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

Patient’s Name: Melvin S.
Patient’s Age: 84-years-old
Admission Date: 05/28/19
Admitted From: Helen Hayes Hospital
Discharge Date: 07/16/19
Discharged To: Home
Length of Stay: 49 days
Reason for Stay: Sepsis, Pneumonia

Details of Experience:
Melvin S. is an 84-year-old male who arrived at our community from Good Samaritan Hospital where he was admitted for septic shock and acute chronic hypoxic, hypercapnic respiratory failure from Pneumonia. The patient also has a diagnosis of Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Hypertension, Obstructive Sleep Apnea, and atrial fibrillation. Also, another point of interest is that he was struck by lightning back in 1971, which left him with afflictions that he still suffers from currently. The patient was on oxygen continuously upon his arrival. Melvin was previously living at home with his wife.

Upon his arrival to our community, Melvin was greeted by our concierge, Yehuda, who welcomed and connected with him on any questions or inquiries he had. Melvin was greeted by our therapy team shortly after arrival. He was evaluated by the Physical, Occupational, Respiratory, and Speech therapy teams to begin his plan of care alongside our nursing team members. A plan and a set of goals were formulated and put into action by each team. Per his speech-language pathology assessment, Melvin began on a chopped food diet and nectar thick liquids. When he was discharged home, he was on a regular diet. With Respiratory Therapy, Melvin came to us on 2 Liters of oxygen via nasal cannula and needed to wear it continuously. Our goal was to have him return home on room air and not be in need of supplemental oxygen at all. We performed exercises that focused on exercise tolerance and building respiratory strength. We also worked on pacing and energy conservation techniques. With these teachings and exercises we were able to reach his goal and discharge him home on room air. In Occupational Therapy, Melvin came to us needing complete and total support with all his occupational goals, which include dressing, toileting, daily living skills, and functional mobility. The therapists worked side-by-side with Melvin during his morning routine to help him reach his goals. The teaching of proper techniques and the use of adaptive equipment were used to help him reach his goals with greater ease.

When he was discharged from our community, he was able to complete all of his Occupational goals with gradient levels of supervision. For Physical Therapy Melvin came to us needing a great deal of assistance with ambulation and transfers. Upon his admission, he was unable to walk at all. With the use of strengthening and resistance exercises, the therapists were able to assist him in being able to stand, to being able to walk short distances. At his mid-point, he was able to complete 60 ft and at discharge, he was able to complete over 150 feet. He worked hard to reach all his goals. There were very few days that he let his fatigue and soreness get in the way of his hard-working nature, which lead to a successful discharge in the eyes of the therapy team.

Melvin looked forward to his daily visits from all staff and especially our concierge, Yehuda. He was extremely friendly and welcoming and enjoyed chatting with anyone who entered his room. His calm and friendly demeanor was contagious and pleasant to be around. Even on his toughest day, he would still be smiling and offering a laughable joke.

Melvin shared that he enjoyed his stay here at The Willows. He complimented how great everything was here, and especially how clean the community was. He also had nice words about our Respiratory Therapist when he said: “He is the tops!” All in all, Melvin’s stay here was extremely productive and successful, which will lead to a very well prepared return home.