Case Study: The Emerald Peek Rehabilitation and Nursing Center (February 2018)

Patients Age: 70
Admission Date: 2/5/2018
Admitted From: Phelps Memorial Hospital
Discharge Date: 3/10/2018
Discharged To: Home
Length of Stay: 37 Days
Reason for stay: Strengthening core and balance along with dietary education.

Details of Experience:

James Ciccarello joined The Emerald Peek family on February 5, 2018. James came to us with Gangrene on his 3rd, 4th and 5th toe on his right foot and repeated falls at home. He was receiving chemotherapy for Stage 2 lung cancer, which was halted due to vascular challenges in his legs and feet. James was greeted by the Katie Cullum, Director of Concierge Services and Sandy Gomas, RN Care Manager. James was evaluated by the remainder of our clinical leadership team within 24 hours of his arrival.

Weeks 1-2 of the Patient’s Stay

James came to us frustrated by his current condition and the limitations the condition was putting on his ability to ambulate and independence. The initial prognosis indicated James would be here for 2-3 months. His priority was to take care of his right foot and get back to ambulating safely. He also wanted to manage his pain more consistently. Tom, Director of Rehabilitation, paired James with Dr. Oluwatosin Osibajo, Doctor of Occupational Therapy and Julie Torregrossa, Physical Therapy Assistant, who are experienced with pre-amputees and amputees and helping those individuals reach their short term and long term goals. For James, Tosin and Julie focused on fall prevention and Activities of Daily Living skills, improving from Maximum Assist of 1 to Moderate assist of 1 or Contact Supervision. Julie also focused on improving steps with James, setting a short term goal of 3 stairs. James was motivated and worked hard to reach all of these goals.

Weeks 3-4 of the Patient’s Stay

James showed such marked improvement that his goals were increased significantly to enable him to demonstrate more independent Activities of Daily Living. For Occupational Therapy, these included increasing standing balance, functional mobility, toileting tasks and safely transfer to and from the bed. For Physical Therapy, increasing ambulation from 10 feet to 100 feet and increasing stairs from 3 to 15 was included. Once these goals were met, James’ short term goal was increased to 250 feet for ambulation. The most important goal for James was to prevent falls. Due to the rehabilitation goals and the interdisciplinary communication between Nursing and Rehab, James has had no significant falls with injury, which is the first time in over a year James has had no significant falls within a 30 day time frame. As James is nearing his discharge date 45 days ahead of schedule, he has made remarkable progress. He said, “I was so scared when I came here. I never thought I would be able to make strides like this. It is really amazing.”