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

Patient’s Name: Marsha B.
Patient’s Age: 92-years-old
Admission Date: 02/04/19
Admitted From: Good Samaritan Hospital
Discharge Date: 05/15/19
Discharged To: Assisted Living Facility
Length of Stay: 100 days
Reason for Stay: Wound Care

Details of Experience:
Marsha B. is a 92-year-old female who arrived at The Willows from Good Samaritan Hospital to recover from a serious, compromising wound that affected her functional status. Marsha also had a diagnosis of cellulitis, heart failure, diabetes, hypertension, and atrial fibrillation. She required continuous oxygen.

Due to all of her current challenges, Marsha was very compromised physically, which affected her day-to-day functioning levels. Marsha arrived from an Assisted Living Facility, which she hoped to return to upon her discharge from The Willows.

When Marsha was admitted to The Willows, she was greeted by our interdisciplinary team who kindly welcomed her to the community.

The nursing team evaluated her physically and reviewed her medications. Proceeding her evaluation with the nursing staff, physical and occupational therapy evaluated her functionality. Finally, Marsha’s pulmonary status was evaluated and goals were set to wean her from continuous oxygen. Goals were set for her discharge back to her Assisted Living!

Wasting no time, Marsha began her therapy program. In occupational therapy, Marsha required maximum assistance with all of her dressings and morning care. In the gym, the occupational therapists offered a mixture of arm, upper body, bending, and standing exercises to assist her in building her exercise tolerance, endurance, and strength.

Along Marsha’s bedside, her therapist worked on accomplishing her dressing tasks and morning care, which included: hygiene, toileting, and overall self-care. Our occupational therapists taught her skills, tips, and provided advice to assist her in her day-to-day routine. As time progressed, Marsha was able to go from maximum assistance to partial assistance and finally, to supervision with all of her morning routines and self-care, except for lower body dressing, which she needed additional physical assistance.

In physical therapy, Marsha began with needing mechanical assistance to transfer out of bed as she was unable to stand up or walk. Within two weeks, the physical therapy team assisted her on her feet and walking very short distances to build up to longer and longer distances each and every day!

With time at The Willows, Marsha’s ambulation and transfers started to dramatically improve! She accomplished being able to transfer in and out of bed without mechanical assistance! Along with that, Marsha also began walking longer distances with decreased physical supervision! This lead to Marsha eventually being able to do it all with just minimal supervision!

Lastly, her pulmonary rehabilitation began with her need for continuous oxygen to maintain safe oxygen levels. The respiratory therapist monitored her oxygen levels during and outside of therapy. As she physically improved, the therapists were able to begin weaning down her oxygen. She was able to go from continuous oxygen to as needed to eventually just room air 24/7. As her time in therapy came to an end, planning for her return to assisted living was in the works. She was able to return back to her Assisted Living Facility with little to no supervision!

Marsha was visited every day by our patient experience team, who enjoyed her company and conversation. Marsha also had a very involved and caring

set of daughters who visited daily. During therapy, Marsha often enjoyed interacting with the other patients and staff. Overall, Marsha was very upbeat and positive throughout her stay here at The Willows, leading to incredible motivation that ensued her recovery.

Marsha made the most of her stay here at The Willows and was able to return back to her Assisted Living Facility with the strength and skills needed to be successful and healthy. With hard work, Marsha found her time here at The Willows productive, fun, and enjoyable.