Case Study: The Willows at Ramapo Rehabilitation and Nursing Center (June 2018)

Patients Age: 86
Admission Date: 5/30/18
Admitted From: Helen Hayes Hospital
Discharge Date: 7/2/18
Discharged To: Home
Length of Stay: 34 Days
Reason for Stay: Pleural Effusion, Hypertension, and Chronic obstructive Pulmonary Disease
How did this patient hear about Ramapo Manor? His brother lives in the area and would be easier to visit.

Details of Experience:

Joe is an 86-year-old male who was admitted to Nyack Hospital with a diagnosis of acute respiratory failure on April 3rd, 2018. He was discharged from Nyack and transferred to Helen Hayes Hospital for acute rehabilitation; afterwards, he was admitted to The Willows at Ramapo for continued therapy. Joe came to The Willows with a diagnosis of pleural effusion, hypertension, AFib, migraines, and chronic obstructive pulmonary disease. In addition, he was on continued oxygen and was constantly being monitored. Upon his arrival to our community he was evaluated by physical, occupational, and respiratory therapists. Based on his prior levels, and current condition, a plan for his treatment was formulated and goals were set for his therapy program.

Joe has had a long journey to get to where he is today. When he first arrived, he was on continuous oxygen with chronic shortness of breath when he would exercise or do any kind of activity. He constantly needed breaks while he was exercising, and he was only able to walk 20 feet. He needed assistance with dressing and the morning routine. During the time he was at The Willows, Joe was being frequently drained for his pleural effusion. He was making excellent progress day to day and week to week with all disciplines of therapy. He eventually was able to be weaned off the supplemental oxygen. Unfortunately, the drainage totals were not improving as hoped. As the totals of his drainage increased, the frequency of the draining sessions also increased.

All attempts were made to improve his condition, but the fluid overload caused a strain on all of his systems. Subsequently, his outcomes with therapy started to decrease and made it difficult for him to achieve his full potential and goals. Joe also had to go back to using supplemental oxygen continuously again. Medical interventions were stepped up and adjustments were made to keep up with his fluid overload. Eventually, Joe’s condition started gradually improving once again. As the outputs from the pleural effusion decreased, Joe’s physical condition improved, and his therapy sessions were starting to improve, and we were beginning to see positive outcomes again. We were able to wean him back off the supplemental oxygen for good as Joe’s respiratory status improved. Joe has not only improved since his setback, but he surpassed his levels prior. He was able to do over 300 feet with ambulation with little to no effect on his respiratory or physical status. His exercise tolerance and length of sustainable activity with a break also increased greatly. Joe was able to self-propel himself around in his wheelchair without assistance which gave him a greater sense of independence. Joe was pleased and grateful for his recovery and all the hard work that was put into him from the entire team at The Willows.

Joe was a patient who didn’t let setbacks get in the way of his recovery and his goal of returning home. He was very humble about his recovery and continuously gave credit to all that helped him here at The Willows, without taking credit for his own hard work. Joe’s return home will be a happy and healthy one. We all wish him a safe return home.