Case Study: The Enclave at Rye Rehabilitation and Nursing Center (January 2017)

Patients Age: 65
Admission Date: 11/30/16
Admitted From: Montefiore Medical Center Bronx
Discharge Date: 1/20/17
Discharged To: Home
Length of Stay: 51 days
Reason for Stay: Rehabilitation following hemiplegia affecting left side of body
How did this patient hear about the Enclave? Montefiore Medical Center Bronx

Details of Experience:

Rafael arrived to The Enclave at Rye from Montefiore Medical Center in the Bronx on November 30, 2016, following a month-long stay from an intracranial hemorrhage resulting in a residual left hemiplegia affecting the non-dominant, left side of his body. Prior to his hospitalization, Rafael was an independent, healthy and fully independent husband and father. He was admitted to The Enclave with an alert mental status, but bedridden where he required total care with his ADL’s (activities of daily living), extensive assist of two nursing assistants for ambulation and mobility, and a PEG tube to administer food and medication. Additionally, his cognitive level was significantly impaired.

The interdisciplinary team at The Enclave convened to design a program with short term goals of being able to perform ADL’s, such as dressing, and hygiene from his bed with longer term goals of ambulating on level surfaces of 150 feet with a rolling walker. Shani, the Occupational therapist, and Sharlene, his Physical therapist, patiently began strengthening his upper and lower body, while concurrently working on his cognitive abilities. After just two weeks, he was able to safely ambulate on level surfaces of 75 feet with a rolling worker and moderate assistance, surpassing the initial goals set for him!

As Rafael’s cognitive abilities improved, Mike, his speech therapist, adjusted his individualized program to focus in on improving his speech and swallowing capabilities. The Barium swallow test was completed and Rafael was excited to enjoy his upgraded mechanical soft textured diet, just one month after being admitted. The dedicated nursing staff carefully monitored his improvement and increased ambulation and functioning to prevent any relapse.

Following this success, the therapy team aggressively raised their long term goals of returning Rafael home, anticipating his ability to perform all ADL’s under contact guard observation as well as improving finer skills, such as balance and gait from a standing position. With his family’s support, Rafael gained the necessary strength to return home to his community after only 51 days at The Enclave – a very different person to the one who was admitted. Two days prior to discharge his PEG tube was removed and he successfully maintained his mechanically soft, textured diet. Rafael was also safely able to perform all ADL’s with supervision, as well as safely ambulate 175 feet unaided with supervision. He and his family were grateful for the “miracle” that was performed in returning Rafael’s functioning to his pre-hospitalization ability.