Case Study: The Enclave at Port Chester Rehabilitation and Nursing Center (July 2018)

Patients Age: 85
Admission Date: 5/21/18
Admitted From: Greenwich Hospital
Discharge Date: Pending
Discharged To: Home
Length of Stay: 10 Weeks
Reason for Stay: Multiple falls resulting in hip fracture, upper extremity fracture. History of hypertension, Non-rheumatic aortic valve stenosis
How did Patient hear about The Enclave at Port Chester? Skilled Nursing Facility

Details of Experience:

Marie was admitted to The Enclave at Port Chester Rehabilitation and Nursing Center on May 21st, 2018 from Greenwich Hospital following multiple falls over the previous months, which resulted in a pelvic fracture, a fracture to her right upper extremity, and extreme weakness. The interdisciplinary team, comprised of the nurse manager, social worker, therapists, and doctor, warmly welcomed her to the community.

Due to Marie’s recent history of falls, Liby the nurse, put in place fall precautions to prevent further accidents in addition to offering ongoing education to remind Mary of the need to be extra cautious. Liby also coordinated with the therapy team to ensure pain management was implemented into her therapy regimen. Robert and Tim, her therapists, performed their evaluation shortly after her arrival assessing her right arm as non-weight bearing with 7/10 level intensity on the pain scale requiring extensive assist of two for functional transfers and mobility, as well as extensive assist of one for dressing and bathing, and minimum assistance of one for feeding.

After two weeks of steady progress, Marie had gained strength which allowed her to participate in functional transfers, no longer needing assistance of two. She also experienced less pain in her arm, allowing her to maximize time in therapy for mobility and ADL’s (activities of daily living). One week into June, however, this progress was slowed as a Venous Doppler scan showed Marie was positive for DVT (deep vein thrombosis) in the right leg. After she was assigned medication, the interdisciplinary team was notified to allow her to participate in therapy, though at a moderated pace.

With her eyes set on returning home, Marie continued to make steady progress. Following an orthopedic consult mid-way into June, her right arm was revised to weight bearing status, allowing her to begin strengthening her arm and to begin performing ADL’s on her own. At this time, she could safely ambulate 100 feet with a rolling walker and standby assist and could transfer in and out of bed with contact guard assist. She could also perform ADL’s with contact guard assist and could eat independently.

Marie is set to be discharged shortly looking much happier and independent than when she came to the community. She can now safely ambulate over 300 feet with a rolling walker and can perform functional transfers independently. She is thrilled to once again be able to care for herself, including dressing and hygiene, as she has increased her strength to be able to perform ADL’s while standing. Equally important, she has gained a greater understanding of her strengths and limitations, greatly improving her safety awareness to keep her home and active.