether it’s saving them the effort of travelling to hospital or helping them feel comfortable and safe in familiar surroundings. “All of those things make a big difference, especially when you’re immunocompromised and you’re not feeling very well,” she says.

In Shirley’s case, home-based care allowed her to continue living the life she loved without major disruption. “I was basically free to live my life as normal.”  

Shirley remembers feeling unwell during the first month of treatment and was touched by the support the nurses provided.

“One day when I had an absolute meltdown and said, ‘I’m not sure I can proceed,’ the nurse gave me a hug and said, ‘If anybody can do it, you will.’ After a while, it just became part of my life,” she says.

During this time, Shirley spoke with Monique about the hypoxia she was experiencing (a condition where the body isn’t getting enough oxygen), which made her feel confused, disorientated and wobbly. She was referred by her doctor to receive formal physiotherapy to support her lung conditioning and receive a rehabilitation program to help her wean off oxygen support.

“It was Monique who said, ‘We can have a rehab program come to you,’” Shirley recalls. “My life was already a bit truncated because of the treatments. To have a physio come here allowed me to have less disruptive treatment and then continue on with my day.”

Beyond delivering her daily medication, keeping her condition under control and providing her with a physio at home, Shirley says treatment at home had a profound impact on her mental and emotional wellbeing.

“I wasn’t kept housebound. I wasn’t kept ward bound,” she says. “That’s not to say there weren’t hiccups...  We’ve navigated all those things without any major crisis.”

Uncommon Care is reimagining treatment

Now on oral medication instead of IV antibiotics, Shirley is still doing the things she loves: caring for her granddaughter, going to film festivals, and spending time with her book club and church group. She even travelled back to the UK recently to celebrate a friend’s 70th birthday.

“I’ve continued to live a very rich, whole life,” she says. “I’ve still got active mycobacterium, but because of the treatments I’ve had, we’ve kept it at bay.”

Shirley credits her medical team, treatment at home providers and HCF for helping to slow the progression of her disease. “They’ve given me back time that I may not have had,” she says. “It makes me very aware how valuable that time is.”

Throughout her health journey, she’s appreciated HCF’s patient-focused support, and was especially pleased to speak with Monique over the phone and even meet her in person. She believes this kind of human contact is “such an important part of your treatment”.

“I’m so well supported at every turn,” Shirley adds. “I’ve been given optimum care and the best possible management, so I can live as long as possible with as much wellbeing as possible. At no point did I feel that I was doing this challenging journey on my own.”

Hospital treatments at home

We're proud to offer eligible members^* a wide range of treatment options in the comfort, convenience and security of your own home, including chemo, rehab after knee or hip surgery, IV antibiotics and complex wound care where possible. Your hospital treating team can make a referral directly to our HST contracted providers or you can call us on 13 13 34 or email hst@hcf.com.au to find out if this is available to you. You can also visit our Treatment at Home page for more information.