Case Study: The Willows at Ramapo Rehabilitation and Nursing Center (December 2019)

Patient’s Name: Joan Mahoney
Patient’s Age: 70-years-old
Admission Date: 11/17/2019
Admitted From: Good Samaritan Hospital
Discharge Date: 12/15/19
Discharged To: Home
Length of Stay: 29 days
Reason for Stay: Metastatic breast cancer with associated hypocalcemia and wound infections


Details of Experience:
Joan Mahoney was welcomed to our community after her stay at Good Samaritan Hospital. Her main diagnosis was metastatic breast cancer with associated hypocalcemia and wound infections. She also had a history of bronchitis, cellulitis, hypertension, and anxiety. She was accompanied by her husband.

Upon entering our community Joan was greeted by our friendly concierge, Yehuda, who welcomed her and showed her to her room. After settling in, she was assessed by one of our nurses and all her medications and orders were checked. Later in the day, our Rehab Team met with Joan for introductions and assessment. The Physical, Occupational, and Respiratory Therapist assessed her current condition and set goals for her stay and eventual discharge. Upon her discharge, she was unable to tolerate radiation therapy and therapy would be needed to help strengthen her to be able to start treatments. Joan also came to us on continuous oxygen, which the team hoped to wean. With the teams’ goals set, therapy could start and her journey to return home began.

The Therapy Team began working with Joan. Very early on, they were able to wean her from the supplemental oxygen. Within the first couple of days of exercise, she found her breathing improving and oxygen saturations holding at high percentages throughout the therapy sessions. She was eventually able to do all exercises on room air with no issues or shortness of breath. Physical Therapy worked on strengthening her lower extremities with weighted and resistance exercises, which included leg weights and the Nu Step bike. She was able to make quick strides and found herself making great progress every day. She also worked on exercises that increased her activity tolerance through different related exercises. With Occupational Therapy, Joan worked on upper body strengthening and Hygiene activities. Upper body trunk and arm exercises helped build up her strength, endurance, and tolerance for the day-to-day activities that she would be doing when she returned home. The use of hand weights, the hand bike, and other tools helped her become stronger each day. Activities like sit to stand exercises and transfer exercise were done to help build her up functionally. The morning routine was a big focus in therapy sessions. Routine activities like dressing and hygiene needed to be re-taught, so she could effectively complete while saving energy to get through it all on a daily basis. The Therapy team achieved their goals of building her strength and endurance, so she was able to tolerate the physically taxing and draining cancer treatments.

Joan was visited daily by the Concierge, Yehuda, with her husband visiting every day, as well. He always had a pleasant comment for everyone. He was a very devoted husband, he would watch her the whole therapy session, as she improved. He would tell everyone I want her home for Christmas. With the teams’ help, they achieved their goals. In less than 30 days, Joan was able to make huge strides. Besides physical and rehab goals, Joan wanted so badly to be home for the Holidays. A week before Christmas Joan was able to achieve all goals in time to be sitting by the Christmas tree to celebrate the holidays with her family and loved ones. Another Willows happy ending.