"al (thereby making a home visit feasible), (5) have a working telephone, (6) be English speaking, (7) show no documentation of dementia in the medical record, (8) have no plans to enter hospice, (9) not be participating in another research protocol, and (10) have documented in their medical record at least 1 of 11 diagnoses, including stroke, congestive heart failure, coronary artery disease, card" . . . .