Bentley Parker and his family think of Duke HomeCare & Hospice (DHCH) infusion nurse Cynthia Macalino as his second mother. Even though the family lives in Guilford County—outside of DHCH’s usual service area—Cynthia has visited their home weekly for the past three years to administer infusion therapy to slow the progression of 10-year-old Bentley’s Duchenne’s Muscular Dystrophy.

“We love the amazing Cynthia so much that there will never be enough words to praise that woman,” said Amberly Couch, Bentley’s mom. “She is so thorough and tells me step-by-step instructions on how to care for him. Communication has always been on point between me and her, and she is quick to respond to any questions Bentley or I have.”

Bentley originally received his medication through an IV. But after months of increasingly difficult weekly peripheral intravenous catheter insertions, and in the interest of the long-term preservation of his peripheral vessels, Cynthia advocated for a port placement for Bentley. Since the port was placed in early February 2023, Cynthia has arrived each week for the infusion procedure.

During those weekly sessions, Cynthia educates both Bentley and his mother on proper port care and infection prevention as well as how to advocate effectively for proper care when needed in other locations. In addition, she has made them aware of the signs and symptoms of potential complications and when to seek medical treatment. Thanks to Cynthia, Bentley avoided at least one ER visit for dehydration. She collected labs, completed an assessment, and administered IV fluids during a regularly scheduled infusion.

“What I have with Cynthia is what I would hope for anybody in my shoes: a close relationship with an in-home care nurse who I can put my trust in.

Bentley has developed such a close relationship with Cynthia that he is comfortable having her in the room without his parents. “He fully trusts that whenever he is in her care that he is fully taken care of,” said Amberly. “Even if we have to go to a hospital and he needs an IV, he will ask for Cynthia to do it because she is his comfort person.”

The rapport between Cynthia and Bentley has enabled weekly visits to become something he looks forward to, even though he gets stuck with a needle each time. “There was one occasion where he was too ill for his infusion and asked his mother, ‘Why can’t she come - I’m feeling better now?,’” said Cynthia. She appreciates the “outside the box” thinking of DHCH leadership which has allowed Bentley to remain with Duke Home Infusion nursing even though a local agency could technically provide the same service. 

“The rapport that has developed between Bentley, his family, his doctor and me has been so beneficial to all involved,” she said. Cynthia is not just a support for Bentley but for his whole family. “She reassures me in moments that are very overwhelming when Bentley gets sick,” said Amberly. “What I have with Cynthia is what I would hope for anybody in my shoes: a close relationship with an in-home care nurse who I can put my trust in.”